Diet Guidelines Essential to the Treatment of All Diabetics
When my friend Kanji sent me a beautifully decorated canister from Japan, I was most impressed and intrigued. You can imagine my dismay when I removed the cover and found seaweed. My dismay was only temporary, however. I reluctantly opened one of the cellophane envelopes and pulled out a tissue-thin slice. My first nibble was quite a surprise—it was delicious. When consumed in small amounts, I
found, it had virtually no effect upon blood sugar. Once addicted, I combed the health food stores searching for more. Most of the seaweed I tried tasted like salty paper. Eventually, a patient explained to me that Kanji’s seaweed is a special kind called toasted nori. It contains small amounts of additional ingredients that include soybeans, rice, barley, and red pepper. It is available at most health food stores, and is a very tasty snack. Five or six pieces at a time have had no effect upon my blood sugar. The Clinistix/Diastix test showed no glucose after chewing. A standard slice usually measures 1¼x 3½inches and weighs about 0.3 gram. Since the product contains about 40 percent carbohydrate, each strip will have only 0.12 gram carbohydrate. Larger sheets of toasted nori should be weighed in order to estimate their carbohydrate content.
Sweeteners: Saccharin, Aspartame, Stevia, Splenda, and Cyclamate
I carry a package of Equal (aspartame) tablets with me, particularly when I go out to eat. Cyclamate is not currently available in the United States, but may be returning. Aspartame is destroyed by cooking and is much more costly than saccharin, which has a bitter aftertaste, but it will work for sweetening hot coffee or tea. I find that using one ½- grain saccharin tablet for every Equal tablet rather than two saccharin tablets or two Equal tablets eliminates saccharin’s aftertaste and keeps costs down. Equal tablets are available in most pharmacies and many supermarkets. Although Equal tablets contain lactose, the amount is too small to affect blood sugar.
Acesulfame-K is a new artificial sweetener being marketed in tablet form outside the United States by Hoechst, AG, of Germany. It is not degraded by cooking. It is added to some “sugar-free” foods in the United States under the brand name Sunette, and is combined with glucose in the packaged powder called The Sweet One, which you obviously should avoid. There are, however, some questions about its causing cancer, so there may be better choices. Other noncaloric tablet
sweeteners will be appearing on grocery shelves in the United States in the future. Stevia, mentioned earlier, is an herbal sweetener and has been available in health food stores for many years. It is not degraded by cooking and is packaged in powder and liquid forms. The liquid must be refrigerated to prevent spoiling. Stevia has not yet been approved in the European Union because of fears that it may cause cancer. Studies of this “possibility” are under way.
Splenda (sucralose) tablets are available now in some parts of the United States, overseas, and on the Internet. They are benign in spite of containing minute amounts of lactose. In powdered form, Splenda, like the others except stevia, is principally a mixture of sugars to provide bulk and should be avoided.
No-Cal Brand Syrups
These artificially sweetened liquid flavors are sold by many supermarkets in the northeast United States. (They are distributed by Cadbury Beverages, Inc., Stamford, CT 06905-0800, and are stocked by Trotta’s Pharmacy.) The available flavors include strawberry, raspberry, black cherry, chocolate, and pancake/waffle topping. This product contains no calories, no carbohydrate, no protein, and no fat. It takes a bit of imagination to put it to good use. For example, I used to spike my coffee with the chocolate flavor, or my tea with fruit flavors. I put the pancake/
waffle topping on my eggs in the morning after heating it in a skillet. In recent years, however, to my taste, the chocolate flavor has deteriorated, so I no longer use it.
Da Vinci Gourmet Syrups
Similar in concept to No-Cal syrups but in my opinion much tastier, this product is available from several Web distributors, including www.netrition.com and www.davincigourmet.com, and from Trotta’s Pharmacy. Da Vinci currently produces more than forty flavors. Internet prices range from $7.49 to $8.95 for a 750 ml bottle. Flavors include banana, blueberry, caramel, cherry, chocolate, coconut, cookie dough, pancake, peanut butter, and watermelon. I like to sometimes mix the toasted marshmallow syrup into my morning omelet. For a list of distributors, phone Da Vinci Gourmet, Ltd., at (800) 640-6779. The product is certified kosher.
There are numerous flavor extracts often used in baking that you can use to make your food more exciting. They usually can be found in small brown bottles in the baking supply aisles of supermarkets. Read carbohydrate content from the label. Usually it’s zero and therefore won’t affect your blood sugar.
Mustard, Pepper, Salt, Spices, Herbs
Most commercial mustards are made without sugar and contain essentially no carbohydrate. This can readily be determined for a given brand by reading the label or by using the Clinistix/Diastix test. Pepper and salt have no effect upon blood sugar. Hypertensive individuals with proven salt sensitivity should, of course, avoid salt and highly salted foods (see page 439).
Most herbs and spices have very low carbohydrate content and are used in such small amounts that the amount of ingested carbohydrate will be insignificant. Watch out, however, for certain combinations such as powdered cinnamon with sugar. Just read the labels.
Low-Carbohydrate Salad Dressings
Most salad dressings are loaded with sugars and other carbohydrates. The ideal dressing for someone who desires normal blood sugars would therefore be oil and vinegar, perhaps with added spices, mustard, and followed by grated cheese or even real or soy bacon bits. There are now available some commercial salad dressings with only 1 gram carbohydrate per 2-tablespoon serving. This is low enough that such a product can be worked into our meal plans. Be careful with
mayonnaise. Most brands are labeled “carbohydrate—0 grams,” but may contain up to 0.4 grams per tablespoon. This is not a lot, but it adds up if you eat large amounts. Some imitation mayonnaise product shave 5 grams of carbohydrate per 2-tablespoon serving.
Although all nuts contain carbohydrate (as well as protein and fat), they usually raise blood sugar slowly and can in small amounts be worked into meal plans. As with most other foods, you will want to look up your favorite nuts in one of the books listed in Chapter 3 in order to obtain their carbohydrate content. By way of example, 10 pistachio nuts (small, not jumbo) contain only 1 gram carbohydrate, while 10 cashew nuts contain 5 grams of carbohydrate. Although a few nuts may contain little carbohydrate, the catch is in the word “few.” Very few of us can eat only a few nuts. In fact, I don’t have a single patient who can count out a preplanned number of nuts, eat them, and then stop. So unless you have unusual will power, beware. Just avoid them altogether. Also beware of peanut butter, another deceptive addiction. One tablespoon of natural, unsweetened peanut butter contains 3 grams of carbohydrate, and will raise my blood sugar 15 mg/dl. Imagine, however, the effect on blood sugar of downing 10 tablespoons.
Sugar-Free Jell-O Brand Gelatin
This is one of the few foods that in reasonable amounts will have no effect upon blood sugar if you get the kind that is indeed sugar-free. I have been informed by some of my patients and found it to be true that in some areas “sugar-free” actually contains some maltodextrin, which is a mixture of sugars and will raise your blood sugar. The ready-to-eat variety in plastic cups does not thus far contain maltodextrin— or at least that which I’ve found on my grocery’s shelves.
Check the labels. Truly sugar-free Jell-O or other truly sugar-free brands of gelatin are fine for snacks and desserts. A ½-cup serving contains no carbohydrate, no fat, and only 1 gram of protein. Just remember not to eat so much that you feel stuffed (see “The Chinese Restaurant Effect,” in Chapter 6). You can enhance the taste by pouring a little heavy cream over your portion. One of my patients discovered
that it becomes even tastier if you whip it in a blender with cream when it has cooled, just before it sets. Of the many flavors of sugar-free Jell-O that are available, I like apple, Hawaiian pineapple, and watermelon.
Unfortunately, very few supermarkets seem to carry the apple and Hawaiian pineapple flavors, and I wonder if they still exist. If the only “sugar-free” Jell-O you can find contains maltodextrin, try adding some liquid stevia and Da Vinci syrup to Knox unflavored gelatin as a tasty substitute.
Sugar-Free Jell-O Puddings
Available in chocolate, vanilla, pistachio, and butterscotch flavors, these make a nice dessert treat. Unlike Jell-O gelatin, they contain a small amount of carbohydrate (about 6 grams per serving), which should be counted in your meal plan. Instead of mixing the powder with milk, use water or water plus cream. Every 2 tablespoons of cream will add 1 gram of carbohydrate.