Vegetables offer an amazing variety of flavors,colors,and textures.But there’s more to vegetables than just their great looks and tastes.A basic principle of the Atkins Blood Sugar Control Program (ABSCP) is that you trade in low-quality, low-nutrient foods (such as refined carbohydrates) for high-quality, high-nutrient foods—and the majority of vegetables fall into the latter category.
Simply replacing poor-quality carbs with high-quality veggies may be enough to make an improvement in your blood sugar. It’s a winwin situation: When you begin eating a greater variety and quantity of vegetables, you realize that they taste so good you won’t really miss re- fined carbs. Plus, vegetables are packed with the nutrients that are missing in most refined carbohydrates. And they’re a rich source of fiber, which can help to stabilize your blood sugar levels. If your daily carb allowance will let you, you can also enjoy many of the same benefits from low-glycemic fruits.
LAYING THE FOUNDATION
Fresh vegetables and low-glycemic fruits are important in the ABSCP because eating these foods can help stabilize your blood sugar—if you eat them instead of refined carbohydrates. People who choose to eat this way early on may actually protect themselves from developing blood sugar problems.
RESEARCH REPORT: VEGETABLES AND HEART HEALTH
In addition to helping to prevent and treat diabetes,all those servings of asparagus, broccoli, cauliflower, and their kin are essential for helping prevent cardiovascular disease. If you have the metabolic syndrome, prediabetes, or diabetes, you know your risk of heart disease and stroke is sharply elevated—and you can use all the help you can get in this area. Let’s look at the results from a recent study that examined the connection between vegetable and fruit intake and the risk of cardiovascular disease.The study,published in 2002 in the American Journal of Clinical Nutrition, looked at almost 10,000 adults who had been followed for nearly 20 years as part of the first National Health and Nutrition Examination Survey.1
Among the study participants, those who ate vegetables and fruits three or more times per day had a 42 percent lower risk of dying from a stroke compared with those who ate produce once a day or not at all.The produce eaters also had a 27 percent lower risk of dying from cardiovascular disease, a 24 percent lower incidence of death from clogged arteries causing heart disease, and a 15 percent lower risk of dying from any cause.2
A study published in 1999 helped to provide more support for the importance of eating vegetables.Eleven hundred subjects completed a food frequency questionnaire and underwent a glucose tolerance test. Those who ate salad and raw vegetables had significantly less incidence of Type 2 diabetes and impaired glucose tolerance than those who ate salad and raw vegetables infrequently. Notably, there was not a statistically significant difference recorded in glucose measurements for those who ate fruit.3 This confirms the benefits Dr.Atkins observed in his patients when they consumed the minimum recommended amount of vegetables. When you’re doing Atkins properly, of course, you should be eating a minimum of five servings of vegetables a day.
VEGETABLES AND BLOOD SUGAR
What is it about vegetables that makes them so good for you? Well, they are generally pretty low in carbs, and almost all nonstarchy vegetables are both low on the glycemic index (GI) and low in glycemic load (GL). Just by replacing high-carb, high-GL foods with low-carb, low-GL foods—substituting broccoli for a baked potato, for instance—you will improve your blood sugar levels. But there’s more to it than that. What may be just as important is that these foods are packed with fiber, antioxidants, vitamins, minerals, and phytonutrients. We know that these nutrients are particularly important if you have the metabolic syndrome, blood sugar abnormalities, or diabetes.
FANCY FRUIT—IN MODERATION
Now let’s take a detour to talk about fruit, before we return to vegetables. Overall, fruits are higher in carbs than an equivalent serving of vegetables.That’s why when you do eat fruits,you should have them as a snack with a food containing protein and fat, or eat them as dessert after a meal that contains protein and fat. Doing so helps keep the sugar in the fruit from entering your bloodstream too quickly. To avoid getting too many carbs from fruits, be aware of portion size. A typical fruit portion on the ABSCP is one small apple, half an orange, or a ½ cup of red grapes or blueberries.
When you get to the point in the program where you can add fruits, begin with those on the “eat regularly”list of the AGR (check the AGR charts beginning on page 467). If you need to limit your carbs, these foods must now be only occasional treats that are always eaten with protein and fat. The few fruits, such as bananas and raisins, that fall into the “eat sparingly” category are basically off-limits if your carb threshold is 60 grams of Net Carbs a day or less.
When you begin to add fruit to your diet,start with only a few servings a week, carefully observing your symptoms and blood sugar response. If you notice that your blood sugar goes above 140 mg/dL 90 minutes after a meal,or if you experience sensations that you associate with blood sugar ups and downs, then hold off on fruit. Perhaps your metabolism has not yet improved enough to allow the level of natural sugar in fruits.In that case,if you’re at the stage where you want to add more carbs to your daily allowance,opt for more low-glycemic vegetables instead and then try adding small amounts of fruit again at some point in the future.
If your insulin/blood sugar metabolism is severely compromised, you may at best tolerate only one serving of fruit a day.As time goes by and your insulin/blood sugar improves, you may be able to increase the amount of fruit you eat, but you’ll probably always have to be aware of portion size.
WHAT’S A SERVING?
We strongly recommend that you eat,at the very least,five servings a day of fresh low-glycemic, low-carb vegetables—more if your daily carb budget allows. We also recommend that if you are consuming between 20 and 40 grams of Net Carbs a day,you eat no more than two daily servings of fruit (other than olives, avocados, or tomatoes, which are regarded as vegetables even though they are actually fruits). What’s a serving? In the ABSCP,a vegetable serving is 1 cup of raw leafy greens or1/2 cup of cooked nonstarchy vegetables, such as broccoli or Brussels sprouts. In the case of vegetables like tomatoes or spinach, which cook down significantly,be sure to measure them raw to avoid overconsumption of carbs.A fruit serving is one small fruit,such as an apple,or ½ cup of berries. Be aware of portion size and check your carb gram counter when in doubt.
HOW ARE WE DOING?
After more than a decade of advertising and public education about the nutritional value of vegetables and fruits,how is the average American doing? Not that well. Between the years 1990 and 1996, according to a 2000 study,only about 45 percent of Americans actually ate five or more servings a day.This is up from 32 percent between 1989 to 1991.4 That is an improvement, yet more than half of American adults are still below the minimum recommended amount.
But here’s the bad news: The nutritional quality of those fruits and vegetables is still low. Only five fruits and vegetables accounted for 30 percent of consumption: iceberg lettuce, tomatoes, French-fried potatoes, bananas, and orange juice. In other words, a significant portion of the fruits and vegetables the average American eats is either very low in nutrients (iceberg lettuce) or high in carbohydrates (bananas and orange juice), or both (French fries). While tomatoes are fairly low in carbs and are a good source of vitamin C, lycopene, and fiber, the average daily amount eaten was only half a standard serving, or about the amount that comes on top of a fast-food burger.
In the same study, the researchers found that for the average person, white potatoes represented 30 percent of total vegetable intake. Of that 30 percent, one-third was French fries. By comparison, broccoli made up only 0.4 percent of vegetable intake. Only 3 percent of the population eats any broccoli on any given day! Although nutritionists classify the potato as a vegetable, it really belongs in the same category as other high-GI carbohydrates such as pasta. In terms of glycemic response, eating potatoes is almost exactly the same as eating an equivalent amount of pure sugar. In fact, it’s worse—a baked potato or a serving of French fries will spike your blood sugar and insulin levels even faster and higher than eating a candy bar.5
How does your intake of vegetables and fruits compare with that of the average American? If you’re following the Atkins Blood Sugar Control Program properly, you rank far above average. Your intake of high-quality vegetables is not only significantly higher,it’s significantly more varied.And that means you’re getting above-average amounts of a variety of vitamins, minerals, antioxidants, and phytonutrients that are known to help your body fight off virtually all the most common life-threatening diseases.
VARY YOUR VEGGIES
Okay, it is understandable that broccoli and spinach may not be your favorite foods. And even favorite foods can get a little dull if you eat them all the time. To keep your taste buds happy, go for variety. Today there’s a whole world of interesting vegetables in the produce section of just about every supermarket. Bored with Brussels sprouts? Try chayote (a sort of squash from Central America), snow pea pods, or turnip greens. Or try a mix of different vegetables, in a stir-fry, for example.You’ll be happy to know that fiber isn’t really affected much by cooking. In fact, many high-fiber vegetables are more digestible when they’re cooked, so try adding them to soups, stews, and casseroles— there are some great vegetable recipes in Chapter 27, as well as at www.atkins.com.
We prefer that you not drink most veggies or fruit—you lose a lot of the valuable fiber that way. Fruits are much higher in carbs, mostly in the form of fructose, and dumping all that sugar into your bloodstream can really make your blood sugar jump. Be wary of fruit juice “drinks,”which often contain a tiny amount of real fruit juice and lots of water and sugar, in the form of high-fructose corn syrup.6–8
ANTIOXIDANTS AND FREE RADICALS
Every second of every day, the trillions of cells in your body are hard at work.One of their jobs is to create energy by burning glucose or fat for fuel.A perfectly normal by-product of this process is the free radical— an unstable atom missing an electron. When an atom is missing an electron, it blunders around, looking for another electron it can grab—and often it steals that electron from another molecule and damages it in the process. To quench free radicals before they can seize electrons from places where they might do damage, your body employs antioxidants. These chemicals capture the free radicals and, in a complex series of steps, quickly neutralize them. To ensure that this defense team can do its job properly, your body needs plenty of vita- mins—particularly beta-carotene (the natural precursor to vitaminA), vitamin C, and vitamin E—and trace minerals, especially selenium and zinc.
SALAD DAYS
When you do the ABSCP, you can and will—and should—eat a lot of salad. Salads are a great way to get more of those fiber-rich leafy greens we keep talking about without racking up a lot of carbohydrates.In general, 1 cup of any salad green has less than 1 gram of Net Carbs.You also get to dress those salads with your favorite low-carb dressings. That gives you a good way to get in the good fats,like olive oil.(See Chapter 12 for more on the value of dietary fats.)
Unfortunately, the most commonly eaten salad green is iceberg lettuce—the variety that’s probably the lowest of all in terms of fiber and nutrients.It’s hard to escape this bland lettuce when you eat out,but you can easily make your salads at home a lot more interesting and nutritious by trying the many other lettuce varieties now available in the produce section. You can also add extra fiber, nutrients, and taste to your salads by tossing in some nuts and seeds—slivered almonds and sun- flower seeds, for example—but only if you stay within your daily carb gram allowance.
Everyone produces free radicals all the time; they’re a normal part of your metabolism, and for the most part your body is able to cope with them. The process of metabolizing big doses of carbohydrates, however, generates oxidative stress by producing an abundance of free radicals. Excess body fat also adds to your free-radical production and puts a strain on your body’s antioxidant system. In addition, if you’re overweight and you’ve become insulin resistant (even if you don’t know it yet), you may have excess glucose circulating in your bloodstream, and that causes a lot more free radicals and oxidative stress. Many researchers believe, in fact, that oxidative stress from free radicals plays a big part in many of the complications of diabetes and also in heart disease. Oxidative stress may also speed the destruction of the insulin-producing beta cells in your pancreas.9
Free radicals also are involved in the formation of what are known as advanced glycosylation end products, or AGEs. Over time, glucose attaches to proteins in your body and gums them up. The results, the AGEs, are believed to damage tiny blood vessels in your eyes, kidneys, and elsewhere. Many researchers believe that free radicals participate in this process, too.10
Of course, losing weight and getting your insulin and blood sugar under control are the clearest ways to reduce free-radical production. Eating antioxidant-rich fresh vegetables and fruits within your individualized carbohydrate limit can help, too. If you implement the ABSCP, your production of free radicals should drop automatically, because your oxidation of carbohydrates drops.11 (Supplements can help too—we’ll discuss them in more detail in Chapter 20.)
RESEARCH REPORT: ANTIOXIDANTS AND THE METABOLIC SYNDROME
A recent study comparing adults with and without the metabolic syndrome showed that those with the syndrome had low levels of important antioxidants, especially vitamin C and vitamin E. The researchers agreed that in addition to nutrient-dense foods, supplements could be beneficial in raising antioxidant levels in adults with high oxidative stress caused by the metabolic syndrome.12 As you know, controlling carbohydrates goes a long way toward controlling the metabolic syndrome.Carbohydrate-laden diets (filled with foods such as French fries) fuel the fire of oxidative stress, using up antioxidants at a high rate. On top of that, you’re not getting enough antioxidant nutrients to begin with, because all those refined carbohydrates have had most of their nutrients processed out of them. This dangerous combination—higher levels of oxidative stress, lower antioxidant intake—causes further blood vessel injury.
THE ATKINS RATIO
All vegetables and fruits contain good amounts of antioxidants, but some contain more than others. If you’re watching your carbs, you want to choose the vegetables and fruits that are highest in antioxidants and lowest in carbohydrates. Figuring that out on your own would be a complicated exercise in chemistry, so we’ve done it for you by listing the Atkins Ratio for the top ten vegetables and fruits (see page 208). This ranking tells you how much antioxidant bang you get for your carbohydrate buck. (The higher the Atkins Ratio, the greater the antioxidant content relative to the carb count.) Whenever you can, choose at least two of your daily vegetable servings and at least one of your fruit servings from these foods,provided that you do not notice a change in your blood sugar level or associated symptoms. (For drinks that are high in antioxidants, see Chapter 19.)
OTHER GOOD STUFF
Magnesium
Fiber and antioxidants are reason enough for veggies and fruit to be valuable foods on the Atkins Blood Sugar Control Program, but there are even more reasons. Here’s one good one: Overall, vegetables and fruits are good sources of the mineral magnesium. For reasons that aren’t fully understood, many people with diabetes and blood sugar abnormalities are low in magnesium, which is needed for a wide variety of normal body processes (we’ll talk more about the role of magnesium in Chapters 20 and 21).13 Adding magnesium to the diet may help you control your blood sugar better. Good choices include broccoli, okra, spinach, and Swiss chard. Nuts and beans are also good sources of magnesium, as are fruits, but they’re not as rich a source as vegetables—and beans are relatively high in carbs.
Phytonutrients
Every plant food also contains a large number of other natural chemicals that go under the general heading of phytonutrients or, sometimes, flavonoids. These substances are often what give a food its characteristic taste and color—and they also have numerous health bene- fits. The phytonutrient list is long and getting longer all the time as research continues in this exciting area. Here are just a few beneficial phytonutrients:
VEGETABLES
FOOD | ATKINS RATIO | TOTAL CARBS | NETCARBS |
|
| (GRAMS) | (GRAMS) |
Garlic (1 clove) | 23.2 | 1.0 | 0.9 |
Leaf lettuce (1 leaf) | 8.2 | 1.0 | 0.5 |
Kale | 6.5 3.4 | 2.1 | |
Onion (1 tablespoon) | 6.2 | 1.1 | 1.0 |
Spinach | 5.0 | 5.1 | 2.2 |
Broccoli | 3.2 | 4.9 2.2 | |
Red bell pepper (raw) | 2.5 | 4.8 | 3.3 |
Brussels sprouts | 2.3 | 6.8 | 4.7 |
Beets | 2.1 | 6.1 | 4.7 |
Cauliflower | 1.8 | 2.6 | 0.9 |
|
All servings are ½ cup cooked unless otherwise noted. | |||
FRUITS | |||
Blueberries | 2.3 | 10.2 | 8.3 |
Strawberries | 2.3 | 5.1 | 3.4 |
Blackberries | 2.2 | 9.2 | 5.4 |
Plum | 1.0 | 3.7 | 3.3 |
Orange | 0.8 | 10.6 | 8.4 |
Kiwifruit | 0.5 | 11.3 | 8.7 |
Pink grapefruit | 0.5 | 9.5 | 7.8 |
Red grapes | 0.5 | 14.2 | 13.4 |
Tomato | 0.5 | 4.2 | 3.2 |
Green grapes | 0.4 | 14.2 | 13.4 |
|
All servings are ½ cup raw. |
- Lycopene. Found abundantly in tomatoes, lycopene may help prevent prostate cancer.
- Resveratrol. Red wine and red grapes are the best source for this phytonutrient; high levels in your blood are associated with a reduced risk of heart disease.
- Quercetin. This powerful antioxidant is found in onions and garlic; it can also be helpful for allergy relief and to enhance the immune system.
- Lutein and zeaxanthin. These phytonutrients, found in dark green leafy vegetables such as kale and collard greens, can help protect your eyes against age-related macular degeneration, a leading cause of blindness in older adults.14
All this and more are the bonus you get from eliminating low- quality carbohydrates and replacing them with high-fiber, nutrient- rich plant foods.
Need we say more? We don’t think so—the evidence is pretty convincing. And now that you’ve got a good grasp of why you need to eat those fresh leafy greens, in the next chapter we’ll move on and explain how to choose other good carbs.
WHAT’S YOUR VEGGIE IQ?
1. A standard serving of a cooked vegetable is:
- 1 pint
- 9 pieces
- 1/2 cup
- 100 grams
2. Vegetables are a good source of:
- dietary fiber
- vitamin C
- magnesium
- phytonutrientse.
- all of the above
3. Which vegetable is not on the low-carb,low GI/GL list:
- Brussels sprouts
- broccoli
- potato
- salad greens
- cabbage
4. The top five vegetables for antioxidant power are:
- zucchini
- cabbage
- garlic
- leaf lettuce
- onions
- string beans
- kale
- cauliflower
- spinach
- carrots
Answers 1.Trick question—c (American units) and d (metric units) are both
correct.2.e.3.c.4.c,d,e,g,i.
MAN ON A MISSION
Since childhood, Steve Horstman battled futilely to lose weight. Once he realized he was a carb addict and well on his way to diabetes, he took the steps necessary to win back his life.
I started doing Atkins on April 28, 1999. I’ll never forget that date—for me, it has the same importance as the days your kids are born. I’d carried extra weight even as a child and had tried every diet in the world. But I’d always lose/regain, lose/regain. In the late eighties, I actually had the most success. I got myself down to 200 pounds by starving myself. Looking back, I was also eliminating carbs without knowing it. But I was so hungry all the time I just couldn’t stick to it. I became a cynic about all diets.
One day I noticed that my wife, Melissa, had bought Dr. Atkins’ New Diet Revolution and put it on top of my dresser without saying anything.Well, it just sat there for two days. I happened to be home on a day off having lunch, which I remember was six hot dogs with buns and two cans of Coke. I like to read while I’m eating, so I decided to take a look at the book. When I finished the chapter “Is This You?” I said, “Wow! That is me.” By 6:30 that evening I had read the entire book twice and started it a third time when I called my wife at work. “We are going to try this diet.” She splurged and brought home steaks and lobster tails for our first Atkins dinner.
The next day I weighed myself at a local store in our town of Burlington, Kentucky, a suburb of Cincinnati, which had an old-fashioned grain scale. I already knew that conventional scales don’t exceed 300 pounds, so this was my only option. I thought I’d weigh in a little over 400 pounds. The scale read 571 pounds. I also had a 70-inch waist and had begun to develop all the signs of Type 2 diabetes.
BEFORE AFTER
NAME: Steve Horstman
Age: 37
Height: 6 feet 1 inch
Weight Before: 571 pounds
Weight Now: 250 pounds
Total Cholesterol Before
(6 months in): 230
Total Cholesterol Now: 151
LDL Now: 85
HDL Now: 66
Triglycerides Now: 132
Blood Pressure
(6 months in): 140/90; resting heart rate: 88
Blood Pressure Now:
115/65; resting heart rate: 56
Even though I was still very skeptical about the program, I decided to give it a try, staying at or under 20 grams of Net Carbs per day as required in the Induction phase. Weighing in on the same scale nine days later, I realized I had lost 30 pounds. “Okay, that’s it; I’m hooked,” I said.
Then I found an electronic scale that could handle my weight at a GNC store. I went there every day to track my progress. Within the first two months, I had lost 100 pounds. That’s when I started exercising by walking to the end of my block and back, stopping to rest halfway each way. The first year, I stayed on Induction for the entire time and lost 273 pounds. I’ve been watching carbs at the Ongoing Weight Loss level since then and have lost an additional 48 pounds. I still have 25 pounds to go to reach my goal weight of 225.
It amazes me now to think about what I used to eat. I skipped breakfast, but for lunch I’d go to a fast-food restaurant and consume four sandwiches, two large fries, and a large Coke. Then I’d go to another fast-food restaurant,eat three or four more sandwiches,maybe a bag of onion rings, and another large Coke. I made two stops because I was embarrassed by the amount I was eating and I was looking for taste variety, too. I would down four or five peanut-butter-and jelly sandwiches or a bag of Doritos while waiting for the lasagna and garlic bread I would have for dinner to be ready. I probably drank the equivalent of 12 large Cokes per day.
Now I’ve really developed a taste for veggies. Broccoli, cauliflower, as-paragus, spinach, mixed greens—these are all new foods for me. Even though I hate the cold days in winter, I continue to walk with my wife, Melissa, who has lost about 100 pounds herself on Atkins, with 35 more pounds to go. We shoot for three to four miles, five to six days per week. I know I need to add some more aerobic activity to get my heart rate up, and I plan to do so.
It is absolutely fun to go shopping for clothes now. I used to have to get everything by mail order. It was a pretty big day for me when I finally shopped at a regular department store and bought a real pair of blue jeans without an elastic waistband. My waist is now 38 inches. I’ve gone from a 6X to an extra-large shirt. My shoe size has dropped from a 14 to an 11½. And my ring size has gone from a 14 to an 11½. I had been wearing my wedding ring on my thumb!
I’ve been working in restaurant management for most of my career. Recently, a young lady came in to apply for a job at my location. “Do you know who I am?” I asked. “You worked for me for four years,” I said. I showed her my ID and she was so happy about how I looked she started crying and gave me a big hug.
I’ve actually become a bit of a celebrity, appearing on the Today show and the area news.About a week after I appeared locally,I was shopping for groceries and bought a lot of Atkins products. I started talking to the manager, who happened to be at the register, and I asked her if low-carb products were selling. “Can’t keep it on the shelves since that guy from around here was on TV.”“I’m that guy,”I said,and she asked me for my autograph!
I have helped counsel about 100 people through the approach. Everybody who does Atkins—and does it right—loses weight. I’ve turned into a walking carb-counter. I help other people find the hidden carbs in what they have been eating.“You can lie to everybody, but you can’t lie to yourself,” I tell them. My three kids are really proud of me.When my youngest, a nine-year-old, sees an old picture of me, she can’t remember that I looked so fat. Diabetes, heart attack, stroke—I might not be here for my kids today if it wasn’t for Atkins.
Note: Your individual results may vary from those reported here. As stated previously, Atkins recommends initial laboratory evaluation and subsequent follow-up in conjunction with your health care provider.