Low Carb Cheese Cake

My amazing wife, among her many talents, makes a wonderful low carb cheese cake.  She has taken the recipe found in Maria Emmerich's "Secret Weight Loss Recipes" and modified it to our family's taste.  It has quickly become one of my family's favorites. 

Low Carb Cheesecake = 1 gram carb per serving
Individual spring-form serving pans

Crust:

2 cups almond flour

1/4 cup coconut flour

1/2 cup butter melted

Pinch of salt

1/2 cup erythritol

Mix and press into spring-form pan.

5 (8 oz) packages cream cheese, softened

1 cup erythritol and 1 tsp liquid Stevia

1 TBS vanilla

1/2 cup whey Protein

1 cup sour cream

3 eggs

Preheat oven to 350F. Mix cream cheese, sweetener, protein and vanilla with an electric mixer

until blended. Add eggs one at a time, mixing on low after each until blended. Blend in sour

cream and pour over crust. Place a pan of water on the lower rack place cheesecake on rack

above. Bake for approximately 45 minutes until set. Watch carefully! 

Refrigerate overnight.

Freezes well too!

My wife will often bake them in individual sized pans (as in the picture above) so that I can pull one out of the freezer, let it thaw and cover it in whip cream and a sprinkle of berries.  Tastes fantastic!

One serving is = 1 gram of carbohydrate.

Green Eggs & Ham . . . I like them, Sam I Am!

You know, Dr. Seuss was right, the whole egg is actually good for you.
A recent study from the University of Connecticut demonstrated that eating the whole egg actually decreases LDL (the bad cholesterol) sub-particles and insulin resistance in Metabolic Syndrome better than the egg white or the egg substitute. 

I like green eggs and ham!
I do!! I like them, Sam-I-am!
And I would eat them in a boat!
And I would eat them with a goat...
And I will eat them in the rain.
And in the dark. And on a train.
And in a car. And in a tree.
They are so good so good you see!

Fat Thoughts on Cholesterol . . .

As a medical bariatrician and family practitioner specializing in low-carbohydrate diets, I often see the panic stricken look on people's faces when they look at their cholesterol profiles just after starting a carbohydrate restriction life-style.  

First, it is very important to understand that if you check your cholesterol within the first 4-6 weeks of dietary changes, there will be a transient rise in the cholesterol profile as your adipose tissues (fat cells) release your new fuel source into the blood stream and the mitochondria in the one trillion cells in your body convert from the use of glucose to the use of ketones (derived from triglycerides) as the primary fuel source.  This is not a problem as the body is designed to handle this increase in triglyceride and cholesterol. I explain to patient's that we are essentially making the figurative change from "un-leaded fuel to diesel fuel."

Second, the standard cholesterol profile does not give you a true picture of what is occurring at a cellular level.  The standard cholesterol panel checks Total cholesterol (all the forms of cholesterol), HDL (the good stuff), LDL-C (the bad stuff) and triglycerides.  It is important to recognize that the "-C" stands for a calculation usually completed by the lab. 
Total cholesterol, HDL and triglycerides are usually measured and LDL-C is measured using the Friedewald equation [LDL = total cholesterol – HDL – (triglycerides/5)].
Third, it is also important to realize that HDL and LDL are actually transport molecules (the buses for the triglycerides (the passengers). HDL is taking triglycerides to the fat cells and LDL is taking triglycerides from the fat cells to the muscles and other organs for use as fuel. 
When you being a low carbohydrate diet, your blood glucose availability as the primary fuel source drops and triglycerides become the primary source.  It takes your body 4-6 weeks to increase the number of mitochondria necessary to effectively use triglycerides as the primary fuel.  (This is why many athletes and patients who are active will feel slightly sluggish during their exercise for the first few weeks). 
Once your body accommodation to the new fuel, there will be a notable drop in LDL-C and a rise in the HDL.
But this still doesn't answer the question and relieve the panic seen above. A deep sigh and the look of relief occurs when I explain that LDL-C doesn't give us the real story. 
To make it simple and understandable, LDL is made up of three main sub-types  big fluffy ones, medium sized ones, and small dense ones. It's the small dense ones that contain lipoprotien A [Lp(a)] found in increased vascular risk. Recent studies reveal that heart disease and atherosclerosis is caused by the small dense LDL molecules. 
A low carbohydrate diet causes the small dense cholesterol to drop and there is a rise in the two other sub-types   This shift in sub-types can actually elevate the Total Cholesterol number and occasionally the LDL-C. 
If you are following a low carbohydrate diet, get your cholesterol levels checked.  It is more ideal to get an NMR Lipoprofile or VAP Cholesterol test that will give you an LDL particle number and this can be explained more fully by your doctor. 
Now, off to the fridge . . . where did I put that package of bacon . . . ?

Legend Has It . . . How Diabetes Was Discovered and How That Makes Me Fat

The German physiologist Oskar Minkowki was the first person to identify the role of the pancreas in diabetes.  Legend has it that on a momentous day in 1889 Oscar  noticed that urine collected from his pancreatectomized dogs (dogs that had surgical removal of their pancreas) attracted a very large number of flies.  He is said to have "tasted" the urine and to have been struck by its sweetness.  (Only in 1889 could you get away with tasting dog urine.)  He then made a very astute observation and realized that the pancreas controlled blood sugar concentration and was a key factor in diabetes mellitus.
Thirty years later, Fredrick Banting and Charles Best identified insulin as the key hormone produced by the pancreas controlling the level of blood sugar.  However, what Oscare Minkowski couldn't taste was the very high level of acetone in the urine which is produced by the liver in the conversion of fat to ketone bodies.  Had Oscar lost his sense of taste, instead of noting the sweetness to the urine he might have noted the pungent smell of acetone.  He would have then concluded that the removal of the pancreas causes fatty acid metabolism to go awry.  He then would could have extended his hypothesis and concluded that the preeminent role of insulin was not in the control of blood sugar alone, but in the control of fat metabolism.
We have become fixated upon the function of insulin and its effect upon diabetes, and in doing so, we have neglected the fact that insulin has even greater effect upon the storage and use of fat and protein in the body.
A series of discoveries from the 1920s-1960s let to a revolution in the understanding of the role of insulin in fat metabolism.  At that time, fat was assumed to be relatively inert and carbohydrates were seen at the primary fuel for muscular activity (which is still commonly believed today).  The belief was that fat is used for fuel only after being converted in the liver to suspiciously toxic ketone bodies.  Forty years of research overturned this assumption, however, it had no influence upon mainstream thinking about fat gain and obesity.  In 1973 when all the details of fat metabolism had been worked out, Hilde Bruch, the foremost authority on childhood obesity, stated "it is amazing how little of this increased awareness . . . is reflected in the clinical literature on obesity."
JAMA just released it's compendium on obesity research and the simple science of insulin's effect on fatty acid metabolism is STILL being ignored. Instead, main stream medicine is starting to push patients toward a very expensive and risky gastric bypass surgery. This scares me.
Hippocrates said, "Let food be your medicine and let medicine be your food."  The body responds with hormonal effect to what we feed it and the science explaining this has been ignored. We have been brainwashed with the dogma that the "calorie is king."

Mayor Bloomburg eating donuts
two days after trans fat ban

Based on this we are now legislating food behavior.  New York has now banned trans fats by the New York City Board of Health and has legislated all soda sizes to no larger than 12 oz. We are creating health policy on bad science.  Let's go back and look at the science before we let our legislators start cooking for us, or soon our grocery stores will look like our government run school cafeterias offering school lunches.

Vanilla Low Carb Ice Cream

I love ice cream. I mean I really love ice cream. This has been one of my vices for years that I thought I would have to forever give up to follow a low carbohydrate dietary lifestyle . . .but worry myself no more!  
My sweet wife did it again.  She perfected the ice cream recipe she has been working on for the last year. 

You have to try this recipe.  It's delicious.  

Thanks, sweetheart!

Vanilla Low Carb Ice Cream:

1 cup Almond or Coconut Milk

1 quart of Heavy Cream

1 tsp Vanilla

1/2 cup Erythritol

1 scoop Vanilla Protein Powder

1/2 tsp of Salt

Blend for approximately 20 minutes in a 2 Quart Cuisinart Ice Cream Maker (that's the one we use) or the ice cream maker of your choice until the desired consistency and then place what you don't finish eating in the freezer for later.

Low Carb Chocolate Chip Cookies

I love chocolate chip cookies! However, over the last three years, as I have followed a low carbohydrate diet I have not been able to indulge my chocolate chip cookie craving -- until recently.  

My gorgeous and very ingeniousness wife has perfected her chocolate chip cookie recipe and - Oh, Wow! - are they good. 

Warm tasty chocolate chip cookies that are actually good for you served up by a beautiful blond in a very cute apron. . . I think this is what heaven is like. 

I have been promising my patients this recipe for quite a few months, but have neglected to write it down and post it. I would forget to take a picture of the cookies before my family had eaten them all.  So, this morning I took a snapshot and I had a few moments while eating the cookies on the plate above.  Here is the recipe:

Low Carbohydrate Chocolate Chip Cookies

1 tsp vanilla

2 eggs

2 sticks (1 cup) of butter, softened

1/2 cup Splenda

1/4 cup Sweet Perfection

1/4 cup erythritol 

1/4 cup Just Like Sugar (chicory root sweetener)

1 tsp salt

1 tsp baking soda

1 tsp baking powder

1 1/2 cup almond flour

1 cup coconut flour

1/2 cup Carbalose flour

2 ChocoPerfection Milk Chocolate bars chopped 

Mix the vanilla, eggs, butter and sweeteners until creamy or fluffy. Add in all dry ingredients and mix. Add chocolate and mix. Place dough on parchment paper covered cookie sheets in 2 tsp sized scoops.

Bake at 350 degrees for 8-10 minutes. 

Makes 45-50 cookies

(~ 2 net carbohydrates per cookie)

Enjoy!!

Mid-Meal Protein Shake. . .

A number of my patients have asked what I use personally as a protein supplement and whether I use protein shakes.  I've struggled to find a great tasting protein shake that does not contain any artificial sweeteners (see my article The Skinny On Sweeteners) that raise the insulin levels.  Most of the pre-prepared shakes (including the Adkins, EAS, Muscle Milk, and many others) will significantly slow weight loss and knock you out of ketosis due to an insulin response stimulated by drinking them.

My sweet wife just perfected our family's favorite high fat, low carbohydrate protein shake.  Oh, it's good and  it's filling.  You'll love it and you won't be hungry for at least 3-4 hours after savoring this sweet taste-bud sensation. 

This is a great shake for a mid-meal snack or a quick meal on the go.

Tiffini's Low Carb High Fat Protein Shake:

• 3/4 cup of frozen strawberries
• 1 tbsp of extra virgin olive oil
• 1 scoop of ISO-100 Gourmet Berry flavor protein powder (carb free)
• 1 packet of Stevia
• 1 1/2-2 cups of heavy whipping cream

[One serving (~ 2 cups) is 4.5 grams of carbohydrate]

Blend to preferred texture. . . (may add more heavy whipping cream if it is still too thick). 
Enjoy!!

What's For Breakfast?

Many of my patient's ask me what I eat regularly.  I thought that I would document my meals for a few weeks to give you ideas and include recipes when pertinent.  Here was this mornings breakfast . . . and, Oh, was it tasty!

Definition: Vegetarian

The Skinny About Sweeteners

I am often asked about which sweeteners are safe and which ones can be effectively used to assist with weight loss and maintenance.  It has been long in coming, but I finally put it all together in my article "The Skinny About Sweeteners". You can find it at The Arizona Bariatric Institute website under Recommended Links.

Ketogenic Diet Reduces Diabetic Neuropathy

Very impressive kidney results were found in both Type I and Type II diabetic mice placed on a low carbohydrate ketogenic causing diet in just 8 weeks. The nephropathy (passage of protein through the kidneys) was completely reversed in all the mice. This is the first in what I suspect will be a series of articles showing that ketogenic diets have significant effect on reversal of age related and diabetic tissue damage.  See the article here.

Low Carbohydrate Diets Finding Great Success

Spent part of the morning reviewing 20 years of journal articles on the "Science of Dietary Carbohydrates, Glucose and Insulin."  Fascinating reading. It is interesting that prior to the advent of insulin as a treatment for diabetes, the most common treatment from 1915-1920 used by William Osler for diabetes was significant carbohydrate restriction.

In 1999 a study was published in Pediatrics looking at twelve obese teenage boys.  They were randomly fed low glycemic equal calorie meals followed by high glycemic index meals or vise-versa.  The fascinating result was that when fed following a low glycemic meal, the boys at 81% more if the meal was high in glycemic index.  The fascinating factor is that their insulin levels were much higher which would correlate with notable weight gain and cholesterol rise based on other research.
Another study completed in 2005 helps to quash safety concerns about low carbohydrate diets and shows them to be just as effective in weight loss and more effective in lowering triglycerides, raising HDL in patients with type II diabetes then low fat diets.

My patient's in the office have had tremendous success with low carbohydrate dietary changes over the last 12 months. Every patient in my practice following a very low carbohydrate diet has drastically improved their cardiovascular risk, lipid profile, and significantly reduced their weight. In those patient with type II diabetes, they have additionally had significant improvement in their blood sugar control, average blood sugars (HbA1c) and there triglycerides (on of the lipid measures placing these patients at risk for heart disease). This correlates closely with recent studies reflecting similar results in the medical literature.  It is essential, however, to be monitored regularly on these types of diets, as rapid and significant metabolic changes can and do occur. Medications, blood pressure, and blood sugar control need to be closely monitored when following a low carbohydrate diet. Close follow up with your physician is highly recommended.