Week 2: History, Lunch, Cuisines, Dining out, Preparation

and Vegetable Guide

Week 2 Page 1 of 8

Historic Treatment of Type 2 Diabetes Before the modern therapies of medication and insulin, (discovered in 1921) leading diabetes doctors used a low carbohydrate, high fat diet to treat diabetes.3 In the “Diabetic Cookery” from 1917, starches and many other high-carbohydrate foods (including fruits) were listed as “strictly forbidden” (see image to the right). In fact, Elliott Joslin, the first physician in the United States to specialize in type 2 diabetes assigned people to very low-carbohydrate diets.

Advice from the Diabetic Cookery, 1917:

Week 2: Lunch

Week 2 Page 2 of 8

Last week we talked about low carb breakfasts and snack. This week we’ll be discussing low carb lunches.

Lunch (and Dinner) Suggestions

Salads

• Big salads with all sorts of additions like chicken, nuts, olives, cheese, avocado, and hard boiled eggs.

• Greek salad (put extra protein on, such as hard boiled eggs, chicken, or seafood) • Chicken (cooked without breading) on top of salad greens, chopped snow pea pods,

chopped green pepper, and walnuts • Low carb cole slaw with chicken and pecans • Tuna salad with greens, tomato and avocado • Salmon on top of greens, blanched green beans, mushrooms, and

sprouts • Chicken with greens, cucumbers, pecans, and crumbled blue cheese • Steak with greens, thinly sliced red onions, green pepper, and

mushrooms • Cobb salad (avocado, blue cheese, chicken, hard boiled egg, bacon)

Note: If you are using bottled dressings, check the label for carbs. Many "light" dressings have sugar added to make up for the loss of flavor when oil is reduced. Roll-ups & Wraps

• Lettuce wrap: Use "mushy" foods, such as tuna, salmon, egg, or chicken salad as a filling for a lettuce roll-up. Large lettuce leaves work best. Include vegetables such as strips of pepper.

• Meat wrap: Roll cheese and veggies up in a slice of roast beef, ham, etc. For example, roll spinach dip in roast beef, or cole slaw in ham.

Soups Most soup recipes can be low carb if you just take out the starch (noodles, rice, potatoes). There are a few low-carb canned soups, but the vast majority are not and it’s advised that you read labels carefully. Make a big pot of soup and freeze portions for later meals. An easy soup is cream of broccoli: broccoli, cheese, cream, and broth blended. Other Entrees

• Meat, fish or chicken dishes with mashed cauliflower on the side. • Stews, soups or casseroles with allowed foods. For example, chicken and veggie

soup or a soup of green veggies, cream, broth, and cheese. • Quiches with bacon, cheese, and veggies—but without the crust. • Low carb lasagna

Week 2: Cuisines

Week 2 Page 3 of 8

Instead of Potatoes, Rice, or Pasta

• Mashed cauliflower: Divide the cauliflower in smaller pieces and boil them until soft with a pinch of salt. Drain, add cream, butter, and/or cheese and mix.

• Sautéed broccoli or green beans with olive oil, garlic, and basil • Sautéed Brussels sprouts in coconut milk and a sprinkle of salt and red pepper flakes • Vegetables au gratin: fry low carb veggies you like in butter, add salt and pepper. Put

in baking dish and add grated cheese. Heat at 450° F until the cheese turns golden. • Creamed spinach: defrost spinach in microwave then cook in pan with garlic, butter,

cream, cream cheese, grated cheese, and salt and pepper • Cauliflower rice: grated cauliflower boiled for a minute or two with any spices you’d

add to normal rice (can buy this at Trader Joe’s) • Low carb cabbage slaw: shredded cabbage with full fat sour cream, mayonnaise

made with olive oil, lemon juice, garlic and onion powder Remember that wherever you eat, whether at home or at a restaurant, you’ll be avoiding rice, pasta, bread, starchy veggies and sugary sauces.

Places with Salad Look for Cobb salads (avocado, egg, bacon) and Caesar salads with no croutons. Beware salad dressings (McDonald’s ranch dressing has 9 g of carbs but KFC’s ranch dressing has only 3 g).

Places with Sandwiches Ask if the sandwich fillings can be lettuce-wrapped (like the “unwiches” at Jimmy John’s) or top a salad. Other “American” Places Steak or fish with low carb vegetable side dishes like steamed spinach or green beans, buffalo wings (no breading) with blue cheese dressing can all work. Indian Curries and meats are often OK. Ask if they are prepared with starches or sugars. Mexican Low carb options may include guacamole, fajitas (no tortillas, beans, or rice), fajita taco salads (no taco shell), fish or grilled chicken. For example at Chipotle, a bowl (salad but no dressing) with lettuce, meat, cheese, and guacamole works. Greek/Kabob/Mediterranean Gyro or kabob meat on salad is often fine.

Week 2: Cuisines

Week 2 Page 4 of 8

BBQ Meat should be OK but skip the BBQ sauces, which are typically very sugary. Pizza Not great unless there’s a salad bar. In a pinch eat the pizza toppings off the dough. Burgers Get burgers with no bun or ketchup. Ask if they can make it lettuce-wrapped (protein-style at In ‘n Out Burger). Avocado, bacon, and cheese are good topping options. Chinese Can be a challenge. Ask for food to be cooked with no added starch and sugar. Anyting steamed should without starchy or sugary sauce should work. Japanese Sashimi (sushi without the rice) can work. Ask for ramen soup with no noodles: toppings can include fatty roast pork, boiled eggs, and seaweed. Asian Hot Pot Japanese Shabu Shabu or Hot Pot (Chinese, Vietnamese, Mongolian): hot water or broth and a plate of raw meat and vegetables—can be a nice low carb meal. Korean BBQ (watch the sauce). Try the Jjigae, a spicy soup of meat and vegetables. Thai Watch out for sugary sauces, such as peanut sauces, but many coconut milk curries will be OK, if not sweetened. Tom Kha soup is great if made without sugar. Malaysian Watch out for sugary sauces. Try kangkung belacan (spicy water spinach) or beef or chicken rendang (made with coconut milk). Vietnamese See if you can get Pho soup without noodles. Then you’ll be eating rich broth and fatty meat. A slice of Cha Trung (meatloaf) can also be low carb. Filipino Try the oxtail soup, a fatty meat stew.

Week 2: Dining out

Week 2 Page 5 of 8

Pointers For Dining Out or Away from Home

• Don’t skip a meal before eating out. Eat a small snack (hard-boiled egg or cheese) to curb your appetite for the bread basket. • Drink a few glasses of water before your meal to help fill you up faster. • Carefully select where you will eat. Visit a restaurant’s web site or call them to help plan your dining ahead of time.

• Don’t be afraid to ask for what you want. Can foods be cooked in a different way? You often get meals that aren't on the menu (can I get that with a side of avocado?).

• Order salad dressing, gravy, sauces, or spreads "on the side." Ask if they are made with added starches or sugars.

• Ask to have your dishes served without the extras of rice, beans, potatoes, or pasta. Instead ask for another portion of vegetables.

• Ask for the server to “doggie bag” half of your dinner before it even comes out of the kitchen. Restaurant portions are always large. Out of sight, out of mind.

• Plan ahead. If you are traveling on the road or flying, try to bring some of your own snacks. Individually wrapped string cheese, jerky, snap-top cans of tuna, salmon, sardines, or chicken are all good ideas.

• Bring a bagged lunch to work. • Don’t give in to the “I deserve it” theory. You deserve to be healthy and on your way to

your goal weight.

Think about your past lunches. � Which are low-carb friendly already? � Which can be made low-carb friendly? � Which foods seem like lunches you would like to try this week? (Look at the

handouts, cookbooks, and online for ideas.)

Prepare Ahead One way to help yourself stay on the diet is to prepare lots of food all at once, maybe on the weekend so you can have pre-prepared meals during the week. For example, one Sunday you could make a huge quiche and a big low carb lasagna. You could make a list of all the ingredients you need, go grocery shopping, mix things up and pop them in the oven. The following week you will be able to have the quiche for breakfasts, or as a snack, and the low carb lasagna as lunch or dinner! It can make things easier to have prepared meals on hand.

Week 2: Preparation

Week 2 Page 6 of 8

Preparation is key - spend one day a week (for me it's Sunday) prepping meals or at least meats/veggies to combine.

— former participant

Set yourself up for success

• Surround yourself with delicious foods, low carb foods. • Eat when you are hungry. Stop when you are full. • Remind yourself and your loved ones that this is for your health. • Be sure to eat enough of both food and fat at each meal to feel

satisfied. If you leave yourself hungry, you will tend to crave food more easily. Clean out your pantry

I have a lot of clients who tell me they’ll start their diet after they finish the [insert carby food here] in their kitchen because, as they learned as a child at the dinner table, there are hungry people in the world, so they hate throwing food away. I can relate to that viewpoint. That’s why, when I started the ketogenic diet, I gave all my rice, sugar, ice cream, maple syrup, and raisins to a friend. You can pack the stuff up and drop it off at a local food pantry if you prefer. Just don’t use it as an excuse to ease slowly into the diet. Ketogenic is all in or all out. Getting rid of the stuff will make it a whole lot easier to jump onboard. — Kristin Mancinelli, author of “The Ketogenic Diet”

Don't surround yourself with food you constantly have to say ‘no’ to -- it depletes willpower. Keep it out of the house, and avoid it in your office, too, if possible. We recommend that you begin by throwing/giving away sugary and starchy foods like the ones below and stocking your home with easy-to-prepare and delicious low-carb foods. Why not start TODAY!

• Candy • Potato chips • Soft drinks and juices • Margarine or any trans fats (look

for "hydrogenated" in the ingredients' list

• Sugar in all forms • Wheat or white flour • Pasta, Rice, Potatoes • Anything “low fat” or “nonfat” • Ice cream, cookies

Week 2: Vegetable Guide

Week 2 Page 7 of 8

Packaged Foods with Labels If you’re worried about finding foods to eat because you’re in the habit of eating fresh foods and don’t like to cook, I want you to go to a grocery store and find five packaged items you’ve never tried before that have no more than 3 non-fiber or net grams of carbs per serving. These items must have food labels (i.e., fresh meat and produce don’t count). Think it’s impossible? Here’s a hint: try the pickled foods section, sauces, and spreads, and the baking ingredients section. You’ll be surprised by what you find! I’ve said this elsewhere and it’s worth repeating — approach this new eating plan with a bit of curiosity, and look for ways to have fun! (Adapted from Kristin Mancinelli)

Low Carb Vegetables The following vegetables are slightly higher than the salad vegetables listed above; they also provide important nutrients and add variety to your daily foods. Make sure you stay within the 12-15 grams net carbs.

Vegetable Serving Size/ Prep Net Carbs • Artichoke ¼ of medium/boiled 4.0 • Asparagus 6 spears/boiled 2.4 • Artichoke hearts 1/ canned in water 1.0 • Avocadoes 1 whole/raw 3.5 • Bamboo shoots 1cup/boiled 1.1 • Beets ½ cup/canned 4.7 • Broccoli boiled ½ cup 1.6 • Broccoli raw ½ cup 1.0 • Broccoli rabe 1 ounce 1.3 • Broccoflower ½ cup 1.4 • Brussels sprouts ¼ cup boiled 2.4 • Cabbage ½ cup boiled or raw 2.0 • Cauliflower ½ cup boiled or raw 1.0 • Chard ½ cup swiss/boiled 1.8 • Collard greens ½ cup boiled 4.2 • Eggplant ½ cup boiled/raw 1.8 • Hearts of palm 1 heart 0.7 • Kale ½ cup 2.4 • Kohlrabi ½ cup 4.6 • Leeks ¼ cup boiled 1.7 • Okra ½ cup boiled/raw 2.4 • Olives green 5 2.5 • Olives black 5 0.7 • Onion ¼ cup raw 2.8 • Pumpkin ¼ cup boiled 2.4 • Rhubarb ½ cup unsweetened 1.7 • Sauerkraut ½ cup canned/drained 1.2 • Peas ½ cup edible podded 3.4 • Spaghetti squash ½ cup boiled 2.0 • Spinach ½ cup raw 0.2 • Summer squash ½ cup boiled 2.0 • Tomato 1 raw 4.3 • Turnips ½ cup boiled 2.2 • Water chestnuts ½ cup canned 6.9 • Zucchini ½ cup sautéed 2.0

Salad Garnishes

• Crumbled bacon 3 slices 0.0 • Diced hard-boiled egg 1 egg 0.0 • Grated cheeses (see above carb counts) • Herbs and Spices (make sure they contain no added sugar)

o Basil 1 tbs 0.0 o Cayenne pepper 1 tbs 0.0 o Cilantro 1 tbs 0.0 o Dill 1 tbs 0.0 o Garlic 1 clove 0.9 o Ginger 1 tbs sliced root 0.8 o Oregano 1 tbs 0.0 o Pepper 1 tbs 0.0 o Rosemary 1 tbs 0.0 o Sage 1 tbs 0.0 o Tarragon 1 tbs 0.0

• Sautéed mushrooms ½ cup 1.0 • Sour cream 2 tbs 1.2

A note about magnesium: If you have frequent muscle cramps, try taking 3 slow-release magnesium tablets daily for 20 days. Try ‘Slow-Mag,’ Mag-64, or Mag-Delay. Other forms of magnesium can cause diarrhea. Or, if you are getting cramps and constipation, try 1-2, 200mg tablet of magnesium citrate daily.

Week 2: Goal

Week 2 Page 8 of 8

Goals for Week 2

� Add low-carb lunches to your low-carb breakfasts and

snacks.

� Anticipate low-carb foods you could eat at restaurants.

� Consider prepping food ahead for the week. � Set yourself up for success by clearing out your pantry

of high-carb foods. � Remember why you’re doing DELISH.

� If the study MDs have made changes to your diabetes

medications, please test your blood sugar 3x/week before dinner and report on the brief survey sent by text.

� Access the website where you can download weekly

handouts as well as other resources and readings. To login, navigate to the following link and use the given password:

• Link: http://www.osher.ucsf.edu/delish-3 • Password: Round3