The American Diabetes Association is trying to kill me.

Newsflash:  People with the inability to convert carbohydrates into energy (those with diabetes) have better blood sugar control if they don't eat so many of the damn things.

I know what you're thinking. That I have a remarkable command of the obvious.

Thanks to some recent research, mainstream medicine and nutrition professionals are finally (slooooowly) getting on the low carb for diabetes bandwagon, but not soon enough.  Hundreds of thousands of lives, limbs and kidneys could have been spared if only this was the advice given to newly diagnosed patients. Instead, we're advised to "eat whatever we want and cover it with insulin."  And in many cases patients are prescribes a large amoung of carbohydrate to go with that; commonly 60 grams of carbs per meal plus two 15g snacks per day.

Here's some really special advice from our friends at the American Diabetes Association, who we know have our best interests in mind (except that they get most of their funding from big pharma and food lobbies, so there's that. My rule is "always follow the money" when it comes to diciphering "research" and medical advice.

According to the ADA's website's fabulous advice for diabetics, the answer to "How many grams of carbohydrate are best for me?" is as follows:

 The recommended number of servings is based on your weight, activity level, diabetes medicines, and goals for your blood glucose levels. Your dietitian or diabetes educator, can work with you to make a personalized plan. A general guideline is to have 45-60 grams of carbohydrate at each meal  15-20 grams of carbohydrate servings at each snack.  And then use lots of lots of our sponsors' drugs to attempt in vain to achieve a non-diabetic A1C." Ok, so I made up that last part.

That's a total of as much as 210 grams of carbs PER DAY.  For someone whose body can't process carbs.  And if you're Type 2, you likely don't have insulin to cover those carbs so all you're doing is putting your body into a constant state of hyperglycemia and hyperinsulinemia.

Think about that the next time you're asked to donate to the organization that's supposed to be protecting our health.

Type 3 Diabetes, a.k.a. Alzheimers?

A high-carb diet, and the attendant high blood sugar, are associated with cognitive decline.

While this theory has been floated about in the medical community for a few years, this is the first in-depth analysis I've seen to corroborate the hypothesis that elevated blood sugars are related to dementia and Alzheimer's disease.

An article published in January inThe Atlantic sheds a bit more light.

In a 2012 study, [the researchers] broke nearly 1,000 people down into four groups based on how much of their diet came from carbohydrates. The group that ate the most carbs had an 80 percent higher chance of developing mild cognitive impairment—a pit stop on the way to dementia—than those who ate the smallest amount of carbs. People with mild cognitive impairment, or MCI, can dress and feed themselves, but they have trouble with more complex tasks. Intervening in MCI can help prevent dementia."

You can read about this in more detail here.

While it stands to reason that high levels of glucose in the blood will damage the blood vessels in the brain in the same way it causes damage to the vessels in the heart and the nerve pathways throughout the body, what's fascinating about this research is the connection to insulin. There's something called an insulin-degrading enzyme, a product of insulin that breaks down both insulin and amyloid proteins in the brain—the same proteins that clump up and lead to Alzheimer’s disease.

The article states, "People who don’t have enough insulin, like those whose bodies’ ability to produce insulin has been tapped out by diabetes, aren’t going to make enough of this enzyme to break up those brain clumps. Meanwhile, in people who use insulin to treat their diabetes and end up with a surplus of insulin, most of this enzyme gets used up breaking that insulin down, leaving not enough enzyme to address those amyloid brain clumps."

The common theme here is hyperinsulinemia, a state where there is too much insulin circulating in the body, essentially.  Type 2 diabetics who eat carbs are in a constant state of hyperinsulinemia, as they produce enough insulin but their bodies don't "use" it properly. This means that the more carbohydrate they eat, the more insulin the have in their bodies. We see from this research the risk of Alzheimers this creates.

In Type 1 diabetes, where the patient doesn't produce an adequate amount of insulin, the injected insulin in large quantities will create the same scenario, without enough of the enzyme needed to break up the amyloid brain clumbs.  How do you use less insulin?  Less carbohydrate.

Time and again research shows that low carb is a healthy option for people with diabetes, and yet diabetes educators, including a few high profile voices in the diabetes community, continue to attempt to discredit any research that shows that their "carb up and shoot up" advice is detrimental, dangerous and, dare I say, deadly.

In the News...Fish Oil Supplements Don't Prevent CVD (but they may prevent statins)

Disclaimer: I'm not a health professional and this is not medical advice. Merely an informed opinion based on my own experiences and research

Something Fishy Here

In a rather surprising twist, it was recently announced that "research" shows that supplementing Omega 3 fatty acids via fish oil doesn't prevent cardiovascular disease.  (Sobering news for those of us who have a 600 count jar of oil-filled, horse-size capsules eating up valuable cabinet space.)

There's a lot about this announcement that I find..fishy. 

Fish or Foe?

One of the take-aways from the research was that you're better off getting your Omega3 from actual fish. Given that much of the Omega3-rich fish we eat in this country are farm raised, I find that advice a bit paradoxical. After all, we know that toxins are stored in fish fat, and we know all about how bad farm-raised fish is in terms of its levels of toxins. So eat that fish at your own risk or take a certified Omega3 supplement? I say eat as much "clean" fish as you can...but keep taking that fish oil.

What, me skeptical?

Why am I so dubious about fish oil's alleged inefficacy? Well, if you've ever had surgery, you've probably been told to stop taking fish oil supplements (as well as ibuprophen or other NSAIDS) at least a week in advance of your procedure. Why? Because like Ibuprophen, it's a really effective blood thinner (it decreases platelet activity).  Think of it like taking low dose aspirin to prevent blood clots and further reduce cardiac risk. But thin blood isn't good in the OR

About That Lipid Profile

Fish oil has also been shown to raise HDL, an important part of a healthy lipid profile. Assuming you believe in the "lipid hypothesis" you know that your goal is supposed to be lower LDL (the "bad" stuff) and higher HDL (the "good" stuff) and nice, low triglycerides (the really bad stuff, in my opinion).  Your doc will look at these numbers, especially the first two, and decide if you "need" a statin. You probably don't, but that's not how that office visit is gonna go down, especially if you're diabetic. 

Fish oil also lowers triglycerides...which are really more dangerous than LDL, in my somewhat educated opinion.  https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186

So even if that fish oil isn't going to save you from a horrible death by CVD, getting those lipid ratios into "optimal" range will probably help save you from satan...I mean, a statin. 

Note: Before agreeing to a statin, please ask your physician to run either the NMR or, preferably, the CardioIQ lipid test. Here's some info:  
https://www.questdiagnostics.com/home/physicians/testing-services/condition/cardiovascular/cardio-iq-report.html

Your Glowing Complexion

Omega3 fatty acids are also important for healthy skin. They are a powerful anti-inflammatory (like ibuprophen, right?) and also a crucial part of your skin’s lipid content which helps bolster its barrier function, which, when working properly, acts like a seal that keeps moisture in and irritants out. In fact, researchers discovered that women who consumed half a teaspoon of omega-3-rich flaxseed oil (another Omega 3 source) a day increased skin hydration by 39 percent after 12 weeks. So no scaly skin for you. (See what I did there?)

My Takeaway

In my opinion, this all adds up to anecdotal support for continuing to take that fish oil. And if you can't handle those enormous pills, there are several liquid forms on the market that you might find easier to take. Consider yourself schooled.  (Wait, did you just groan out loud??)

But the label says "no added sugar"!

Good news!  The FDA is about to require food manufacturers and packagers to indicate the amount of added sugar on product labels.  Fabulous, right?  Like many people, you're probably looking to cut the sugar in your diet so you might be really excited about this. But "added sugar" is only half the story and that's why this girl isn't popping the champagne cork just yet.

Let's take a look at where our sugar comes from.

An 8 oz glass of orange juice has 21 grams of sugar. Coke has 23. Orange juice is comprised of fast-acting sugar. Yes, it's "natural" but it's still sugar and your liver responds to "natural" sugar the same way it responds to added sugar. In fact, the sugar in orange juice is fructose, which our body doesn't produce on its own. Its glycemic load is high and further, fructose doesn’t affect satiety in the same way as glucose, making you eat more total calories automatically if your fructose intake is high.

My point is that, pretty much without exception, "sugar is sugar is sugar" whether naturally occurring or added. Your body responds the same way (more on that later). So to my way of thinking, when you read a label, you should be most concerned with the total sugar count, not just the added sugar. (That said, something with a lot of added sugar is probably also empty of any nutritional value, so in this way, the new information may be useful for those looking to eat fewer "manufactured" foods.)

Further, and I need to read more about this, but I'm wondering how the FDA labeling will this address this situation...your kids' "100% juice" in the little boxes. Hey, it's 100% juice so it must be healthy, right?

Take a look at that label. Same amount of sugar as 8 oz of Coke! (But hey, it's natural!) Nearly every kids' 100% juice box has whatever the base juice is, plus "white grape juice concentrate" or in this case "pear juice concentrate." Which is...? (Let's see who's paying attention.) Fructose. Concentrated juice from some of the most sugary fruits on the planet. Would the FDA consider that "added sugar"? I would! Should you care?
Damn right you should care!

As a person who knows exactly what everything I eat does to my blood sugar, I know that my body would respond to the 21g of sugar in orange juice exactly the same way it would respond to the 23g of sugar in a Coke or the grape juice concentrate in those "healthy" juice boxes. "But wait! I'm not diabetic," I hear you cry! It may surprise you to know that up to a point, our bodies will respond the same way. Your body and mine will turn all that sugar (fructose, dextrose, sucrose, etc.) into glucose to be used for energy. Your body responds by producing insulin to convert it to energy. Mine does not.

But what happens when you, a non-diabetic, are eating foods that cause your body to produce insulin? If you're constantly putting sugar into your body, you are causing your body to produce insulin. Too much sugar can create a situation called hyperinsulinemia. (This result occurs not just from sugar but ALL carbohydrates, even those "good ones" you've been eating...again, more on that in a different post.) So what happens to your body with all that insulin floating around? The current hypothesis on carbohydrates is that the resultant elevated insulin acts on fat cells to cause fat storage, leading to obesity.  And the state of obesity creates insulin resistance. So here you have the double jeopardy of carbs; eating more carbs causes you to produce more insulin, which leads to fat storage, which leads to insulin resistance, which leads to your body producing even more insulin.  The result? A dangerous cycle that has Americans, who have been taught that fat is the enemy,  fatter and sicker than ever. What's the most important thing to take away from this post? Whether the carbohydrates you are consuming are from added sugar or HFCS, a banana, a cookie, a coke or a bowl of brown rice, the result is the same. Your liver can't tell the difference between added and natural sugars. So while the new information is "nice to have", it's not the metric you should be most concerned with if your goal is good health and normal blood sugars. Questions? Post in the comments!

Maybe it was Just a Bad Dream

The birds woke me this morning, chattering in the kwanzan cherry tree outside my bedoom window. Their incessant chirping was followed immediately by a few friendly smacks from the resident feline.

Just another Saturday morning in Southeast Michigan. A day to be spent working in the yard, going for a bike ride and then late afternoon grocery shopping, wandering the aisles of my favorite grocery store until I found something fresh and unusual for dinner. And then it hit me.

I won't have too many more Saturdays like that.

Hiller's Markets announced yesterday that they were selling all 7 of their stores to Kroger.  Anyone who knows me can tell you that I spent an inordinate amount of my food budget at this family-owned, Detroit-based supermarket chain.  When you consider there are 2 other stores closer to my house and that I also, like many Hiller's shoppers, shopped at other stores for some basic items, I still spent the majority of my food budget on my weekend visit to Hiller's.

And that's not because it's expensive.  Hiller's prices were competitive on many items...and not so much on others. Sometimes it costs a little more to "buy locally" and I always felt good about sliding my debit card there.  I'll miss the premium meats (hamburger meat ground fresh every day and sourced from their own herd), the unparalleled selection in the deli and best fish and seafood of any grocer in town.

Sorry, Kroger, no matter how much you attempt to up your game, your meats are still mediocre, your chicken isn't what you claim it is, and I wouldn't eat fish from your store if it was free.  Your produce doesn't turn over fast enough for my taste, and I am pretty sure I couldn't find juicy frozen duck breasts, bison meat, rattlesnake and 40 kinds of pickles in your store.

Foodie life as I know it is over. I woke up this morning thinking, "maybe this is all a bad dream."  And I almost believed it until I checked social media this morning.  I can't imagine the closing of a few grocery stores causing such a media frenzy in any other city. Or rather, I can't imagine any community so distraught over it.

There are bigger problems in the world and right here in our own community than the closing of a grocery store.  But when the announcement was made, my inbox was flooded with emails, mostly asking if it was really true. "Say it isn't so," seemed to be a recurring theme.

I'd love to say it isn't so.  Jim Hiller is a good man; philanthropic, warm, funny and damn smart. It's my pleasure to consider him a friend, and I worked for him on a free lance basis for a short time. He was generous and fun to work with.  He wanted nothing more than for his stores to thrive and to be able to continue to employ the best people in town.

The Jim I know and love would not have taken this decision lightly, nor would he have sold the stores if it wasn't best for the people in the community, including the 800 or so people he employed here in Oakland and northwestern Wayne counties. This I know for a fact.

Part of me doesn't want to go to Hiller's today. Let it go, move on. Find a new place to shop.

But the way I figure it, I have about 6 more Saturdays in life that I can spend marveling at 30 kinds of extra virgin olive oil.  Six more Saturdays that I can spend wandering aimlessly through a world of ingredients that the folks at Kroger have never even heard of.

When those six Saturdays are in my rearview window, I'll do what most other shoppers do.  Make a list, run into Kroger, dump everything in my cart, and pay at the U-Scan.  No familiar face greeting me by name.  No new discovery from the produce department in my bag.

But I bet my grocery bill will be a few bucks less than it would have been at Hiller's.  Bittersweet savings, this.  And what will I do with that money I saved today?  I'll do what Jim would do....I'll donate it to charity.

Pumpkin Creme Brulee (low carb)

My son requested pumpkin creme brulee for dessert this Thanksgiving, because he is a foodie and I freely admit to having created that monster--as they say down South--my ownself.

Fortunately, cream based desserts lend themselves so well to low-carb adaptation. Cheesecake, for example, can be made sugar- and flour-free so well it will fool even your most discerning guests.  (And all of my guests are discerning, aren't yours?)

So I ventured forth with a Food Network creme brulee recipe and replaced the sugar with Swerve. But it didn't have enough eggs (I should have trusted my instincts) and it never set. The flavor wasn't "pumpkin-y" enough for me, either. (But it made a great custard base for ice cream!)

After researching a little further, I saw similar complaints from other cooks in the recipe reviews.  "Not enough pumpkin flavor," or "texture too much like pumpkin pie," and "if you want pumpkin  pie make pumpkin pie; if you want creme brulee make tradiational creme brulee."  The general consensus was that this dish did neither "creme" or "pumpkin" very well. But I wasn't giving up that easily. It ain't over 'til the fat pumpkin sings. Or something like that.

Undaunted, I continued my search.  Almost every recipe had similar complaints.  Not enough spice. Spices fell to the bottom of the custard.  Pumpkin flesh made the texture too coarse and dense.

So I set out to rectify all of those things, while replacing the sugar in the custard with a low carb sweetener.

Fix number one: Spice, spice and spice again.  I heated the milk with the spices and then let it steep in the fridge overnight.

Fix number two: Spice the pumpkin, also.  Same amount of spices into the 1/2 cup of canned pumpkin.

Fix number three: Make the pumpkin super smooth.  After adding the spices, I added about 1/4 cup of cream and the sweetener, and used my stick blender (a small food processor would work) to puree the pumpkin further and then forced it through a strainer with a rubber spatula. The result was airy, light and beautiful...delicious enough to eat off a spoon.

Fix number three: maple extract (www.olivenation.com) and bourbon (2 tbs. of the best hooch you have in the cabinet).  Both of these seem to amplify the warm flavors you want from anything pumpkin.

Fix number three: an extra egg yolk.

Now, about that pesky "brulee" part.  Swerve WILL caramelize but it burns easily with a torch.  Putting them under the broiler will work if you put the custard dishes in a pan of cold water while you brown them.  (I would use foil ramekins if you're going this route.)

Depending on the rest of your meal and whether or not you want to use insulin to cover it, 2 teaspoons of real sugar is 8 grams of carbs.

But they're just as good without it or topped with a little unsweetened whipped cream and chopped nuts.

Adapted from recipe by Williams-Sonoma Home.

INGREDIENTS:

For the custard:

• 
  
  2 cups heavy cream
  1 1/2 tsp. Penzey's cinnamon
  1/4 tsp. ground allspice
  1/2 tsp. Penzey's dried ginger
  3/4 tsp. freshly grated nutmeg
  7 egg yolks
  1/2 tsp. vanilla extract
  Pinch of salt
  
  
  For the pumpkin:
  
  
  1/3 cup pumpkin puree
  1/8 cup heavy whipping cream
  1/2 tsp. Penzey's cinnamon
  1/4 tsp. ground allspice
  1/2 tsp. Penzey's dried ginger
  1/4 tsp. freshly grated nutmeg
  1/3 cup Swerve granulated sweetener
  
  
  For final seasoning:
  
  
  1/2 tsp Penzey's cinnamon
  1/4 tsp ground allspice
  1/2 teaspoon dried ginger
  1/4 tsp. grated nutmeg
  1 tsp. Olive National natural maple extract
  2 tbs. good bourbon or dark rum (not flavored)
  
  
  For topping:
  
  
  8 tsp Swerve (or sugar if you're living dangerously)

DIRECTIONS:

Preheat an oven to 300°F. Have a pot of boiling water ready.

Pour the cream into a small saucepan and whisk in the cinnamon, allspice, ginger and nutmeg. Set over medium-low heat and warm the cream mixture until bubbles form around the edges of the pan and steam begins to rise from the surface, about 3 minutes. Remove from the heat. When cooled, pour into a clean jar, cover, and refrigerate for 8 hours or overnight.

Combine the heavy whipping cream and cream and process until smooth in a small food processor or in a small bowl using a stick blender. Force through a mesh strainer into a small mixing bowl. (This step is optional but it will yield a lighter custard.) Whisk in the sweetener and the spices. Cover and refrigerate until ready to assemble the custards.

Warm the cream again in a small saucepan over medium-low heat until it bubbles around the edges. Remove from heat. Bring the pumpkin mixture to room temp in the microwave.

In a large bowl, whisk together the egg yolks, vanilla, salt, pumpkin puree mixture until smooth and blended. Slowly pour in the cream mixture, stirring until blended. Add the final spices, the maple extract and the bourbon and whisk to combine.

Pour the mixture through a fine-mesh sieve set over a bowl. Divide the mixture among four 8-fl.-oz. ramekins (or 8 smaller, deeper ones) and place in a large baking pan. Add boiling water to fill the pan halfway up the sides of the ramekins. Cover the pan loosely with aluminum foil and bake until the custards are just set around the edges, about 30 minutes. (The taller ramekins will take about 7 minutes longer.)

Transfer the ramekins to a wire rack and let cool to room temperature. Cover with plastic wrap and refrigerate for at least 4 hours or up to 3 days.

Just before serving, sprinkle 1 tsp. granulated sweetener (or sugar if you're living dangerously) evenly over the surface of each custard. Using a kitchen torch according to the manufacturer's instructions, move the flame continuously in small circles over the surface until the sugar melts and lightly browns. Serve immediately. Serves 4 - 8

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