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Diabetes Diet

Good Veggies

When I began to eat a very low-carb diet in December, I was in for several surprises. The biggie was how easy low-carb eating is for me. I had long thought — and written — that it was hard to be satisfied without a heavy load of carbs. Experience taught me otherwise.

Another surprise was how many veggies I eat now. Like most folks, I assumed that a low-carb diet meant going veggie-less.

This article won’t go into my reasons for this huge dietary change, except to say that I wanted better control of my diabetes. Several of my articles here in the past couple of months tell how I was able to lose more weight on this diet.

I have indeed stopped eating any type and form of grains and lentils, which can be low-glycemic but are certainly not low-carb. Following a low-GI diet for the past dozen years, I have eaten almost no rice, no potatoes or other root vegetables like sweet potatoes and beets. I do eat carrots, which for years got a bad rap for supposedly being high-GI.

But the green leafy vegetables are very low-carb and nutritious. And I am learning that they can taste absolutely wonderful too.

Some of my favorite vegetables are the salad and cooking greens, carrots, red peppers, and okra. Now that I am low-carbing, I usually have a big salad for lunch and a side of cooked greens for dinner along with a quarter pound of fish, chicken, bison, or Quorn — or just the greens.

Unless I go for a huge helping, none of these lead me to exceed my chosen carb quota of about a dozen available carb grams per meal. It is the available carbs — in other words the starches and sugars but excluding fiber, which we don’t digest — that I pay attention to.

The late Dr. Robert Atkins likewise considered what he called digestible or net carbs in his books like Dr. Atkins New Diet Revolution.

So to do the Doctors Michael R. and Mary Dan Eades. They subtract fiber to get the “effective carbohydrate content” in The Protein Power Lifeplan.

However, it wasn’t clear to me after studying Dr. Bernstein’s Diabetes Solution by diabetologist Richard K. Bernstein, M.D., whether his recommendations for no more than 42 grams of carbohydrate per day included fiber or not. So I asked him.
“I use total [carbohydrates], because I feel that the indigestible part actually participates in the Chinese Restaurant Effect, now known as the incretin effect,” Dr. Bernstein wrote back to me. “Large meals will cause greater stretching of the intestinal cells that release hormones into the bloodstream when they are stretched, as after a meal,” he wrote in his book about the Chinese Restaurant Effect.

Dr. Bernstein’s allotment of carbohydrates for himself and his patients is low. He makes the point in his book that carbohydrates “are totally nonessential to your health and well-being….There is no such thing an an essential carbohydrate for normal development, despite what the popular press might have you believe.”

Then, why eat any carbohydrates, which are of course the main culprit in raising the blood glucose level of anyone who has diabetes?

“The main reason I don’t suggest that you avoid all carbohydrate,” Dr. Bernstein writes, “is that there are many constituents of vegetables — such as vitamins and minerals, but also many other non-vitamin chemicals (phytochemicals) — that are only recently becoming understood, but that are nonetheless crucial to diet and cannot be obtained through conventional vitamin supplements.”

So, when I began to eat low-carb I simultaneously began to seek out the best veggies. To do that I consulted the best sources that I know.

First, is The World’s Healthiest Foods, sponsored by the George Mateljan Foundation.>That website lists 36 healthy vegetables. It’s a start, but it includes several high-carb vegetables and doesn’t say why the chosen three dozen veggies are the healthiest.

So, next I turned to an analysis of “The Healthiest Vegetables” according to “Nutrition Action Health Letter.” It ranks 53 vegetables, scoring them for their carotenoids, Vitamin C, folate, potassium, calcium, iron, and fiber. But this list too includes several vegetables that are too high-carb for me.

From there, however, it was easy to make my own list. Why do this? Because I wanted to broaden my horizons to include vegetables that I had passed up before.

In fact, the healthiest of all vegetables, according to “Nutrition Action Health Letter,” is one that I had never prepared before: collard greens, with a score of 461. Eventually, I learned how to simmer it for hours together with a ham shank to make something incredibly delicious.

The number 2 vegetable, spinach, with a score of 424, is one that I eat both raw and cooked. Like collards, and number 3 kale (score 410) and number 4 Swiss chard (322) all of these green leafy vegetables pair extraordinarily well with ham or bacon or other smoked meat and vinegar (a tip I picked up from Ruth Reichl’s Gourmet Cookbook).

Then comes red pepper (score 309), which I usually add to my salad but is also great cooked. Skipping a couple of high-carb veggies, the list then goes to carrots at 241 and broccoli at 179.

Next in order are okra, 165; Brussels sprouts, 143; lettuce, 141; and asparagus, 84. I was surprised that tomatoes and avocados, two honorary vegetables (technically fruit), ranked at 76 and 71 respectively. Wonderful cauliflower ranked even lower at 64, cabbage at 44. Near the bottom of the list are cucumber, eggplant, mushrooms, and alfalfa sprouts.

These numbers are, of course, not gospel. They make a big assumption — that the micronutrients that we know are the ones that we need, when in fact we are learning more about nutrients every day. We don’t even have a Daily Value (DV) for carotenoids, so “Nutrition Action Health Letter” made up its own. It doesn’t even consider the amount of omega-3 fatty acids, which is one of the main nutritional reasons to eat a lot of green leafy vegetables. But what this list did for me — and can do for you — is to focus more attention on them.

My attention went in that direction anyway after reading Michael Pollan’s In Defense of Food. He notes there that when we largely switched from eating leaves to seeds (as in grain), the problems with the so-called “Western Diet” began. It is indeed striking how many of the top veggies are leaves.

“Leaves provide a host of critical nutrients a body can’t get from a diet of refined seeds,” Pollan writes. “There are the antioxidants and phytochemicals; there is the fiber; and then there are the essential omega-3 fatty acids found in leaves, which some researchers believe will turn out to be the most crucial missing nutrient of all.”
To round out my list of the best low-carb veggies I went carefully through the 800-plus pages of The Complete Food Counter by Annette Natow and Jo-Ann Heslin to determine which ones have less than half a dozen available carb grams in a 1/2 cup portion. But then I realized that this book has some substantial differences from the authoritative source, the “USDA National Nutrient Database,” which I use here instead to show the results for the highest ranking low-carb foods named by “Nutrition Action Health Letter:” Collards, cooked, boiled, drained, without salt, 1/2 cup: 2 grams of available carb Spinach, cooked, boiled, drained, without salt, 1/2 cup Spinach, raw, 1/2 cup: less than 0.5 Kale, cooked, boiled, drained, without salt, 1/2 cup chopped: 3 Chard, swiss, cooked, boiled, drained, without salt, 2 Peppers, sweet, red, raw, 1/2 cup chopped: 3 Peppers, sweet, red, cooked, boiled, drained, without salt, 1/2 cup chopped: 4 Carrots, raw, 1/2 cup chopped: 4 Carrots, cooked, boiled, drained, without salt, 1/2 cup slices: 4 Brocolli, raw, 1/2 cup chopped or diced: 2 Broccoli, cooked, boiled, drained, without salt, chopped: 3 Okra, 1/2 cup cooked, boiled, drained, without salt: 2 Brussels sprouts, cooked, boiled, drained, without salt, 1/2 cup: 4 Lettuce, butterhead (includes boston and bibb types), cos, romaine, green leaf, or red leaf, raw, 1/2 cup shredded : less than 0.5 Asparagus, cooked, boiled, drained, 1/2 cup: 2 Tomatoes, red, ripe, raw, year round average, 1/2 cup chopped or sliced: 2 Tomatoes, red, ripe, cooked, 1/2 cup: 4
Avocados, raw, all commercial varieties, 1/2 cup sliced: 1 Artichokes, (globe or french), cooked, boiled, drained, without salt, 1/2 cup hearts: 1 Cauliflower, raw, 1/2 cup: 1 Cauliflower, cooked, boiled, drained, without salt, 1/2 cup: 1 Cabbage, (including Chinese (pak-choi or bok choy), cooked, boiled, drained, without salt, 1/2 cup shredded: 1
I grew up with some disdain of leafy vegetables as “rabbit food.” Maybe we all did.

The first reference to lettuce as rabbit food dates back at least to the 1930s. Considering how wrong everyone from the medical establishment on down has been about nutrition in general, it’s not a surprise that we have also been wrong all along about leafy vegetables.

This article is based on an earlier version of my article published by HealthCentral.

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  • Saana at

    I am very happy to hear from you and thanks a lot for your prompt reply.I myself trying to search for low carb but of course my research is very limited so i hope you wont mind if i bother you most often.
    To my surprise you replied that cottage cheese is not so good so my immediate action would be NO to cottage cheese.
    Yes bottled camel milk is available here so i will start that,it would be ok if i take one glass daily?
    As far as the oil is concerned i use olive oil for cooking.
    And please comment on the intake of black tea with milk.I take that twice a day.I used the artificial sweetener in tea but now i am trying to avoid that too.

  • Saana at

    Hi,Sana from UAE.I have a family history of diabetes and im PCOd too.so obviously insulin resistant.Could you please guide me which cheese can i have?i am a normal weight person so when i avoid wheat and carbs i become very thin.But i think i should not eat them.2ndly comment about normal milk intake.
    I tried fenugreek powder to control blood sugar levels.It do work a bit.Please comment. Moreover i love your wesite…its like a fresh air in the blunt tunnel of diabetes.

    • David Mendosa at

      Dear Sana,

      Thank you. I really like your phrase, “fresh air in the blunt tunnel of diabetes.”

      All hard cheeses and many soft cheeses are great by almost all standards. The exception is if you follow the Paleo Diet, which avoids everything that our ancestors didn’t eat before the agricultural revolution. I try to mostly follow the Paleo Diet, but to control my diabetes I very closely follow a very low-carb diet. And hard cheeses almost never have any carbs (a soft cheese like cottage cheese is not low carb). Personally, I like cheese too much so that I eat too much of it when I have it in the house, so I seldom buy it. When I eat too much of it, I gain weight — but that is exactly what you need to do. I do regularly eat plain unsweetened Greek yogurt (also known in your part of the world as labneh, labni, or lebni). Yogurt and kefir, being fermented foods with probiotics, are even better for us than cheese.

      I would not suggest eating carbs to gain weight. Particularly avoid wheat, which has a lot of toxins (if you get a chance, do read William Davis’s book, Wheat Belly, which I reviewed very positively here). I do question whether we should drink milk once we are weaned. However, I am becoming interested in camel milk, which you might have a lot easier time getting where you are than I can here in the Rocky Mountains.

      The way to increase your weight is to eat more fats. Avoid transfats, of course, and also polyunsaturated fats except for that in fish and fish oil (omega 3 fatty acids). I have begun to consume about three tablespoons of coconut oil each day because of all the good things that I hear about it (I haven’t written about it yet, because I am still researching it). But I absolutely know that the fats in avocados are great for you. And, of course, I always recommend nuts, particularly raw almonds and pecans and macadamia nuts, to anyone who wants to gain weight on a very low-carb diet.



  • Arun at

    Oops!…the last sentence above should read …..but not eliminated them altogether.


  • Arun at

    Thanks David. I have totally avoided table sugar, and thankfully high fructose corn syrup is not available in this part of the world. I am already beginning to see appreciably lower BG readings, both fasting and 2 hours after meals. Hopefully I should see an improvement 2 months down the line. I have drastically cut down my portion of fruits but eliminated them altogether.


  • David Mendosa at

    Dear Arun,

    You need some protein and quite a bit of fat in your diet, certainly not “veggies alone.” What you don’t need, and can safely cut out is starch, from grains like wheat and corn, and fructose, from table sugar and high-fructose corn syrup.


  • Arun at

    Hi David,
    I seem to be getting confused a bit. Please help me. I am from India and my latest a1c read 6.8. I have already a couple of comments on your blog including my effort to reduce a1c without medication to say 5.5. I am making a step by step reduction, though steep from my regular intake of high carb meal, that is rice and whole wheat rotis (though diabetologists in our country ask rice eating diabetics to switch over to whole wheat rotis). At the moment I am not sure whether I can switch over to veggies alone. I propose to have a combi of green veggies + a cup of lentils (boiled). The lentils available here are varied and plenty. Am I making a horrid mistake ? Thanks for your help.