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Remember that scene in Super Size Me - the one where Morgan Spurlock eats a McDonald's meal in his parked car? It made me so twitchy I contemplated leaving the theater. It's been years since I saw it, but thinking about how that scene made me feel inspired me to look up the carbohydrate load of a typical McDonalds meal:

Cheeseburger - 33g carbs
Small Fries - 29g carbs
12oz Strawberry McCafe Shake - 90g carbs

152g of carbohydrate. That's more carbohydrates than I consume in a typical day (and I'm not walking around hungry).

We live around the corner from Park Burger. Our kids love it (who wouldn't?) so we eat there a few times a year. I usually order the turkey burger, no bun, on a bed of greens. (No, I am not vegetarian.)

Not long ago, I emailed the restaurant and inquired about the number of carbohydrates in the veggie burger. I had eaten it once and it was delicious, but tricky to dose for - what exactly was in it, and in what amounts? What was used as a binder? Really, the carbohydrate and fiber information would be sufficient. The chef-owner replied in a very nice email that he was unable (unwilling?) to provide the information I was requesting. Alas, by that time, I'd thought so much about the veggie burger, that I really wanted one.
I  rallied my family for dinner, having decided to take my chances.

As soon as we sat down, I tested my BS: 83 mg/dL. A pre-meal ideal.

Service being quick, I wanted to dose immediately, and so began my quiet calculations. I recalled the burger as a grilled grain-and-bean-based patty, not enormous. But which grains and which legumes? Surely brown rice. Lentils? Black beans? I settled on 40g/carbs for the burger, plus 30g total for the beer, salad and my share of the fries, subtracted my best guess for total fiber, and in the end dosed to offset 62g/carbs. Conscious of the role fat plays in metabolizing carbohydrates, I didn't want to risk creating a stubborn, lingering high. So my estimate was generous. In a matter of clicks, I was set. And when dinner arrived, I savored every bite of that very fine burger.

Two hours post-meal, with some trepidation, I tested my blood. 83 mg/dL! Amazingly, the post-meal blood sugar exactly matched the pre-meal one. That lucky occurrence happens only a handful of times a year. And it makes me giddy, like I've won a prize.

There are dozens of reasons why I won’t hit the lucky numbers the next time I eat at Park Burger. Even if I eat the same meal at the same time of day and dose exactly the same, my pre- and post-meal numbers won't match. But for that one moment it was a thrill to experience a seamless surrogate pancreas.

This is a quick, healthy, and tasty breakfast for one. It's so easy my 6 year old makes it!

1) Crack an egg into a bowl and mix well.
2) Lightly but thoroughly coat the inside of a ramekin with olive oil.
3) Pour the egg into the ramekin.
4) Optional: add diced peppers, onions, jalapeño, chopped herbs, cheese...
5) Microwave on high for approx. 1 minute (microwave times vary).

Uncooked Egg
Uncooked Egg
Cooked Egg
Cooked Egg

 

Healthy Foods That Contain Hidden Sugar

Thanks, Networx.com, for the great infographic.

The case against sugar got another big boost, thanks to this study published in the February 27 issue of the online journal PLoS One. The peer-reviewed study provides strong evidence that increased sugar consumption leads to increased prevalence of Type 2 Diabetes (t2D).

The study examines data from the United Nations Food and Agricultural Organization and the International Diabetes Federation regarding the availability of sugar and prevalence of diabetes in 175 countries over a ten-year period. Results of the study indicate that increased access to sugar is associated with increased rates of diabetes, even when obesity is factored out. According to the study, for every 150 added sugar calories consumed (e.g., a 12-oz can of Coke), the rate of diabetes increases by 1.1%.

The study’s lead author, Stanford University's Dr. Sanjay Basu, concludes, “The bottom line is that this is one of several studies from independent scientific groups that have questioned the old mantra that ‘a calorie is a calorie.’ Some calories may be more metabolically harmful than others, and sugar calories appear to have remarkably potent properties that make us concerned about their long-term metabolic effects."

Another of the study’s authors is Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco. Dr. Lustig has been building the case against sugar for years. In 2011, his work was featured in the attention-grabbing New York Times Magazine cover article Is Sugar Toxic? His 2009 lecture Sugar: The Bitter Truth has over three million views on YouTube (two of those are mine - there’s a lot to absorb). In that video, Dr. Lustig details the science behind his concerns about sugar, specifically fructose. He explains that excessive intake of fructose – which is added to both refined sugar and high fructose corn syrup – increases insulin production which, in turn, disables the satiety hormone leptin. Instead of understanding that we’re full, our brains get the message that we’re hungry – starving, in fact. As a result, we eat more, expend less energy, and gain weight.

Dr. Lustig goes on to explain that much like alcohol (and unlike glucose), fructose can be metabolized only by the liver. Chronic, excessive fructose consumption over-taxes the liver and leads to non-alcoholic fatty liver disease and ultimately to chronic metabolic diseases such as obesity, hypertension, heart disease and type 2 diabetes.

I find Dr. Lustig’s work, including the aforementioned PLoS study, enormously encouraging. Positive food policy changes are beginning to feel inevitable. I am hopeful that fewer people might develop chronic metabolic diseases, including type 2 diabetes. And certainly for those of us already affected by diabetes (of whichever form), life will be less conspicuous, less isolating, and generally easier to cope with when the food landscape contains less added sugar.

At a recent annual physical, I was discouraged to see that despite a healthy diet and more frequent trips to the gym, I was gaining weight (the unwanted, non-muscular kind). “How could this be?” I asked my doctor.

Dr:   [glancing at medical record] Let’s see… oh, you’re turning 40 next week.
          Happy Birthday! And welcome to your 40-year-old metabolism.
Me:  For real? Doesn’t reaching my target A1c count for anything metabolically?
Dr:   Nope.
Me:  Here’s the thing: I don’t want to gain weight.
Dr:   Great! Do you count calories?
Me:  (Pause) No. I don’t count calories.
Dr:   Have you ever counted calories?”
MeNo. I count carbohydrates.

(She’s my endocrinologist. She knows I count carbohydrates. And fiber. She knows I consider exercise. And stress. And how much sleep I got last night. And what time of the day it is. And what day of the month it is. Every. Single. Time. I. Eat. Calories? Hell, no!)

DrOkay, so from now on you’ll count carbohydrates and calories.
(I’m sorry, did you not hear everything I just thought?)
Dr:  You get 1,500 calories per day. 50% carbs / 30% protein / 20% fat. Got it?

(Damn you, slowing metabolism, how dare you take more fun out of eating?
But… I don’t want to gain a pound a year either.)

Me:  Okay. I’ll do it. I’ll get an app.

That night I downloaded LIVESTRONG’s Calorie Tracker app and played with it for way longer than I should have. It's pretty cool. It incorporates a large database with nutrition info for most of the foods I eat. There’s a place to track exercise. At a glance I can see progress toward my daily calorie threshold. I like this app! It’s going to help me reach my goals. It’s even going to remind me to drink water. Awesome.

         

The following week, my schedule was dreamily predictable. I exercised, ate, worked, and slept at consistent times. I had complete control over the carbohydrates in my meals. There are were no unexpected twists, no curve balls. It was the perfect week to be a carb-and-calorie-counting diabetic.

But, really, who has weeks like that? Life is full of schedule-wreckers. Within three weeks I had fallen off the calorie-tracking wagon. And yet, I like Calorie Tracker and continue to reference it for counting carbs (and the odd calorie).

But as far as a strategy to prevent weight gain, it’s more time in the gym for me.
And maybe I'll consider drinking my coffee black.

Do you know the website Foodily?

You can use it to compare the nutritional content of different versions of a recipe. It's especially helpful if you cook for people with dietary (or gustatory!) constraints. Here's how it works:

Say you want to make tomato soup for a dinner party. And you want it to be low-fat and low carb. And one of the guests is allergic to dairy. You just input "tomato soup" and check the appropriate filters. In seconds, Moodily serves up a bunch of recipes that meet your criteria. The recipes are displayed in a side-by-side format (often with images), so it's ridiculously easy to compare ingredients and nutritional data, and determine which recipe is right for you.

One downside for me is how the nutritional content is calculated. It's calculated per recipe rather than per serving. That makes the site less helpful for calculating insulin dosages. (You can read here why Foodily doesn't generate per-serving data.) Even despite that shortcoming, I like the site a lot.

Thanks to Foodily, I'll be making this tomato soup tomorrow night.

Estimating portions is more fun with attractive cheat sheets, no?

estimating-portions-infographic
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