Cooking as a Survival Skill
Dieting for Life - What's in a Name?
Weight Loss Phase
This is not so much a diet as a general guide to cooking and eating. There are no absolutes. If you find any value in my experience – terrific. However, what follows is purely my own method of dealing with my own situation. It is also a work in progress – because what I needed was a "way of eating" that I could comfortably follow for the rest of my life. Not just a short-term weight loss diet. The plan was developed over a few months after I was diagnosed with diabetes and leukemia in early 2002. It is based on a distillation of research on the internet, advice from doctors, a course with a dietitian and general reading on the subject over some years.
It is titled "weight loss phase" because I did it in stages – first I lost weight, then used my meter to modify my menu for better blood glucose numbers, then I refined the result to improve various other aspects for health and nutrition. I’ll post on that later. In April 2002, at the time I was advised I had type 2 diabetes, I weighed 117 Kg or 257 lbs. Like many fat people I was adept at not getting my photo taken so I don't have many to choose from that era.
By Christmas 2002 I weighed 94 Kg or 207 lbs, a loss of 23 Kg or 50 lbs. Equally important, I was reasonably fit (apart from a few incurable diseases!), I didn’t feel hungry and I didn’t put it all back on over the Christmas/New Year feasting period. This is taken in Pisa in May 2003 on our first World Trip, the other was taken in August 2006 in Hawaii on the second trip.
I wrote the first version of this in early 2003, when some friends on the CLL list asked for a copy of my "diet". So I had to write it down for them. Since then I’ve travelled a lot, eaten out a lot, and learnt a lot. And I’ve still kept the weight off. I’ve re-written it slightly to be specific for type 2 diabetes. So I’ve worded it on the assumption that not only does the reader need to lose weight – but also wants to reduce excessive blood glucose (BG) numbers. In effect, to compress my first two phases into one. This is only the starting point. As time goes on and weight comes off the constraints on fat can be eased – but your meter will show you that the constraints on carbohydrates tend to remain.
Reduce Meat portion sizes
Start by halving, then adjust as required.
Reduce Quantity of Red meat Portions
Replace them with fish.
Increase Vegetable serves
Particularly greens and low Glycemic Load veges, to create fullness. Cabbage, celery, broccoli, spinach, silverbeet(chard) is your friend.
Increase Omega III fish meals
Salmon, sardines, tuna etc, preferably fresh rather than canned.
All types, regardless of fat content. Skim milk will actually cause bigger BG spikes. Cheese – I eat full-fat cheese, but less of it; I cannot stand "plastic"low-fat cheeses. I use low-fat cheeses like cottage, ricotta, Philadelphia in dips where I can add flavours. Take Calcium supplements if necessary to replace the loss of dairy calcium - however I added some yoghurt which helped there (see later).
Fruit in moderation (use your meter to define moderation), nuts in small portions, avocado. Low-fat crackers or vegetables with dips such as hommus or guacamole etc. Slices of crisp veges (celery, carrots etc) with dips. Experiment with cottage cheeses, ricotta, lo-cal Philly, avocadoes, onions, peppers etc. Add a little plain yoghurt to your day, flavoured with fresh or frozen berries and a little artificial sweetener. If you must have a slice of bread, leave off the marg/butter and use a thin smear of the spread (not jam) of your choice. And make it a half-slice.
Lots of Variety
Vary meals and menus as much as possible to prevent boredom. Experiment by creating tasty dips etc for snacks, adding unusual spices to casseroles or marinades etc (but always have a stand-by in the freezer to allow for the occasional inedible disaster).
Guilt and Failure
I allow myself a "guilt-free" day or meal occasionally. Pizza, fish and chips (deep-fried battered fish with french fries for those people who drive on the wrong side of the road), chocolates etc. However, try to keep the portion size to a minimum or cook it at home (see tips below). Yes, I know, it’s impossible to eat one chocolate out of a full box. But try. If you allow this luxury it makes it easier to return to the plan, rather than to think "well I’ve blown it, so what the heck!".
Cooking and Preparation Tips
Saturated Fat Elimination/Reduction
Trim all fresh meats carefully to discard as much fat as possible. Do not use processed meat (e.g. all sausages, salami, bologna, chicken roll etc.) Do not eat take-away chips (fries) etc. Most are cooked in saturated fats. Substitute deli sandwiches (careful of the bread – I often discard the top piece) , salads etc for take-away. If you’re caught with a group at a take-away have salad (watch the dressing), skin-free chicken or just a very small serve. Grill (Broil?) meats when possible so that fats drain during cooking.
Although some other fats are good, I still try to reduce their quantity. Use cooking sprays instead of butter or spoonfuls of oil for cooking. Use a thin smear of mayo or a spread you like instead of marg/butter on sandwiches or rolls and don’t have the top half of the bun or the top slice of bread. Experiment. Cook casseroles in advance and cool in the refrigerator (or strain the liquid and cool separately before re-combining). The saturated fat will rise to the top and solidify and can be removed before re-heating or thickening. Similarly, reduced fat gravies can be made from pan juices by pouring them off into a jug and skimming. Add some ice cubes to speed up the process if the diners are waiting. They will still contain fat, but not as much.
Use a non-stick pan or griddle. Most meats will not need additional oil to cook, or will only need a light spray from a cooking oil. If you must deep-fry (a rare luxury – see "guilt-free" days), use a vegetable oil (preferably peanut, not palm or coconut), wait until the oil is at the correct temperature before adding the food, don’t overcrowd the pan (this would reduce the temperature and cause the food to absorb more oil), and drain the fried food well on kitchen paper before serving. When I say it’s a luxury, I fry fish once a fortnight (two weeks) but I oven fry the chips.
Oven fry french fries – cut them large (not like thin McDonalds), throw them in boiling water until not quite cooked (still firm), spray an oven tray with cooking oil then place the "fries" on the tray and spray again lightly. Cook in the oven at about 200c (390F) until done. Use your meter to see what portion size you can handle. Mine is three chips.
I won’t buy into the arguments about sweeteners. People say some may give you cancer. Do you think that worries a Diabetic/CLLer? Find the sweetener and lo-cal drink that you like (or that you dislike least) and consider all things flavoured with sugar as poison. If you must eat them, make it a special and rare treat.
You need carbs for energy, fibre and brain food, but steer clear of the white starches. A moderate intake of grains, cereals and legumes will keep you regular, reduce the risk of bowel cancer and provide variety in your diet without adding excess weight (provided you are sensible about portion sizes). However, once again – your meter will be your guide to your limits there. It is likely that you will be cutting back drastically on your present carb intake- add other sources of fibre, particularly leafy or green veges; I also add psyllium husk to my daily menu for extra fibre without extra kj/cals or BG spikes.
Water, lo-cal soft drinks, tea, coffee. Nothing with a sugar content, including excessive milk (lactose). Check soy milk for fat and sugar content. No juices. Coffee is OK subject to moderation in caffeine intake – watch the milk content. Try cinnamon instead of sugar or cream.
Alcohol is a very personal issue, so that is one to be discussed directly with your doc. Personally, I drink 2 or 3 glasses of good red wine a day. One of the pleasant things I discovered by blood glucose testing is that a good red wine helps reduce my numbers. Unfortunately, too much of a good thing makes them go up again! I have the occasional (2 or 3 a week) scotch or rum and lo-cal mixer. This is probably more than the doctor would recommend – but (as I’ve learnt) life’s too short to give up all the good things.
Nutrition Labels – Important!
Learn to read nutrition labels on the packet. Until you start to read them you don’t realise just how much variation there is in the fat, carbohydrate and sugar content of the products you buy. Modify your purchasing habits as a result. If an article is advertised as low fat or low cal but there is no nutrition detail – it’s probably false advertising. Be very wary of "lite" or "97% fat-free"; they often compensate for the reduced fat by increasing the sugar content and can contain more kilojoules/calories than the standard product.
My Personal Diabetic Eating Rules
These apply only to me. They may or may not apply to other type 2 diabetics. Find out what does apply by testing one and two hours after every meal or snack until you know what you can eat, when you can eat it, and how much you can eat in a serve.
There are five small meals a day – breakfast, lunch, afternoon tea, dinner, supper, not more than three to four hours apart. No carbohydrates before lunch, then I gradually increase carbs at each meal until supper. I eat my cereal as my final meal (my morning regularity has significantly improved).
Minimise or eliminate serves of white starches, most fruits, all high Glycemic Index (GI) foods. Replace high GI with low, e.g. multigrain bread for white etc.
Maximise low-carb and low GI vegetables such as cabbage, celery and cauliflower.
Jams, high sugar relishes, high fat and high sugar crackers etc are poisons that other people eat. Convince your mind that these people don’t know how bad they taste. It’s a mind game, but don’t start telling your partner not to eat them unless you want a divorce.
Set a healthy target in consultation with your medics, then set smaller targets (say 2.5 Kg or 5lb) on the way to your goal and celebrate in some way each time you reach the target. Involve those you care about so that they can encourage you. It won’t work if you quit, and you will quit if you don’t get results. Weigh yourself regularly and record the results. Don’t get dejected if the waistline or weight doesn’t go down every day – the body seems to take time to adjust to the changes. In my case I lost 3 Kg (6 ½ lbs) in the first week, but this stabilised to an average of about a kilo (2 lbs) per week and later to half a kilo. There were some weeks or months when I seemed to hover or even go up, but then I would lose a lot in the next week.
Postscript and Restaurant Eating
PS. Aug 2003. After writing the original cooking and eating plan we spent five months travelling the world. I didn’t gain weight but we left a reputation behind us as Aussie cheapskates because, wherever we went, we would order one main course and a spare plate for the two of us. It took some cheek, but we didn’t put the weight back on (and also saved some cash :-) Where it wasn’t possible because of language or embarrassment of others, we would order a main course and a side salad or starter – just to get the plate – then mix between the two. This allowed me to leave the high GI or high carb items for my non-diabetic wife.
We often found that we still left food on the plate, even when we shared. Because the food is actually the smallest cost in running most restaurants many provide enormous serves to attract customers. If you are eating alone in a restaurant it takes more discipline to leave over half the food when you know you are paying for it. But if you eat it, you will pay much more eventually. Specify that you absolutely, definitely do NOT want chips/fries. Many restaurants add them automatically.
Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter