Backing away from diabetes, ISO low carb/fat that doesn't kill my joy

November 12, 2022 11:48 AM

My average glucose is high and my liver is chonky. Doctor didn't use the word "diabetic" or even "pre-diabetic" but says to get some exercise and eat low fat AND low carb when possible. I want to see better blood tests in a month but meanwhile eating is how I feel better about [gesticulates at world.] Hit me with recipe links for things that are satisfying and don't feel terribly like an emergency rescue plan?

Bonus difficulty! I have been easing off meat. I'm not being rigid about it and I feel a-ok about seafood that is not superintelligent (hit me with no octopus recipes!) So I guess what I'm saying is ideas for chicken would ordinarily be great but aren't ideal at the moment.

To be completely impossible, dairy isn't top of my list for digestive reasons but possibly it's time to get some Lactaid and have a few more options. I do not aspire to veganity. Eggs are a-ok.

Thanks for your ideas!

posted by less-of-course to Food & Drink (17 answers total)

Did they talk to you about fiber? A pre-diabetic person I know saw nutritionist and the importance of fiber was drilled in.

Delicious breakfast - open a can of black beans and warm up in skillet. Then cook two eggs and top with salsa.

Bob’s Red Mill Oat Bran - pretty great cereal. 1/2 cup with 1 cup water cook in microwave for 2 minutes. Top with whatever. Applesauce, bananas, maple syrup, agave.
posted by MadMadam at 1:01 PM on November 12, 2022 [5 favorites]

How about roasted veggie bowls? I’m thinking along the lines of this bowl from Smitten Kitchen, with adjustments to add more veggies/less carbs if necessary. A lot of these kind of bowls could also be delicious with an egg on top to increase the protein. I’ve done a similar thing with roasted sweet potatoes and bell peppers with Mexican spices, a high fiber grain blend and some salad greens dressed with lime juice.
posted by MadamM at 1:19 PM on November 12, 2022 [1 favorite]

Matiz brand sardines packed in olive oil feel fancy and are delicious but are also quite good for you and super convenient, with portioning built right in.

If you want to eat them in a style similar to a Mediterranean tuna salad, this one is pretty good; plop on a bunch of fresh greens or spread on rye.

What I’m going to go make for a late lunch is: heat some of the oil from the can in a sauté pan. Sauté some red bell peppers, capers, and garlic. Add the sardines in as big pieces as I can get them, and let them get a little browned. Add some tomato paste and smoked paprika, then thin it out with sherry vinegar and water, seasoned with salt and pepper, until I have a bit of a sauce. Let it all simmer and mingle for a couple minutes on low as I chop a scallion and whatever fresh herbs I have to sprinkle on top. This is good on any grain, basically, though I will probably eat it with some toasted whole grain pita. If I want to make it into much more food I add some extra peppers and add a drained can of chickpeas or butter beans in the simmering step. You can crack an egg into the sauce and let it cook like shakshuka, too.
posted by Mizu at 1:56 PM on November 12, 2022 [5 favorites]

Best answer: Oat bran, applesauce, bananas, maple syrup, and agave are all high carb, and as a type 2 diabetic who has the disease in remission via diet, I would absolutely avoid them. Agave and fruits, fyi, have a veneer of healthiness but for someone with blood sugar issues and fatty liver, fructose is actually worse for your liver and metabolism than regular sucrose or glucose.

My suggested low-carb, high-fiber alternative to that meal would be:
1/4 cup hemp hearts
1 Tbsp chia seeds
1 Tbsp ground golden flax seeds
1 Tbsp dried shredded unsweetened coconut
1/2 cup water
A dropper full of vanilla stevia drops, or a Tbsp of allulose or erythritol or monkfruit (I generally avoid sucralose like Splenda or other sweeteners like aspartame)
1/4 tsp cinnamon
A pinch of salt
Microwave for 1 minute, stir, and top with goodies like almond butter, chopped nuts, fresh berries (the lowest carb fruits!) like strawberries, raspberries, or blueberries. It is very much like oatmeal and has many of the same benefits but is much lower-carb.

I also have done a savory version of that mixture (sans sweetener/cinnamon/coconut) topped with melted cheddar, scallions, caramelized onions, and a fried egg with a runny yolk, and it was a delicious stand-in for grits.

Eggs are awesome for low-carb vegetarian eating. I’ve been eating a lot of deviled eggs and egg salad sandwiches lately, on the high-fiber “keto bread” they have at Aldi, or cauliflower egg thins that are like big crepes that are even lower in carbs.

Roasted Brussels sprouts, cauliflower, or broccoli with a squeeze of lemon are low carb, high fiber, and delicious. I often make a sheet pan meal of this plus a piece of salmon and it’s delicious and very easy. If you’re craving mashed potatoes, try a cauliflower purée instead, or do half and half with potatoes.

Salads are an obvious option, just replace croutons with nuts and replace any sugary dressings with homemade vinaigrette.

Zucchini is another great low-carb vegetarian staple. A bed of diced zucchini pan-fried till it’s a bit brown is a great alternative to rice as a bed for stir-fries, shakshuka, stews, etc.

If you like noodles, I have enjoyed making versions of pad Thai, drunken noodles, spaghetti bolognese, japchae, and more using shirataki noodles, spiralized zucchini, or kelp noodles instead of their high-carb equivalents.

Are there specific types of foods you’re craving or especially want recipes for? I have all kinds of subs and suggestions if you can narrow things down.

You might also consider working on just the carbs piece and not restricting your fat—from what I understand, often NAFLD resolves itself under those circumstances as the liver is more affected by carb-related dysfunction than dietary fat intake.

Check out The Glucose Goddess on Instagram as well, as she has science-based tips for continuing to enjoy carbs while preventing insulin/glucose rollercoasters, eg “dressing your carbs” by eating fiber and protein first and then following up with the carb you want to enjoy, slowing its digestion.
posted by music for skeletons at 2:27 PM on November 12, 2022 [17 favorites]

Response by poster: Thanks for these suggestions. I think I'm looking at a lot of sheet pan meals with salmon or tofu.
posted by less-of-course at 3:05 PM on November 12, 2022

The Aldi's near me recently had frozen salmon patties in teriyaki and chipotle flavors. I threw it in a pan with a tiny bit of olive oil and cooked it on both sides for about 4 minutes. Threw a bag of frozen veggies in the microwave and seasoned them with some everything bagel seasoning. Full meal in less than 10 minutes.
posted by kathrynm at 3:13 PM on November 12, 2022 [1 favorite]

Probably one of my main go-tos for less meat low carb is to make a pasta sauce of my liking, and serve that over a lot of roasted vegetables, which for me is usually eggplant, mushrooms, lots of cauliflower, zucchini, and maybe some green beans if I have them. Use meat, don't use meat, use one of the soy meat crumbles or vegan Italian sausage, but definitely make sure you have some nice fresh fennel seed on hand to get that zing. I personally do keep some legumes in my diet for general functionality, so I use lentils a lot in place of or alongside ground meats. White beans are also delicious with tomatoey pasta sauce.

For stuff that wants a skinny noodle, shredded cabbage is my preferred replacement. Cabbage is a miracle food, you can even grill it.
posted by Lyn Never at 3:18 PM on November 12, 2022 [3 favorites]

Best answer: I was in a very similar situation last year, though my doctor's opinion is that we deal with my mental health issues first. Still, when I had my numbers this year, the blood sugar and liver counts were vastly improved because I have changed my foodways, counter to his advice. The thing is, there is a lot of research out there suggesting that mental health and physical health are connected, and I really want to get better.

I have made a non-judgemental spreadsheet for each month where I register what I eat and my step count. The steps have improved a lot. I am more focused on being honest with myself than reaching any particular goals, though obviously there are goals. That's what I mean by non-judgmental. If my dinner is pasta with gorgonzola and a glass of red wine, I'm not gonna lie to myself. And hey, those things have other health benefits. The problem was perhaps that they were all I was eating.

First of all, I am trying to get to those five fruits and vegs a day. I'm not there, but I am much closer than I was a year ago. This month's spreadsheet has four a day. When I started last year there were 1.5. Remember that you can't just do it with fruits, they have too much sugar in them.

Second, I am working to get to 30 different vegetable products a week. This sounds crazy, but is actually the easiest part: herbs and spices count, so a curry with five or six spices gives you a lot. But the rule helps you remember to eat a curry rather than a burger. Then a chili gives you a different set of veges. I reach this goal every week. It's nice to feel some succes.

Third, I measure my carbs. I love all carbs, and I will not stop eating them unless my life depends on it. But I can see it really benefits my health to limit them. So now I never eat more than a 1/2 cup of pasta, rice or white bread per meal. I eat cake maybe once a week, max. And since I have felt the result instantaneously, I can easily keep it up. Now that I am monitoring what I eat, I can see the direct connection between too many refined carbs and both physical and mental health issues. Potatoes seem to work differently, so I eat them as much as I want, mostly unpeeled. The same goes for whole grains.

Now I know you asked for recipes, but that is a huge question. You really need to change your habits, and with that comes an other perspective on recipes. But here goes:
ful medames
shakshuka
French Lentil Salad
Vegetarian chili
Fish en papilotte

I don't know why, but daal is a really good organic vegetarian take-away option here, so I just buy it. Also, I live on a street that is famous for its many Middle Eastern restaurants, so I just buy the fresh falafels. But if you don't live here, frozen organic are OK.

All the omelettes and frittatas and the Spanish tortilla are good in moderation. Try the Persian Kuku Sabzi. Or have your Spanish tortilla with a side of ratatouille.

An open sandwich on whole grain rye, with potatoes and both pickled and roasted onions is delicious, but also very, very good for you. Something happens to the potatoes when they cool down, and the onions develop different properties when they are roasted vs. pickled. Whole rye is always good. Butter and/or mayo.

Pickled heering on whole rye with raw onions and eggs is another super healthy lunch option, but I'm not sure you can get the right type of rye bread or heering.

Avocado on toasted sourdough with seeds and stuff is a cliché, but it is also a very good meal when you want to improve your health.

Peanutbutter on whole grain bread, with apple slices instead of jelly, is really good for you.

Both peanutbutter and avocado are high fat, for vegetables, but compared to a pork chop, they aren't fatty at all.

Spanakopita has a bit of carbs and fat in the pie crust, but mostly it is vegetables and cheese. At this time in my life, I'm making it with more and more herbs and different greens, so more like a hortopita, though still spinach based.
Which reminds me that you should perhaps look at Mediterranean cooking in general for inspiration. There are tons of recipes and a lot of them are vegetarian and relatively low fat.
posted by mumimor at 4:45 PM on November 12, 2022 [5 favorites]

Ugh, low fat is so hard.

1) my mom’s easy lentil soup recipe

1 cup lentils
4.5 cups water
Vegeta, 1/2 spoon, 1/2 spoon salt (my mom means like a soup spoon)
Green onions, 1 bunch, chopped
5 cloves garlic, minced
2 carrots, chopped

Boil then cook at medium 30 mins.

2) BRILLIANT answers were offered to a question I asked

https://ask.metafilter.com/362083/Safe-and-easy-to-maintain-cookware-for-very-low-fat-diet
posted by cotton dress sock at 5:02 PM on November 12, 2022 [1 favorite]

An easy thing to do also, when you’re tired, would be to get an air fryer, and do fish that way (if you can find a masala fish recipe you like that would be great), and then nuke some frozen veg and season that with lemon juice. I usually like green beans, because their texture is still ok after freezing. Or, shred cabbage and either stir fry that (with like a “better” oil) or have it as a salad. Or, get frozen spinach & garlic, nuke that, then cook that with a dairy substitute for “creamed” spinach.

To mumimor’s point, a serving of veg is just (usually) 1/2 a cup! So if you do 2 cups of green beans for dinner, which I don’t know about you but I can eat like nothing, that’s almost there. Have a tomato with breakfast and there’s your five.

Baked potatoes, also, with a better-for-you fat and 0% fat Greek yoghurt.
posted by cotton dress sock at 5:09 PM on November 12, 2022

Just want to say that soups in general are an easy way to make filling low-fat meals and to eat a lot of vegetables. Chilis would be the same. I used to put crackers on chili, but I've switched to roasted chickpeas, which can get really crunchy in the air fryer. (I've heard people say these get soggy after a few days, but mine never do, and I wonder if that's because I just skip the oil.) For me, making a soup and eating it over several days feels way easier than creating multi-ingredient bowls every night. If you're in a place where it's getting cold, soup is especially nice this time of year.

My favorite recipes are all vegan, and I really don't know if beans are OK for low carb (they're carbs, but so are carrots), but lots of people love Budget Bytes, and there are a lot of soup recipes on that site.
posted by FencingGal at 5:37 PM on November 12, 2022 [1 favorite]

Get rid of butter and cheese. Go with olive oil for everything. It is the type of carbs that makes the difference. Check out the glycemic index of foods. Cabbage is a miracle food, I make slaw with fried garlic and olive oil, pumpkin seeds and basil. Cool it that is part of the dressing. Slice cabbage in long, thin shreds, mix into the cooled oil and seeds, and add lemon juice, seaoned salt, chopped red or yellow peppers, add dill to taste, add cooked fish if you want, or cold chunks of rotisserie chicken. Find a mix you like. I add pasta to mine, and garbanzo beans at times. The idea is this is the whole meal. Lots of variety in it, and lots of long chain carbohydrate from the cabbage that make it to the large intestine and attract water to clear excess cholesterol out. Cholesterol is re-absorbed in the large intestine if we don't eat sufficient fiber. Oatmeal for breakfast without butter or oils, with blueberries, and nuts, daily will drop cholesterol levels by 10%. A good, high fiber breakfast helps keep the noon meal reasonable.
posted by Oyéah at 6:25 PM on November 12, 2022 [2 favorites]

As someone who loves dairy but whose lactose intolerance has decreased with age, I cannot say enough good things about Fairlife brand milk. Lactose free and so much tastier than the Lactaid brand milks.
posted by smorgasbord at 7:13 PM on November 12, 2022

Also - while I know you asked about diet and that should definitely be your main focus, in furtherance of your goal of kicking your bloodwork’s butt in a month, moderate cardio exercise is excellent at helping to lower triglycerides and bad cholesterol & increasing HDL, and at regulating blood sugar (especially if you can walk after dinner).

https://www.webmd.com/cholesterol-management/features/cholesterol-how-much-exercise

Definitely *moderate* exercise (vs HIIT or weightlifting) for blood sugar though, intense exercise can spike it (and watch carbs around workouts)

https://www.health.harvard.edu/staying-healthy/the-importance-of-exercise-when-you-have-diabetes

Lastly, if you drink coffee, use a filter!

https://pubmed.ncbi.nlm.nih.gov/22713771/
posted by cotton dress sock at 9:59 PM on November 12, 2022 [2 favorites]

Doctors get almost no education in nutrition and dietetics in medical school, so unless your doctor has specifically sought out education in that area, I'd try to set up an appointment with a registered dietitian (or whatever the equivalent of that is where you are, if you're outside the US). The fact that your doctor has been nonspecific about what diagnosis this treatment plan is meant to address, much less how it will work, concerns me, and leads me to believe the advice may not be science-based. A dietitian can look at your numbers and talk with you about the symptoms you're experiencing, and help you come up with a meal plan that will improve your quality of life without driving you crazy.
posted by decathecting at 7:56 AM on November 14, 2022 [3 favorites]

The fact that your doctor instructed you to eat a diet that is both low carb and low fat, without giving you a specific diagnosis or a dietician referral, is raising a lot of alarm bells. Eating both low carb and low fat at once is very difficult to do, and at a minimum requires a lot more guidance than it sounds like you’ve been given.

Generally a low fat diet is considered to have 30% or fewer of total calories from fat. If you use the most liberal definition of 30% and assume a 2000 calorie diet, that allows you 600 calories of fat (67 grams). Definitions of low carbohydrate diets vary, but if we go with a moderate low carb diet that would be 130 grams or less. If we again assume the most permissive option, that would put your carbohydrate intake at 520 calories (130 grams). That leaves you with 880 calories to make up the remainder of your diet, and having hit your max of carbs and fat that must all consist of protein. That’s 220 grams of protein per day at a minimum, or 44% of your calories, and is an off-the-charts high protein diet.

A 6oz salmon filet has about 35 grams of protein, so you’d have to eat a little over 6 of those every day. 6 oz of firm tofu only has 18 grams of protein, so you’d have to eat 12 of those servings, at least. 4 and a half pounds of tofu. A day.

There are some bodybuilders who eat protein in that range and are generally okay, but it’s not something you do overnight. Aside from digestive issues, it comes with real risks of kidney damage. Not what you’re hoping for, I’m sure, when you’re trying to make dietary changes for your health.

I would try to get clearer information from your doctor about what your lab values are and how outside of the norm, and what the goal is of these dietary changes, and request a dietician referral. Many doctors, as decathecting pointed out, do not have much in the way of nutrition knowledge, and it sounds like your doc is throwing a bunch of “healthy eating” ideas at you to see what sticks. I would hate to gave you make big dietary changes based on that, rather than on empirical medicine.
posted by bookish at 2:06 PM on November 14, 2022 [5 favorites]

Amplifying mumimor - it can feel a lot nicer making changes to your diet if you're focusing on what you want to eat MORE of, rather than what you want to avoid.

I'd recommend borrowing mumimor's tracking approach and just keep track of how many vegetables you can eat in a week. I've found that I really like things like peas with butter and cabbage with butter - and you really can use a pretty tiny amount of butter or olive oil if you're using it for flavoring on otherwise plain microwaved peas or corn. (I often use something like 4 or 5 grams of butter for 150 grams of peas.)

See if you can increase your vegetable intake for a few months in ways you really enjoy. If you can do that with moderate amounts of fat, and still enjoy them, I think that might help.

Good luck!
posted by kristi at 10:25 PM on November 14, 2022 [1 favorite]