This entry is also posted on Dr. Sukol’s blog, Your Health is on Your Plate.

About a year ago, a friend of mine got interested in the raw food movement.  Raw foodists prefer their food, as advertised, raw.  Uncooked.  She said it changed her life.  OK, lots of people say stuff like that.  But I have to admit that I see the difference – she is more relaxed, and brimming with beauty and energy.  Four kids?  No problem!

So she had been wanting to introduce me to her new style of cooking, and we decided to get our families together for dinner.  No deal.  We couldn’t make it fit all our crazy schedules.  We resigned ourselves to the fact that we had to put the idea on hold until things settled down a bit.  My daughter was a little disappointed, having been introduced to the raw food movement as a college student in Toronto, but the boys were secretly relieved, skeptical as they were about the idea of eating “raw food.”  I decided to withhold judgment for the meanwhile. 

Then last night I had the good fortune to attend a picnic in the woods complete with tiny electric lights, an enormous bonfire, spectacular grilled salmon, great company, children of all ages, and a talented guitar player.  Something for everyone.  And a raw peach pie, courtesy of my friend, who was also in attendance.  It was fantastic.  I couldn’t stop thinking about it afterward.

This morning I called her for the recipe.  She measured one cup each of raw almonds and brazil nuts, and placed them in a water-filled jar to soak overnight.  The next day she drained the water, and placed the nuts in a food processor with 1/2 cup unsweetened coconut flakes, 1/2 teaspoon vanilla, and a scant 1/2 teaspoon of cinnamon.  She processed the contents until the consistency of meal, and then added 6-8 dates (Medjoul variety, the finest and sweetest) to make a dough.  She pressed the dough into a pan to form a crust, and then placed it in the freezer to firm up while she finished the recipe.

Next she cut 6-8 peaches into chunks, and mixed them with 1 teaspoon cinnamon, 1 teaspoon lemon juice (optional), and 1/4 teaspoon grated nutmeg.  I was surprised to learn that the less sweet the peaches, the more important it was to include the lemon juice.  Then she slid the peach mixture into the crust, and refrigerated it until it was time for dessert.

Now, here’s what I want to know, and I’m going to need your help, dear readers.  First, you have to make this recipe, or take it to the family cook in your kitchen, and help them make it.  Then, you’re going to take out your glucometer or borrow one from a friend or relative.  Now you’re going to check and record your sugar, eat a slice of raw peach pie, and recheck your sugar 1 hour later. 

How much did your blood sugar rise?  Send a comment and let me know.  If I’m right, this pie will not spike your blood sugar like a traditional one made with a flour crust.  So, depending on how insulin-resistant you are, you may be able to eat a slice of this pie without hesitation, without worry, and without spiking your blood sugar.  And even if you are diabetic, you may be able to eat a slice, knowing that the blood sugar spike will be modest instead of astronomical.   

And did I mention how good that pie was?  I went back for a second piece before I’d finished the first.  OK, yes, I’m hooked.

Last summer, after my patient Mrs. Price heard me say that her blood sugar was 204, a single tear ran down her cheek as she said,  “My eldest granddaughter is getting married next year.”  A blood sugar measurement over 200 is one way to confirm a diagnosis of diabetes.  Her parents had both died in their 60’s from complications of chronically elevated high blood sugars.  Here is what I told her.

“The most important difference between your situation and mine right now is that your body is no longer able to keep its blood sugars in the normal range by itself.  But that doesn’t mean you are going to suffer the terrible complications that your parents did.  Kidney failure, blindness, heart attacks and amputations are not inevitable complications of diabetes.  It’s not diabetes itself that’s the problem; it’s uncontrolled diabetes.”

“There’s good news here: First, we found out about this before it turned into a serious problem.  Secondly, as long as you learn to keep your blood sugars in the normal range, your risk of developing complications will be pretty close to mine, which is to say, low.  A diagnosis of diabetes doesn’t mean that you’re going to have trouble.  It just means that your body can’t control its sugars automatically anymore, and it’s going to need your help.  But as long as you give your body the help it needs, and you learn how to conserve your insulin, the payoff will be huge.  I have no doubt that we will be able to get your sugars in the normal range.  You’re just going to need to involve your brain in the process.”

“You’re not going to be able to keep your blood sugars in the normal range automatically anymore, because if you could, your blood sugars wouldn’t be over 200.  And I can’t keep your blood sugars in the normal range all by myself either.  But if we work together, we can and we will.  So let’s figure out what we need to do to get your sugars under good control.  And then let’s do it.”

When I take care of patients with diabetes, I have lots of goals.  I want to get their average blood sugars under 125.  I have goals for total cholesterol, triglycerides, HDL and LDL.  I want blood pressures below 135/85, and I want kidney function in the normal range.  I want strong peripheral pulses and I want my patients’ feet cared for expertly, at home and by the podiatrist.  I want my patients’ eyes checked at least once a year.  And so on.

“But you, Mrs. Price,” I continued, “have only one goal.  Your goal is to dance at your grandchildren’s weddings.  Not just attend them, but dance at them.  All of them.  Starting next summer.”  She smiled a little.

“Did you know that one hundred years ago, before we had medicine for diabetes, the only treatment for diabetes was a high fat diet?,” I asked.  She did not know that.

I taught Mrs. Price how to conserve her insulin using the “Four Recommendations.”  She stopped buying the cereal and orange juice she’d been eating at 11:30 a.m. for years.  I prescribed a medication “to make my insulin more efficient,” as she put it.  We made an agreement that she would begin to walk 5 minutes every day, and that she would begin to increase that number by 1 minute a month.  I reminded her that “Slow but steady wins the race,” because I certainly didn’t want her to sprain an ankle or get shin splints, two complications that would prevent her from getting much exercise at all for months.  She also made a rainy-day plan — to walk in the nearby mall in bad weather.  This is Cleveland, after all. 

We got Mrs. Price a glucometer, and I showed her that she could actually figure out which foods were causing blood sugar spikes by testing before she ate and then an hour afterward.  As time went by, she got better and better at predicting which foods were going to cause unacceptable spikes, and which foods kept her blood sugars in the normal range, more or less.  She stopped buying foods that spiked her blood sugar, except once in a while “special for the grandkids,” as she put it.  She started eating a protein-rich breakfast at 8 a.m., and noticed, to her surprise, that it resulted in significantly less after-dinner snacking.  As the year went by, we watched her 3-month blood sugar averages drop from 190 to 150 to 120.

Last weekend, I am pleased to report, Mrs. Price danced at her granddaughter’s wedding.

When I ask patients what they put in their coffee, they almost always say “cream.”  So I say, “Like from a cow?”  And they usually say no.

What do they mean by “cream” then?  They mean coffee whiteners.   “Cremora Rich ‘n Creamy!”, “Coffee-mate Lite The  Original,” “International Delights Coffee House Interpretations Vanilla Latte,” “Spoon ‘N’ Stir Non-Dairy Creamer,” and so on.  They mean corn syrup solids and partially hydrogenated vegetable oil.  Translation?  Sugar and trans fat.  Some of my patients even have a favorite flavor, now that the folks who make and market coffee whiteners have identified and exploited the consumer’s insatiable desire for variety.

Coffee whiteners are everywhere.  They’re at the office, at meetings, at the workshop I attended last week, and at parties given by folks otherwise committed to fresh food, backyard gardens, and the like.  Like some kind of stealth bomber, they slip in under everybody’s radar.  Coffee whiteners are Trojan horses filled with diabetes, obesity, heart attacks, and strokes.

A visit to my neighborhood supermarket reveals a few interesting facts about coffee whiteners, also known as non-dairy creamers.  In and of themselves, they are a study in advertising spin.  First, although they contain no milk sugar (lactose), they are NOT non-dairy; virtually all of them contain a milk derivative called sodium caseinate.  People who are allergic to milk protein cannot consume them.  That is why the Orthodox Union classifies them as dairy for those consumers, Jewish and otherwise, who purchase kosher food.  And that’s just the beginning.

Coffee whiteners, a very successful form of fabricated calories, are advertised as containing zero trans fats even though they actually contain almost 1/2 gram per serving.  That’s because, according to the law, products containing up to 1/2 gram may be advertised as trans-fat free.  But a teaspoon of powder isn’t very much.  If you use more, whether in one cup of coffee, tea or cocoa (as recommended on the label), or several cups, you get more trans fat.  And even small amounts of trans fat cause damage to blood vessels, increase the risk of heart attacks and strokes, and interfere with fat storage, cholesterol synthesis, and fertility.  There is no amount of trans fat that is safe to consume. 

Okay, so if you use more than the recommended serving size, you’ll get more trans fat.  That’s obvious.  What of it?  Well, I’m having a hard time with the fact that the advertising on packages of coffee whitener actually encourages people to use more than a single teaspoon (powder) or tablespoon (liquid) serving size:  “Pour in a teaspoon or more of Cremora.”  “Savor the rich flavor and smooth creaminess of Cremora, cup after creamy cup.”  “Scoop or pour…”

Remembering that the more manufactured the product, the more creative the names, let’s take a look at the coffee whitener flavors: Coffee-Mate makes liquid versions in French Vanilla (blue), Hazelnut (yellow), Peppermint Mocha (light blue), Vanilla Caramel (orange), and Italian Sweet Creme (purple), this last one part of their special “World Cafe” line.  Linking each flavor to a particular color spectrum improves identification, selection, and loyalty.  International Delight makes French Vanilla (blue), Hazelnut (orange), Hershey’s Chocolate Caramel (brown), Amaretto (pink), Irish Creme (green), White Chocolate Mocha (purple), Caramel Macchiato (light brown), and Vanilla Latte (turquoise), the last three from their “Coffee House Inspirations” (silver) line. 

Coffee-Mate liquid French Vanilla comes in regular, sugar-free, and fat-free versions.  I can’t figure out how it is that all of these list the same first three ingredients (water, corn syrup solids, and partially hydrogenated soybean and/or cottonseed oil) in the same order.  But they do.

International Delights also makes a product called Sweet Buttercream, advertised as Limited Edition, whatever that is.  Sweet Buttercream features a thickly iced cupcake in hues of tan, gold and ivory.  I figured since it had the word “buttercream,” there must be some butter, or maybe cream, in the ingredient list, but I just found the usual — corn syrup solids and partially hydrogenated vegetable oil, i.e., sugar and trans fat.

So what should you do?  Don’t use coffee whiteners.  Put cream (from a cow!), half-and-half, or milk in your coffee.  You will not gain one single pound.  Substitute soy, rice, coconut, or almond milk if you are intolerant of dairy, and stick to the original without added sugar and flavorings.  Or drink your coffee black.  Don’t use “fat-free half-and-half.”  I’m still trying to figure out what that even means. 
 
Don’t buy anything with the words “partially-hydrogenated” in its ingredient list.  “Partially-hydrogenated” means trans fats, and there is no place for trans fats in the diets of your loved ones, friends, or coworkers.  We will not build healthy communities with coffee whitener.

Wise Organic Pastures – The Processing Plant

This Article is Cross-Posted on KosherEye.com

Our Bubbie and “grand” Bubbies may have known how to make a famous roast chicken and of course, chicken soup, but certainly did not face the same chicken challenges that the kosher shopper faces today. Most chicken is no longer raised in the back yard! The consumer is now faced with numerous choices in quality, type and price.

Chicken has become a multi-billion dollar industry in America. Kosher chicken is no exception, but is somewhat more complicated. There has been extraordinary growth in kosher poultry sales in the last few decades. Along with observant Jews, many non-Jews and Jews who don’t necessarily adhere to kosher laws now purchase kosher poultry. Why? There is a perception that kosher certification adds a layer of clarity and transparency to poultry purchases. In addition to the FDA and government regulatory agencies, the processing plant must adhere to the specifications of a supervising kosher agency and rabbinical authority. Many consumers welcome this extra layer of inspection.

Kosher shoppers have choices to make. Our goal is to understand and to explain some of them to our readers.

Recently, as part of the KosherEye “kosher” summer road trip through Pennsylvania and Maryland, we were invited to tour both The Wise Organic Pastures processing plant in Scranton, Pennsylvania and a Wise Organic Poultry Farm, which is a 50-mile drive out into the Susquehanna Valley.

In Scranton, we had the pleasure of meeting Moshe Fink, founder of David Elliot Chicken and owner of the processing plant used by Wise Organic Pastures. He answered many of our technical kosher “processing” questions and provided background information.

According to Moshe, for poultry to be considered kosher, they must be in good health when slaughtered. The shochet must use a sharp knife and no stunning or electric shock is permissible before “shechita” (slaughter). Kosher poultry may not be heated, and blood must drip freely from the bird after slaughter. The knife must be sharp, the killing respectful, and the resulting blood symbolically “buried” under a floor covering – in this case a layer of sawdust, coal and ashes. The processing method is cold and no heat is ever applied.

Following slaughter, non-kosher poultry may be scalded with hot water. A natural occurrence from the use of hot water is that feathers just “slide” off. The result of kosher slaughter and cold processing is an unwelcome problem: residual feathers. If consumers are asked the one negative of kosher chicken, it is the feathers!

The David Elliot processing plant uses the “Cadillac” of defeathering machines, the LINCO, made in Sweden. But even with this mechanical wonder, which can be adjusted to the average size of the birds, due to the cold water processing system, feathers must be removed manually at the end of the processing line.

At the David Elliot plant, teams of workers stand with defeathering razor sharp knives and manually remove feathers after the machines have completed the initial process. Yes, this extra step of manual defeathering adds to the price of the poultry, and therefore, it is understandable that value priced poultry has more feathers when delivered to the consumer.

One positive aspect of the “kashering” process is very welcome. All kosher birds are soaked in fresh cold water for 1/2 hour, are than covered in salt for one hour, and then washed in fresh running water 3 times. This is done to follow the biblical prohibition to eating blood. Because of the salt “bath”, most consumers applaud the taste, which taste similar to culinary brining. Kosher chickens have won numerous taste awards including a contest held by the Pennsylvania Department of Agriculture. In this contest, a main rule is no seasoning is allowed on the chickens. Empire Kosher Poultry has won several of these prizes and Moshe Fink attributes the consecutive awards to the kosher process – specifically salting!

Our poultry facility visit began with the gracious invitation of our host Issac Wiesenfeld, president and owner of  Wise Organic Pastures.His mother, Rachel Wiesenfeld started Wise Organic Pastures in 1992. She founded the company after the family faced a financial setback. According to Mrs. Wiesenfeld, there was “a need in the kosher poultry market for wholesome chicken raised the old-fashioned way — free range, organically fed, hormone-free — and processed according to strict kosher standards. At the time, there was organic chicken and there was kosher chicken, but no one was offering chicken that was both organic and kosher.”

Her son, Issac, the fifth child of 11 siblings, was the only sibling to join the company! The offices are based in Brooklyn, but the plant and farms are in Pennsylvania. The family has had a thriving business relationship with Moshe Fink for the past 18 years. Although the Wise Organic Pastures started 18 years ago, the company could not add the official organic label until the legislation was passed in Washington in Oct 2001. The Wiesenfelds are truly organic kosher pioneers! And, timing is everything. Since USDA established the National Organic Program officially in 2002, the organic food market has grown by almost 20 percent annually.

KosherEye was given a full tour of the entire David Elliott  processing plant. What did we see?

The sanitation and efficiency we observed at the plant was impressive. Before we were permitted to tour, we had to dress from head to toe, (including boots and hats) in sanitary cover. The shechita atmosphere was antiseptic. The Rabbi inspects each bird for blemishes or problems, and then skillfully and quickly cuts through the neck with a slash of his constantly sharpened knife. The job must be both holy and professionally precise. From the off-loading dock to the packaging area, the plant appears clean, well run and intense in purpose. Certainly the atmosphere is not for the squeamish; however it was a realistic view of how the chickens we eat are slaughtered, kashered, cleaned and packaged.

Both the Organic and Kosher poultry market has grown over the years. The economy certainly affects the consumer’s ability to buy the higher priced organic chickens- but, conversely, the number of organic buyers is growing.

For more information about Wise Organic Pastures, visit WiseOrganicPastures.com. To learn more about David Elliott poultry, call 570-344-6348.

This list, from Consumer Reports, of Common Industry Chicken Terms, is very informative.

 I spent most of the day yesterday on Orchard Street on the Lower East Side of Manhattan.  Not literally.  I was reading Jane Ziegelman’s new book, 97 Orchard: An Edible History of Five Immigrant Families in One New York Tenement.  I wanted to know what they ate in the days before Crisco, Cool Whip, corn syrup, and Cocoa Puffs. 

Besides the foods we commonly eat today, New Yorkers in the 1800’s ate buffalo, bear, venison, moose, mutton, otter, swan, grouse, and dozens of other species, both domestic and wild.  Organ meats included sweetbreads, hearts, livers, and kidneys.  Fish dealers offered eel, 15 types of bass, 6 types of flounder, and 17 types of perch.  Produce included purslane (I’m sure there is some growing in your backyard), salsify (a root vegetable), borage, burdock, beach plum, black currants, mulberries, nanny berries, black gumberries, and whortleberries.  Note the extraordinary variety in comparison to today’s offerings.

Breakfast often consisted of mutton chops, fish steaks, and porridge.  Oysters, whether raw or cooked, were abundant and extremely popular at all meals.  Herring was prepared in a myriad of ways, such as with sour cream and mayonnaise, pickled, fried in butter, smoked, rolled, stuffed with pickles, or as “chopped herring” salad.  I know this salad well because I used to help my Grandma Rosie make it. 

Grandma Rosie was born July 31, 1910, the fourth child in her family, and the first to be born in America.  Yesterday would have been her 100^th birthday.  Here’s her recipe:  Soak 12 pickled herrings overnight, drain, remove the skin and bones, and chop fine.  Add 2 cups cooked potatoes, 1 cup apples, and 2 hard-boiled eggs, all chopped.  Mince 2 medium onions, and add to salad.  Add 1 tablespoon each of oil and white vinegar, and salt and pepper to taste.  The book also called for 1 cup of beets and some capers, but I never saw Grandma Rosie put capers or beets in her “chopped herring.” 

Signature dishes on New York’s Lower East Side included hash, soups, and pies.  Pie was so popular that immigrants called Americans “pie-eaters.”  Mince pie, oyster pie, apple pie, pumpkin pie, chicken pie, and “sweetbreads in pastry” were among the choices.  Leftover beef, mutton, pork and fish was frequently made into “hash,” and boardinghouse dwellers were called “hash-eaters.”  Soups were made from bones, root vegetables, turnips, potatoes, cabbage, and dried beans.  I learned an old Yiddish proverb:  “Poor people cook with a lot of water.”  In contrast, the American government chose from among pork and beans, beef hash, corned beef with cabbage and potatoes, pot roast, boiled mutton, and mince pie to feed to newly arrived immigrants at Ellis Island. 

Smoked salmon is now considered a delicacy, but a century ago it was a food of necessity.  Without refrigeration, food was kept fresh and edible with four agents: heat, smoke, salt and acid.  Meats, fish and fowl were smoked, salted, or pickled.  Fruits and vegetables were pickled, jarred, or dried.  Corned beef, so named because of the large “corns” of salt used in its preparation, also belongs to the large family of preserved meats and fish. 

Here’s a recipe for turning cucumbers into dill pickles.  It’s very similar to the recipe Grandma Rosie gave me.  Pack 30 kirby cucumbers of approximately the same size into 1 large or 2 small jars, alternating the layers of cucumber with layers of dill (20 sprigs total).  Boil ½ cup kosher salt in 2 quarts water, and turn off the heat.  Add 2 tablespoons white vinegar, 4 cloves garlic, 1 dried red pepper, ¼ teaspoon mustard seed, 2 coin-sized slices of fresh horseradish, and 1 teaspoon of mixed pickling spice to the boiled liquid and pour over the cucumbers.  If necessary, add more salt water to completely immerse them.  Cover and keep in a cool place for a week.  If you like the cucumbers green, try one after 5 days. 

New York was famous for a squishy and gummy white bread called the “New York split loaf.”  In contrast, German immigrants made less expensive whole-grain rye and pumpernickel breads with dense, chewy textures and a sour, mildly nutty flavor.  These latter ones were the breads my family bought to slather with real or vegetarian chopped liver, depending on who was coming to visit.  Here’s Grandma Rosie’s recipe for vegetarian chopped liver:  Saute 3 chopped, medium onions in 3 tablespoons of oil until soft and golden.  Mash the contents of 1 large can of drained sweet peas, and add to the onions.  Add 1 ½ cups chopped walnuts and 2 chopped, hard-boiled eggs.  Chop by hand to desired consistency.  Season with salt and a generous amount of freshly ground black pepper.

As Grandma Rosie said often, “Hearty appetite!”

This entry is cross-posted at http://yourhealthisonyourplate.com .

I am pretty excited this morning, because today’s the day that the grounds manager from a small local college is coming over to spend a few hours helping me salvage a row of overgrown, antique quince bushes and convert a small corner of my yard into an edible garden.  I expect that we’ll be working pretty hard, so before he gets here I need to eat breakfast, and that’s what we’ll be discussing today.

Well then, what’s for breakfast?  In one word?  Protein.  In three words?  Not refined carbohydrate.  For more on why not, read here,  here, and here.    When I stayed in a youth hostel in Cairo, Egypt, many years ago, breakfast consisted of steaming bowls of mashed fava beans.  In Germany the breakfast tables were filled with plates of thinly sliced cheeses and meats.  In Israel, we ate soft cheeses, cucumber and tomato salads, and roasted eggplant.  Where refrigeration is less common, people typically eat the leftovers from dinner when they awaken. 

The six major categories of protein include meats, eggs, fish, beans, nuts and dairy.  Now I’m not saying you have to eat them all.  Just pick what you like from among all these choices.  Want some examples?  OK — here goes.

In the meats department, you could have a leftover hamburger.  Or ribs.  Or heat up some chicken wings from last night.  Yes, for breakfast.  In the Midwest, you know, a typical breakfast 150 years ago might have been a pork chop and a cup of coffee with real cream.  They didn’t have a diabetes epidemic then.  Want something more exotic?  Check your refrigerator.  Chopped liver maybe?  Anything goes, from aspic to venison, or veal, if you prefer. 

Don’t care for meat?  What about fish?  There’s smoked whitefish, catfish, tuna (straight from the can if you’re in a hurry), sardines of course, kippered salmon, leftover trout, cod or shellfish, though I expect the chances are slim that you’d find much leftover lobster.  Still…

Eggs.  My favorite, hands down.  Boiled, fried, scrambled, poached.  You can crack one into a little ramekin containing a spoonful of basil pesto. Put the dish into a water bath (loaf pan with 2 inch water) and stick it in the toaster oven at 350 for 15-20 minutes.  You cannot believe how extraordinary this recipe is until you taste it.

For really busy people, nuts are a mainstay of healthy breakfast eating.  When my children were younger, particularly the one who did not usually appear downstairs until 2 minutes before the bus was scheduled to come, I would run plastic spoons along the surface of the peanut butter and hand them over, calling them “peanut butter lollipops.”  A short time later, on my own way out, I would collect the empty spoons from the mailbox at the top of the driveway.  Peanuts not your thing?  Try almond butter, or cashew butter.  It’s not cheap, but then again you don’t have to eat it every day.  I also keep a jar of peanut butter at the office for the 11 a.m. and 4 p.m. hungries. 

Then there are the nuts themselves.  If you keep a bag of nuts in the car, you can eat a handful or two on the way to work.  This has to be the easiest way to eat breakfast!  If your excuse is that you don’t have time to eat breakfast, this is the way to go!  Don’t care for peanuts?  No problem.  Try almonds, cashews, brazil nuts, pecans, walnuts, pine nuts, hazel nuts…did I miss any?  Buy a different kind each time, or make a trail mix from a few.  The more the merrier.  Don’t buy coated nuts.  Make sure to avoid salted nuts, especially if you have salt-sensitive high blood pressure.  You want to buy pure, unadulterated nuts.  I would also suggest storing large bags in the refrigerator or freezer to protect their fragile oils.  They will keep fresh a lot longer. 

Allergic to nuts?  No problem.  Substitute sunflower seeds and pumpkin seeds.

Now let’s talk about beans.  Maybe there’s some lentil soup in your refrigerator, or a three-bean salad.  If you have refried beans, you could heat them up in the microwave with some cheddar melted on top.  Hummus and tahini are great choices for breakfast.  Scoop them up with slices of cucumber, celery sticks, carrots or even apples. 

What about a burrito?  Is it ok to eat a whole-grain tortilla for breakfast?  Here are your guidelines for eating grain at breakfast time:  If you are 1) diabetic, 2) pre-diabetic (at high risk), or 3) more than 30 lbs. overweight, do not eat grain for breakfast.  Can’t deal with that?  OK, maybe one serving once a week, like at a Sunday brunch, or on another special occasion.  Otherwise, stay away.  It’s making you sick. 

Why?  Because grain requires a ton of insulin to metabolize.  Even whole grain.  Worse, stripped grain requires even more insulin.  Stripped (refined) grain requires an absurdly enormous load of insulin to digest and metabolize.  Remember that insulin works less efficiently in the morning, and that learning to eat smart is all about learning to conserve your insulin.  So if you eat refined carbohydrate at breakfast time, not only are you wasting your body’s insulin, but you are wasting it at the exact time of day when it works worst.  That’s like hitting a man when he’s already down.  Don’t do it.  Eat plenty of fresh produce with your high-protein breakfast instead.  Especially vegetables.

Now, as long as you do not fit into one of the above 3 categories, you should feel free to incorporate some grain into your breakfasts — BUT it must be a whole-grain product. 

Lastly, let’s discuss dairy.  Last week’s post about yogurt works.  So does cheese, and milk.  Less well known, but just as good, are kefir, clabber, and so on.  Goat milk works, just like all the other mammals whose milk is consumed by humans, although not commonly in America.  What kind of cheese?  You name it, as long as it doesn’t contain the words “processed” or “food.”  If someone has to tell you it’s food, it probably isn’t. 

So what did I choose for breakfast?  Leftover guacamole, tomatoes, and 3 generous slices of jarlsberg (a type of swiss) cheese.  A cup of tea with real cream.  And 1 banana for good measure.  Now watch me garden! 

Most of the time I feel like we’re really making progress.  Patients are looking younger, losing inches, feeling better and decreasing their medications.  Still, not a day goes by that Angie, Barb, Chuck, Doris, Elijah, Fritz, or Gayle doesn’t tell me proudly that they have switched to “wheat bread.”  I thought I covered that, I say to myself.  I thought we discussed the fact that practically all bread is made from wheat.  That buying “wheat bread” is the same as buying “bread.”  That the word “wheat” means nothing in terms of good nutrition unless it is prefaced by the word “whole,” as in “whole wheat.”  That someone is trying to confuse you, and they are succeeding.  That’s when I feel as if I’m climbing a mountain with a Wonder Bread truck tethered to my backpack.

If nothing is working, no matter how hard you try, it’s time to reexamine the fundamentals.  So let’s go back to the beginning, and take a careful look at the words that are being used to sell bread. The goal here is to understand what you are choosing to eat.

When I enter a Subway, the sandwich maker asks me, “White or wheat?”  What are my choices again?  White bread or wheat bread?  But white bread is made from wheat.  And wheat bread is made from wheat.  Both white bread (always) and wheat bread (usually) are made from the starchy core, or endosperm, of a wheat kernel.  So what’s the difference?  Near as I can figure, the major difference is the color.

I checked out the nutrition information for the white and wheat breads.  They both contain 200 calories, but white bread has less fat (0.5 versus 2.5 g), less carbohydrate (38 versus 40 g), less fiber (1 versus 3 g), and less protein (7 versus 8 g).  So how can they both have 200 calories?  Something isn’t adding up.  The only thing that white bread has more of is sodium, at 470 versus 360 mg.

What is white bread?  It’s bread made from wheat kernels that have had their bran fiber coat and oil-rich germ stripped out.  What is wheat bread?  Same.  So why are some wheat breads tan instead of white?  Usually because they have had caramel coloring added.  What else can we learn about “wheat bread?”  Well, manufacturers use a variety of descriptive words to make bread seem better for you, including “enriched,” “unbleached,” and sometimes even “organic.”  ”Enriched” was the name given to flour to which vitamins and minerals were added, after it became apparent that stripping grains caused anemia, beri-beri, and other nutritional deficiencies in the people who consumed them.

The only time bread is really made from whole grains is when the first ingredient is WHOLE wheat or WHOLE grain flour.  The very FIRST ingredient.  Not the second.  Why is it important for you to know this?  Because there is virtually no place in a nutritious diet for refined (i.e., enriched, stripped) flour.  Yes, it’s that serious.  The standard American diet (SAD), based as it is upon refined flour, is one of the major contributors to the diabetes and obesity epidemics.

Now, just for the record, I will restate that folks should eat very little (if any) grain at breakfast.  I’m not saying that we should never eat refined wheat products.  I’m not really the “never” type.  Like Julia Child, I prefer moderation.  I think people can handle a little bit of refined flour now and then.  But not at breakfast, except on very, very rare occasions like your birthday, or your niece’s wedding brunch.  It just doesn’t make any sense to waste large amounts of insulin at the very time of day it works worst.

Remember that some people need to be more strict about their intake of grains (like “wheat bread”) than others.  Who?  Those people who are 1) inactive, 2) more than 30 lbs. overweight, 3) pre-diabetic, or 4) diabetic.  This short list includes around 85% of Americans.  That means no toast, bagels, muffins, waffles, pancakes, cereal, biscuits, bread, grits, leftover mac & cheese, at all.  Even if they are made from whole grains.  Why?  Because grains are absorbed very rapidly, which raises your blood sugar quickly, which means that you need to release a huge load of insulin to catch the sugar.  And insulin works worst when we wake up in the morning.  We can’t afford to waste our insulin like that.  So don’t eat foods made from flour (which, as you have learned, is almost always wheat flour) for breakfast.  The remaining 15% of us can have a little bit, sometimes.  Not every day, unless we are very active.

As for “wheat bread,” don’t let anyone fool you.  Call it by its more correct name –  bread — and switch to whole-grain bread.  Avoid it for breakfast always, and don’t eat it every day in any case.  Send me your questions if you’re still confused.