Tag Archives: low-carb mediterranean diet

Recipe: Bacon Bit Brussels Sprouts

Bacon Bit Brussels Sprouts

Bacon Bit Brussels Sprouts

You can incorporate this meal into the Advanced Mediterranean Diet, Ketogenic Mediterranean Diet, or Low-Carb Mediterranean Diet since I provide the nutritional analysis below.

A while back I posted a meal recipe for Bacon Brussels Sprouts to accompany Brian Burgers. To make it a little more convenient, I’ve substituted off-the-shelf real bacon bits instead of frying my own bacon. I traded olive oil for the bacon grease. The two versions taste very similar.

diabetic diet, paleobetic diet, low-carb diet

It took 10 minutes of chopping to shred the sprouts

Ingredients:

1 lb (454 g) Brussels sprouts, raw, shredded (slice off and discard the bases first)

4 tbsp (60 ml) extra virgin olive oil

5 tbsp (75 ml or 35 g real bacon bits or crumbles (e.g., by Hormel or Oscar Mayer)

2 garlic cloves, minced (optional)

1/8 (0.6 ml) tsp salt

1/4 tsp (1.2 ml) ground black pepper

3 tbsp (45 ml) water

Instructions:

diabetic diet, paleobetic diet, low-carb diet

Steaming in progress

You’ll be steaming this in a pan with a lid. Put the garlic and olive oil in a pan and cook over medium-high heat for a few minutes to release the flavor of the garlic. Add the water to the pan and let it warm up for a half a minute or so on medium-high heat. Then add the shredded sprouts and cover with the lid. After a minute on this medium-high heat, turn it down to medium. The sprouts will have to cook for only 4–6 minutes. Every minute, shake the pan to keep contents from sticking. You might need to remove the lid and stir with a spoon once, but that lets ourtyour steam and may prolong cooking time. The sprouts are soft when done. Then remove from heat, add the bacon bits, salt, and pepper, then mix thoroughly.

When time allows, I’d like to experiment with this by leaving out the bacon and using various spices instead. Do you know what goes well with Brussels sprouts?

Number of Servings: 3 (1 cup or 240 ml each)

Nutritional Analysis per Serving:

Advanced Mediterranean Diet boxes: 2 veggie, 1.5 fat

71% fat

19% carbohydrate

10% protein

270 calories

14 g carbohydrate

6 g fiber

8 g digestible carbohydrate

328 mg sodium

646 mg potassium

Prominent feature: High in vitamin C (over 10o% of your RDA)

diabetic diet, low-carb diet, paleobetic diet

Brian burger and bacon Brussels sprouts

Recipe: Chicken Avocado Soup

FullSizeRender

Avocados in soup? Yeah, I was skeptical, too. But it works amazingly well. Since I provide the nutritional analysis below, you can easily work this into the Low-Carb Mediterranean Diet, Ketogenic Mediterranean Diet, Paleobetic Diet, or Advanced Mediterranean Diet.

Ingredients

1.5 lb (680 g) boneless skinless chicken breast

1 tbsp (15 ml) olive oil

1 cup (240 ml) chopped green onions

1/2 jalapeno pepper (or 1 or 2 peppers if you wish), seeded and minced (use the seeds, too, if you want it very spicy hot)

2 roma tomatoes (5 oz or 140 g), seeded and diced

2 garlic cloves, minced

60 oz (1,700 g) low-sodium chicken broth

salt and pepper to taste (nutritional analysis below assumes no salt added)

1/2 tsp (2.5 ml) ground cumin

1/3 cup (80 ml) chopped cilantro

3 tbsp (45 ml) fresh lime juice (2 limes should be enough)

3 medium California avocados, peeled, seeded, and cubed

Instructions

Heat up the olive oil in a large pot over medium heat, then add the green onions and jalapeño; sauté until tender (1–2 minutes) then add the garlic and cook another 30 seconds or so. Next into the pot goes the chicken broth, cumin, tomatoes, chicken breasts, and optional salt and pepper. If adding salt, I’d wait until just before serving: taste it and then decide if it needs salt. Bring to a boil with high heat, then reduce heat but keep it boiling, covering with a lid while the chicken cooks through-out. Cooking time depends on thickness of the breasts and may be 15 to 45 minutes. When done, it should be easy to shred with a fork. Turn the heat down to low or warm then remove the chicken breasts and allow them to cool for 5–10 minutes. When cool enough, shred the chicken with your fingers and return it to the pot. Add the cilantro. Ladle 1.5 cups (355 ml) into a bowl, add one fifth or sixth of the avocado cubes (half of an avocado) and the juice of 1/4 to 1/2 lime. Enjoy!

IMG_2233

Serving size: 1.5 cup of soup plus 1/2 of an avocado

Servings per Batch: 5

Advanced Mediterranean Diet boxes: 1 veggie, 1 fat, 1 protein

Nutritional Analysis per Serving:

43 % fat

13 % carbohydrate

44 % protein

350 calories

12 g carbohydrate

8 g fiber

4 g digestible carb

638 mg sodium

1,180 mg potassium

Prominent features: Rich in protein, vitamin B6, vitamin C, niacin, pantothenic acid, phosphorus, selenium; plus a fair amount of fiber

PS: You can fancy this up just before serving by adding a couple large triangular corn tortilla chips (broken into a few bits) or half of a 6-inch (15 cm) corn tortilla (first, microwave for 20 seconds, then break into a bits). Both items each add 5 g of digestible carbohydrate; the tortilla chip option adds 60 calories and the corn tortilla adds 25 calories. Shredded cheese might be a nice topper, too.

 

Recipe: Spaghetti Squash Spaghetti

paleobetic diet, diabetic diet, low-carb diet, spaghetti squash, spaghetti

Meaty spaghetti sauce over spaghetti squash

Recently we’ve looked at low-carb spaghetti sauce and cooking spaghetti squash. It’s not too much of a stretch to put them together and call it spaghetti. Substituting spaghetti squash for spaghetti pasta means lower calories and more fiber per serving. And everybody needs to eat more vegetables, right?

Use the nutritional analysis below to fit this easily into the Advanced Mediterranean Diet or Low-Carb Mediterranean Diet.

paleobetic diet, spaghetti, squash, low-carb diet, diabetic diet, paleo diet

Cooked spaghetti squash partially teased apart with a fork

Ingredients:

3/4 cup (240 ml) low-carb spaghetti sauce

2 cups (480 ml) cooked spaghetti squash

Instructions:

Prepare the ingredients after clicking on links above. Assemble as in the photo. Enjoy.

Number of Servings: 1

Advanced Mediterranean Diet boxes: 2 veggies, 2 fats, 1/2 protein

Nutritional Analysis: 

52% fat

33% carbohydrate

15% protein

408 calories

36 g carbohydrate

7 g fiber

29 g digestible carbohydrate

1,398 mg sodium

1,201 mg potassium

Prominent features: Rich in B12, copper, iron, niacin, thiamin, B6

Recipe: Apple, Pecan, Blueberry Lunch Bowl

paleobetic diet, diabetic diet, low-carb diet

So simple even a redneck can make it (I is a redneck)

Since I provide you with nutritional analysis below, you can easily work this meal into the Advanced Mediterranean DietLow-Carb Mediterranean Diet, or KMD: Ketogenic Mediterranean Diet.

Ingredients:

2.5 oz (70 g) apple, diced (“red delicious” variety works well) (this is half a medium-sized apple)

2.5 oz (70 g) pecans, crumbled into small pieces

2.5 oz (70 g) raw blueberries

Instructions:

Mix all together in a bowl, then enjoy. I know a lotta you bros will just eat all the components individually—but try the mix once for new flavors.

Servings: 1

Advanced Mediterranean Diet boxes: 1.5 fruit, 2 fat

Nutritional Analysis:

76% fat

20% carb

4% protein

570 calories

30 g carbohydrate

10 g fiber

20 g digestible carb

1.4 mg sodium

421 mg potassium

Prominent features: Quick and easy. Rich in copper, manganese, and thiamine. Inadequate protein to get you through the day, but you’ll make up for it at breakfast or dinner.

Recipe: Beef Soup, Asparagus, and Blackberries

low-carb diet, paleobetic diet, diabetic diet

Yum!

The entree is a cross between stew and soup. Stoup?

Since I provide the recipe’s carbohydrate grams in the nutritional analysis below, you can fit this into the Ketogenic Mediterranean Diet and Low-Carb Mediterranean Diet, as well as the Advanced Mediterranean Diet.

Ingredients:

2 lb (0.9 kg) stew meat, lean, bite-sized chunks (tenderized by the butcher if able)

1 garlic clove, finely minced

6 sprigs cilantro, de-stemmed, whole leaves

2 oz (58 g) sweet onion, diced (1/2 of a small onion)

1/4 of a medium-size green bell pepper, de-seeded, diced (medium bell pepper weighs about 5.5 oz or 155 g)

8 oz (227 g) canned tomato sauce

2.5 cups (590 ml) water

1.25 tsp (6.2 ml) table salt

freshly ground black pepper to taste (1/4 tsp or 1.2 ml?)

16 oz (454 g) fresh raw asparagus, no larger in diameter than your little finger, with any dry or woody stalk cut off and discarded

1.5 tbsp extra virgin olive oil

7.5 oz (213 g) raw blackberries

Instructions:

Stoup first. In a frying pan or electric skillet, place the stew meat, cilantro, garlic, bell pepper, onion, and cook over medium heat (350º F or 177º C) until the meat is done. Then add the tomato sauce, two cups of the water, one tsp of the salt, and pepper to taste. Simmer for two hours, then add a half cup water to replace evaporation loss.

low-carb diet, paleobetic diet, diabetic diet

Cooking stew meat. NOTE: this is double the amount the recipe calls for.

paleobetic diet, low-carb diet, diabetic diet

Meat is done and the “gravy” has magically appeared

low-carb diet, diabetic diet, paleobetic diet

Appearance after addition of the tomato sauce and 2 cups water

Now the asparagus. Preheat oven to 400º F or 204º C. Place asparagus on a cooking sheet covered with foil, brush the asparagus with the olive oil, then lightly salt (1/4 tsp?) and pepper to taste. (If you don’t mind cleaning up, just use a baking dish without the foil.) Roast in oven for 8–15 minutes; thicker asparagus takes longer. It’s hard to tell when it’s done just by looking; if it’s still hard, it’s not done. Click for another post I wrote on cooking asparagus and brussels sprouts.

paleobetic diet, low-carb diet, diabetic diet

Asparagus roasted at 400 degrees F for 12 minutes

Enjoy the berries for desert.

low-carb diet, diabetic diet, paleobetic diet

2.5 oz or 1/2 cup of blackberries

Servings: 3 [one serving is 1.5 cups (355 ml) of soup, a third of the asparagus (5 oz (140 g), and 2.5 oz (70 g) berries]

Advanced Mediterranean Diet boxes: 2 veggies, 2 fats, 1 protein

Nutritional Analysis per Serving:

40 % fat

12 % carbohydrate

48 % protein

590 calories

19 g carbohydrate

8.5 g fiber

10.5 g digestible carb

1,557 mg sodium

1,778 mg potassium

Prominent features: Rich in protein, B6, B12, copper, iron, niacin, phosphorus, selenium, and zinc

low-carb diet, paleobetic diet, diabetic diet

The fresh cilantro is a nice touch

 

 

 

Mediterranean Diet Helps With Maintenance of Weight Loss After Ketogenic Diet

Italian seaside tangentially related to this post

Italian seaside tangentially related to this post

Investigators affiliated with universities in Italy and Greece wondered about the effect on obesity of two ketogenic “Mediterranean” diet spells interspersed with a traditional Mediterranean diet over the course of one year. They found significant weight loss, and perhaps more importantly, no regain of lost weight over the year, on average.

This scientific study is right up my alley. I was excited when I found it. Less excited after I read it.

The Set-Up

This was a retrospective review of medical records of patients of a private nutritional service in three fitness and weight control centers in Italy between 2006 and 2010. It’s unclear whether patients were paying for fitness/weight loss services. 327 patient records were examined. Of these, 89 obese participants met the inclusion and exclusion criteria and started the program; 68 completed it and were the ones analyzed. (That’s not at all a bad drop-out rate for a year-long study.)  The completers were 59 males and 12 females (I know, the numbers don’t add up, but that’s what they reported). Ages were between 25 and 65. Average weight was 101 kg (222 lb), average BMI 35.8, average age 49. All were Caucasian. No diabetics.

Here’s the program:

  1. 20 days of a very-low-carb ketogenic diet, then
  2. 20 days of a low-carbohydrate non-ketogenic diet for stabilization, then
  3. 4 months of a normal caloric Mediterranean diet, then
  4. repeat #1 and #2, then
  5. 6 months of a normal caloric Mediterranean diet

In the ketogenic phases, which the authors referred to as KEMEPHY, participants followed a commercially available protocol called TISANOREICA. KEMEPHY is combination of four herbal extracts that is ill-defined (at least in this article), with the idea of ameliorating weakness and tiredness during ketosis. The investigators called this a ketogenic Mediterranean diet, although I saw little “Mediterranean” about it. They ate “beef & veal, poultry, fish, raw and cooked green vegetables without restriction, cold cuts (dried beef, carpaccio and cured ham), eggs and seasoned cheese (e.g., parmesan).” Coffee and tea were allowed. Items to avoid included alcohol, bread, pasta, rice, milk, and yogurt. “In addition to facilitate the adhesion to the nutritional regime, each subject was given a variety of specialty meals constituted principally of protein and fibers. “These meals (TISANOREICA) that are composed of a protein blend obtained from soya, peas, oats (equivalent to 18 g/portion) and virtually zero carbohydrate (but that mimic their taste) were included in the standard ration.” They took a multivitamin every morning. Prescribed carbohydrate was about 30 grams a day, with macronutrient distribution of 12% carb, 36 or 41% protein, and 51 0r 52% fat. It appears that prescribed daily calories averaged 976 (but how can that be prescribed when some food items are “unrestricted”?).

I found little explanation of period #2 mentioned above, the low-carb non-ketogenic diet. Prescribed macronutrients were 25 or 33% carb, 27 0r 31% protein, 41 or 44% fat, and about 91 g carbohydrate. Prescribed daily calories appear to have averaged 1111.

After the first and second active weight loss ketogenic phases, participants ate what sounds like a traditional Mediterranean diet. Average prescribed macronutrient distribution was 57% carbohydrate, 15 % protein, and 27% fat. Wine was allowed. It looks like 1800 calories a day were recommended.

Food consumption was measured via analysis of 3-day diaries, but you have to guess how often that was done because the authors don’t say. The results of the diary analyses are not reported.

What Did They Find?

Most of the weight loss occurred during the two ketogenic phases. Average weight loss in the first ketogenic period was 7.4 kg (16 lb), and another 5.2 kg (11 lb) in the second ketogenic period. Overall average weight loss for the entire year was 16.1 kg (35 lb).

Average systolic blood pressure over the year dropped a statistically significant 8 units over the year, from 125 to 116 mmHg.

Over the 12 months, they found stable and statistically significant drops in total cholesterol, LDL cholesterol (“bad cholesterol”), triglycerides, and blood sugar levels. No change in HDL cholesterol (“good cholesterol”).

Liver and kidney function tests didn’t change.

The authors didn’t give explanations for the drop-outs.

Although the group on average didn’t regain lost weight, eight participants regained most of it. The investigators write that “…the post dietary analysis showed that they were not compliant with nutritional guidelines given for the Mediterranean diet period. These subjects returned tho their previous nutrition habits (“junk” food, high glycaemic index, etc.) with a mean “real” daily intake of 2470 Kcal rather than the prescribed 1800 Kcal.”

Comments

A key take-home point for me is that the traditional Mediterranean diet prevented the weight regain that we see with many, if not most, successful diets.

However, most formulas for calculating steady state caloric requirements would suggest these guys would burn more than the 1800 daily calories recommended to them during the “normal calorie” months. How hard did the dieters work to keep calories around 1800? We can only speculate.

Although the researchers describe the long periods of traditional Mediterranean diet as “normal caloric,” they don’t say how that calorie level was determined  and achieved in the real world. Trust me, you can get fat eating the Mediterranean diet if you eat too much.

I’ll be the first to admit a variety of weight loss diets work, at least short-term. The problem is that people go back to their old ways of eating regain much of the lost weight, typically starting six months after starting the program. It was smart for the investigators to place that second ketogenic phase just before the typical regain would have started!

There are so few women in this study that it would be impossible to generalize results to women. Why so few? Furthermore, weight loss and other results weren’t broken down for each sex.

I suspect the results of this study will be used for marketing KEMEPHY and TISANOREICA. For all I know, that’s why the study was done. We’re trusting the investigators to have done a fair job choosing which patient charts to analyze retrospectively. They could have cherry-picked only the good ones. Some of the funding was from universities, some was from Gianluca Mech SpA (what’s that?).

How much of the success of this protocol is due to the herbal extracts and TISANOREICA, I have no idea.

The authors made no mention of the fact the average fasting glucose at baseline was 103 mg/dl (5.7 mmol/l). That’s elevated into the prediabetic range. So probably half of these folks had prediabetes. After the one-year program, average fasting glucose was normal at 95 mg/dl (5.3 mmol/l).

The improved lipids, blood sugars, and lower blood pressure may have simply reflected successful weight loss and therefore could have been achieved  by a variety of diets.

The authors attribute their success to the weight-losing metabolic effects of the ketogenic diet (particularly the relatively high protein content), combined with the traditional Mediterranean diet preventing weight regain.

The authors write:

The Mediterranean diet is associated with a longer life span, lower rates of coronary heart disease, hypercholesterolemia, hypertension, diabetes and obesity. But it is difficult to isolate the “healthy” constituents of the Mediterranean diet, since it is not a single entity and varies between regions and countries. All things considered there is no “one size fits all” dietary recommendation and for this reason we have tried to merge the benefits of these two approaches: the long term “all-life” Mediterranean diet coupled with brief periods of a metabolism enhancing ketogenic diet.

I’ve attempted a similar merger with my Low-Carb Mediterranean Diet. Click here for an outline. Another stab at it was the Spanish Ketogenic Mediterranean Diet. And here’s my version of a Ketogenic Mediterranean Diet.

Steve Parker, M.D.

Reference: Paoli, Antonio, et al. Long Term Successful Weight Loss with a Combination Biphasic Ketogenic Mediterranean Diet and Mediterranean Diet Maintenance Protocol. Nutrients, 5 (2013): 5205-5217. doi: 10.3390/nu5125205

Are You Ready for Your 15 Minutes of Fame?

Steve Parker MD, Advanced Mediterranean DIet

Caprese salad: mozzarella cheese, tomatoes, basil, extra virgin olive oil

A major U.S. women’s magazine is considering doing an article on my Low-Carb Mediterranean Diet. The writer would like to be able to interview folks (by phone) who have done the diet and successfully lost weight with it. Before and after pics would be icing on the cake but are not necessary.

If you’ve The Advanced Mediterranean Diet (2nd edition)KMD: Ketogenic Mediterranean Diet, or Control Diabetes and Prediabetes: The Low-Carb Mediterrean Diet, then you’ve seen the Low-Carb Mediterranean Diet. Advanced Mediterranean Diet also has a traditional portion/calorie-controlled diet. Control Diabetes and KMD both start with the ketogenic Mediterranean diet (30 carb grams/day) and than add more carbohydrates as tolerated by the individual, resulting in the Low-Carb Mediterranean Diet. Most folks following the Low-Carb Mediterranean Diet will max out carb consumption at 80-100 grams a day.

I’m terrible at marketing myself and my ideas, so I’ve not kept track of individual success stories from the past.

If you’d be willing to share your success story, please email me with a few of the details at steveparkermd AT gmail.com and I’ll keep your name on file in case the magazine decides to run with the article. I’ll not divulge your information to anyone else. If you share with me, I’ll assume I have your permission to send your story and e-mail address to the writer.

Thanks for your consideration.

Steve Parker, M.D.