Alternatives for Starches

One of the most frequent questions I get asked is “what can I substitute for starchy carbs that tastes good?’

Mother Nature has provided us with natural alternatives to starches packed with nutrients and natural carbohydrates that don’t raise insulin levels and keep blood sugars on a more even keel.  These sustitutions are great for individuals who have diabetes or just want to keep their carbs under control.

What are a few you can incorporate into your diet?

1.  Spaghetti Squash - this yellow squash is easy to prepare and substitutes nicely for pasta.  Cut in half, scoop out the seeds and dot with some organic butter, and your favorite spice.  Cook in the oven at 350 degrees for 30-45 minutes or until tender.  Remove from the oven and use a fork to scoop out the “spaghetti.”  Sprinkle with some parmesan cheese and enjoy with your favorite protein or some meatballs and tomato sauce.

2.  Eggplant - this squash is underused and tastes great as a substitute for noodles in lasagna or in any vegetable dish.  Slice the eggplant in medallions and put in the oven at 300 degrees for ½ hour to remove the water and use as the layers for lasagna.  See High Protein Lasagna for more ideas.  Eggplant can also be diced and sautéed with Indian spices for a meaty like side dish.

3.  Portobello Mushrooms – these mushrooms have multiple uses.  A few years back a study tested the satiety level of participants after eating Portobello mushrooms versus a piece of meat and the results were surprisingly similar.  They both provided a high satiety level.  Portobello mushrooms can but used as a pizza crust (scoop out insides and bake slightly before adding pizza toppings) or a holder for any protein dish or hearty vegetable side.

4.  Butternut or Acorn Squash – these two squashes make great substitutions for potatoes and are packed with phytochemicals and nutrients.  Cut them in half, scoop out the seeds, and bake in the oven with dots of organic butter, cinnamon or nutmeg. Enjoy cut in chunks or mashed.

All these vegetables are hearty, satisfying and filled with nutrients your body needs.  Stepping outside the box may be a bit daring but eventually becomes routine and ultimately increases your health.

The Third Type of Diabetes?

Many people know there are 2 types of diabetes.  Type 1, formerly called juvenile-onset diabetes and type 2 or adult-onset diabetes.  Gestational diabetes or pregnancy-induced diabetes resembles type 2.  

But did you know there is a third type of diabetes known as LADA (latent autoimmune diabetes in adults) or type 1.5 diabetes?

What are the differences?  Type 1 diabetes usually occurs in babies to young adulthood.  Those that have some type of genetic pre-disposition to diabetes get a virus such as mononucleosis or the flu bug which triggers the pancreas to stop producing insulin. This type of diabetes requires life-long insulin therapy.

Although Type 2 diabetes used to occur later in life we are now seeing young children and adolescents develop type 2.  It is brought on by a combination of genetics, weight, poor diet choices, and inactivity.  Insulin resistance precedes adult onset diabetes and occurs when your insulin becomes almost “sleepy” or sluggish, which increases carbohydrate cravings, weight issues and fatigue.  This type of diabetes can usually be controlled with lifestyle and oral medications.

The third type of diabetes is not as well known or understood.  Rather than the insulin being resistant, with LADA or type 1.5, an individual’s insulin becomes deficient.  The cells of their pancreas stop producing as much insulin as they once did - like a slowly developing type I diabetes.

This individual is usually thin, has slowly increasing blood sugars and develops diabetes over many months or years.  This type of diabetes is caused by the person’s immune system which develops antibodies that attack the pancreas hence lowering the amount of insulin produced over time.

Many times this type of diabetes is misdiagnosed or treated as type 2.  What do you do if you suspect you have LADA?  Ask your doctor to check a blood test called the c-peptide and measure over time.  C-peptide is a simple blood test which measures how much insulin your pancreas is producing.  Knowing the value can determine whether your antibody levels need to be checked.

What can you do in terms of your lifestyle?  Diet balance is essential and eating plenty of protein, healthy fats and moderating your carbohydrate intake with non-starchy sources such as fruits and vegetables can help give the pancreas a rest and keep your blood sugars normalized. 

Exercise helps the insulin you do make much more effective and efficient - up to 50%.  Besides diet and exercise, sleep and stress management are invaluable in keeping your system healthy.

If you suspect you may have LADA lifestyle and self-monitoring are of utmost importance.  Knowing what to do and what parameters to check can keep your system in good health.

What about Sugar?

With the holidays upon us and so many sweets around the house, office, and parties it is not hard to be bombarded with high sugar items.  We all know too much sugar is not good for us but what exactly is important to know about sugar, how much is okay to eat and will it really affect your health in a major way?

Sugar has been blamed for many things from diabetes, hyperactivity in children, and autoimmune problems to acne.  The real key is how much you consume.

Many names for sugar exist – some may be but are not limited to sucrose, dextrose, maltose, glucose, mannitol, sorbitol, molasses, monosaccharides, polysaccharides, maple syrup, maple sugar, date sugar, brown sugar, raw sugar, turbinado sugar, or high fructose corn syrup. If the product contains any of these, it could be a high sugar product.

Since American culture is accustomed to high levels of sweetness, many of our foods have additional sugar added. This includes anything from small yogurts to salad dressings, and many other foods you may be eating on a regular basis.  Many fat-free and low fat products have sugar added, causing them to become basically high sugar products.  The following list reveals foods that can have sugars or hidden sugars you may not be aware of:

• flavored, sweetened yogurts
• condiments, such as ketchup, barbeque sauce or other sauces
• relish – sweet pickle
• any low fat or fat-free product
• salad dressings
• smoothie drinks
• canned or bottled tomato sauces
• pre-made deli case salads or entrees
• teriyaki sauce
• frozen vegetables and entrees
• canned fruits – in syrups
• specialty waters and drinks (coffee, tea)
• processed meats

The new guidelines of the American Heart Association suggest limiting sugar intake to no more than 100 calories per day for woman and 150 calories for men. This translates to no more than 5-8 teaspoons of sugar per day.  On a label 1 teaspoon of sugar equals 4 grams of sugar so the label limit is 20-32 grams of sugar per day.

To put this concept in real life terms, a 12 ounce can of soda has 40 grams of sugar which is over the recommended level.  If you look at the labels of foods you normally eat, you will be able to monitor how much sugar you are consuming.

Although sugar is not the culprit for many of the adverse affects it has been blamed for it is still a concern for your health.  A high sugar diet can increase all types of inflammation in the body which can lead to many health-related problems. 

Sugar can also lower the immune system, leading to increased risk of colds and flues.  One of the most important considerations is having even blood sugars leading to good sustained energy throughout the day.  If you are consuming increased amounts of sugar in any form, your body produces high amounts of insulin, leading to fluctuation in blood sugars and fatigue.

So keep to the limits if you want to have good energy, maintain your health and avoid illness during the holiday season.  Your body will think you gave it a wonderful gift!

Gestational Diabetes

Yesterday’s Los Angeles Times had a review on how treating both mild gestational diabetes in addition to gestational diabetes leads to less preterm births and fewer cases of problems with pregnancy and delivery.

Since pregnancy is a state of insulin resistance, many pregnant women are susceptible to blood sugar changes.  Women with gestational diabetes (diabetes brought on by hormones in pregnancy) have a high propensity to have diabetes later in life.  Gestational diabetes mellitus is defined as carbohydrate intolerance of variable severity with onset of first recognition during pregnancy.

Having gestational diabetes can almost be looked at as a blessing since it is a forewarning and can be treated.  If women with gestational diabetes change their diets and lifestyle both during pregnancy and afterward, they can avoid getting adult onset or Type 2 diabetes in the future.  Of course, this is not always the case, but a diet and exercise alteration now can deter or obliterate diabetes later in life for many women.

Treating gestational diabetes can be as simple as eating more protein with a balance of healthy carbohydrates from vegetables, fruits and dairy products with healthy sources of fats such as nuts, seeds, peanut or other nut butters and avocado. 

Checking the blood sugars one and a half to two hours after eating can also be helpful in terms of knowing how your food is affecting you right now.  It is important to get help from a Registered Dietitian who is familiar with diabetes in pregnancy and can help you stay on track.  I have more detailed information on pregnancy and gestational diabetes in my new book A Recipe for Life by the Doctor’s Dietitian, which became available last week.