Sunday, October 11, 2009

The Big Fat Diet for Diabetics with Recipes
ALERT BAY, B.C. -- Greg Wadhams tipped the scales at 291 pounds when he joined a bold dietary experiment in this island village.

Today, he's a poster boy for the Big Fat Diet, one of the most extreme dietary interventions for diabetes ever tried in Canada.

The low-carbohydrate, high-fat diet is heavy on traditional foods like seafood, game and oolichan grease, a delicacy finer than the best olive oil to connoisseurs here on the Pacific coast.

Doctors say the benefits of the diet, for diabetics who can stomach the strict regime, can be remarkable.

Within weeks of giving up sweet, starchy foods, Wadhams lost 19 pounds and went off the diabetes medications he had been swallowing for years.

"It was incredible," the 56-year-old Wadhams says. "It was like I was young again, I had energy to burn." Three years later he is down nearly 40 pounds and still off the medications.

"What more can you ask for?" says Dr. Jay Wortman, a Métis doctor with Health Canada and a maverick when it comes to nutrition and diabetes.

He recruited Wadhams and close to 100 residents of Alert Bay, off the northeast tip of Vancouver Island, to try his "therapeutic diet" for a yearlong federally funded project.

He says the Canadian Diabetes Association, which sets guidelines for doctors and nurses treating the two million diabetics across the country, needs to wake up to the benefits of eating more fat and eliminating carbohydrate-rich foods like pop, pasta and potatoes.

"This diet should be offered as a valid option," says Wortman, who describes Type 2 diabetes as an "intolerance" to carbohydrates that are loaded into many modern foods. In susceptible individuals, he says, eating sweet and starchy food drives a "vicious" metabolic process in which excess sugar gets stored away as fat, often leading to Type 2 diabetes.

Low-carb diets "take away the trigger" driving the cycle, says Wortman, who is a walking endorsement for his diet. He developed diabetes seven years ago and has kept his blood sugar in check by eliminating carbs.

There appears to be no going back once an intolerance develops, says the 58-year-old Wortman, who eats eggs without toast, meat without potatoes, fish without chips.

Wortman says First Nations people appear to be particularly susceptible to carbohydrate intolerance, which made Alert Bay an ideal setting for his experiment, which began in 2006. The community of 800 residents is home to the Namgis First Nation and had plenty of potential volunteers who were overweight and either had, or were at risk of having, diabetes.

"We keep seeing more and more diabetics," says local physician Dr. Clayton Ham, who was skeptical about Wortman's diet at first. But Ham grew so intrigued he signed on to help chart the dieters' progress.

So did local filmmaker Barb Cranmer, who co-produced a documentary, My Big Fat Diet, about the project with Vancouver director Mary Bissell. Local merchants bought in, with the Pass'n Thyme restaurant introducing Wortman's ribs, made with the doctor's recipe. Sales of salad greens, cauliflower and eggs soared at the grocery store and the dieters' bimonthly potlucks became major social events.

"My specialty was seaweed and clams," says Wadhams, who learned he had diabetes when he dragged himself off his commercial fishing boat about five years ago. He headed straight to the local clinic and left on medication to control his sky-high blood sugars.

This story is part of a Canwest News Service series that has been funded in part by a journalism award from the Canadian Institutes of Health Research.

The Big Fat Diet has reinforced Wadhams' belief, shared by many, that a traditional diet, or a modern version of it, is a recipe for good health. First Nations on the Pacific Coast sustained themselves for thousands of years on a high-protein, low-carb diet of seafood, game, roots and berries.

Alert Bay is in the Broughton Archipelago, which was one of the most bountiful places on the planet until industrial logging and fishing depleted its resources. "It was a Garden of Eden," says Wortman.

The locals still fill their freezers with clams, salmon, halibut, prawns and wild game -- "goodies," as Wadhams describes the foods that are mainstays of the Big Fat Diet, which is basically a traditional take on the controversial Aitkens Diet.

Oolichan grease, an amber-coloured oil rendered from smelt-like fish that spawn in glacier-fed rivers, is also allowed.

"I can't eat fish without it," Wadhams says of the oil so sought after by coastal people they used to lug it over mountains on "grease trails." Recent chemical analysis shows oolichan oil to be ideal fuel for the human body.

For those without access to seafood and game, the Big Fat Diet permits unlimited amounts of beef, lamb, pork, chicken and turkey. It also allows bacon, eggs, butter and cream, which doctors and nurses -- and the dietary guides from Health Canada and the Canadian Diabetes Association -- have long urged diabetics to avoid.

While Wadhams was invigorated by the diet, not everyone could stomach it. "I love my rice and pasta," says Art Dick Jr., who lasted just a few weeks.

In the end, about 60 participants stuck with it and collectively shed 1,213 kilograms after a year. They celebrated in the "Big House," showing how much weight they'd lost.

"I carried in 40 pounds of flour," laughs Wadhams, over a recent lunch at Big Al's, the local diner that has several low-carb options on the menu. Wadhams had Caesar salad topped with grilled chicken, without bread.

Even more notable than the weight loss, the diabetic dieters eliminated or reduced their need for drugs and insulin to control their blood sugars, says Wortman. He doesn't go so far as to say the diet is a cure, but he says it can keep blood sugar at healthy levels.

The American Diabetes Association guidelines issued earlier this year say low-carbohydrate diets can help diabetics lose weight. And Wortman is calling for the Canadian Diabetes Association to endorse low-carb, high-fat eating. He cautions that medical supervision is needed as the diet's effect on blood sugars can be dramatic in the first few weeks.

The Big Fat Diet has certainly raised eyebrows, says Dr. Keith Dawson, who started one of British Columbia's first diabetes clinics and works closely with aboriginal communities.

He says Wortman's experiment builds on evidence Type 2 diabetics on low-carb diets can lose "prodigious" amounts of weight and reduce their need for medications. "And that's a really important thing," says Dawson, who wants the diabetes establishment and dietitians to acknowledge the potential.

Dietitian Shelly Crack, who works on Haida Gwaii off the B.C. coast, cautions that The Big Fat Diet is so restrictive it sets most people up to fail. She favours a more balanced approach that promotes "healthy eating and active living."

Dr. Sheldon Tobe at the University of Toronto is intrigued by Wortman's diet, but warns that diabetics with signs of kidney disease should stay away from it. "When someone has kidney disease, a high-protein diet is not good," says Tobe.

"I'm cautious," says Tobe, who is looking forward to seeing a detailed report on Wortman's experiment. "He's got to get the data out."

Wadhams has managed to keep his weight down, but many of the Alert Bay dieters started to pack it on when the project wrapped up and Wortman curtailed his monthly morale-boosting visits to Alert Bay last year.

Andrea Cranmer says she tried to carry on, but gained back 12 of the 22 pounds she lost. "I got bored," says Cranmer, co-owner of the Culture Shock Gallery, which serves up cappuccino along with jewelry and award-wining videos about First Nations culture.

She and her sisters are now working to keep their weight down through a combination of diet and early morning workouts at Alert Bay's waterfront gym, lifting weights and running the treadmill as bald eagles soar by the window and otters eat fish on the beach.

Wortman can't say how many people have stuck with the diet, but Ham estimates there are "enduring benefits" in about 25 per cent of the participants. He also points to "ripples" like the healthy foods that continue to show up at community feasts and events.

Wadhams, a Namgis band councillor, say there should have been more followup.

"We told Dr. Jay that it's crazy to come somewhere, find a solution and then all of sudden shut the taps off," Wadhams says, noting that many more people were game to try the diet but need support.

Wortman says it's a valid criticism and he is keen to build on the project.

"It hasn't been for lack of trying," says Wortman, who has Health Canada funding for a half-time nurse in Alert Bay and hopes to soon return to motivate the community to continue.

Here are some of my favourite low-carb recipes, some I invented myself and others I have picked up along the way. Enjoy!

Pesto Pork Medallions

3 pork loins
1 c pesto sauce (from Costco, or make your own)
2 cans Money’s sliced mushrooms (drained)
½ cup cream (or cream cheese)
Olive oil

Slice loins into ½� medallions and sauté in olive oil over medium heat, add mushrooms and cream, lower heat and stir in pesto and cream. Serve hot or can be stored in freezer and gently reheated.

Beef Shortribs

5 lbs beef shortribs
medium onion, sliced
1 whole garlic, chopped
3 cans Money’s sliced mushrooms (drained)
½ c porcini mushrooms
beef bouillon
½ l red wine (optional)

brown shortribs in butter, layer in dutch oven with other ingredients (or other heavy stove-top pot or crock pot), add red wine and bouillon to cover, cook with lid on over low heat for 3 hours or until beef is tender, to thicken sauce, remove ribs and run the sauce through a food processor, return to pan and reduce before placing ribs back in. Can be stored in freezer.

Very Complicated Chicken Curry

4 lbs chicken thighs (skin on)
curry powder
red peppers
olive oil

drizzle a little olive oil in the bottom of a dutch oven (or other heavy stove-top pot or crock pot), add chicken and cover liberally with curry powder, cover and cook on low heat for about 3 hours, stirring occasionally, add chopped red peppers at the 2-1/2 hour point.

Serve with steamed cauliflower. I like to use as a little mango pickle as a condiment

Hot Chicken Thighs

2 lbs chicken thighs, skin on
Hy’s Seasoning Salt
Frank’s Hot Sauce

Sprinkle seasoning salt on the chicken, bake at 400 F for about 30 minutes, toss with hot sauce and serve.

BBQ Pork Chops

Thick boneless pork chops (Costco’s are best)
Worchestershire sauce
Montreal Chicken seasoning (from Costco)
Olive oil

Score pork chops with sharp knife
Toss with other ingredients and marinate for an hour
(extra pieces can be put in freezer bags and frozen for later use)
BBQ over medium-high heat

Can be stored in fridge and reheated or served cold with Dijon mustard.

Steak Marinade

¼ cup olive oil
2 T Tabasco sauce
2 t salt
6 cloves garlic

crush garlic
mix ingredients
marinate steaks for about 1 hour

My Favourite Salad Dressing

3 T olive oil
1 T white wine vinegar (or plain white vinegar)
1 t balsamic vinegar
2 T Hellman’s mayonnaise
coarsely ground pepper
pinch of Equal

whisk ingredients together in a small bowl
toss with salad greens

Blueberry Pecan Feta Salad

Organic mixed salad greens
1 cup fresh blueberries
½ cup crumbled feta
¼ cup chopped pecans
My Favourite Salad Dressing

Toss ingredients in large salad bowl
Serve with BBQ Pork Chops

Never Boring Breakfast Fritata

6 eggs
cheese (Swiss, Gruyere or cheddar)
½ cup cream
chopped chives (or small amount of finely sliced onion)

Mix eggs, cream, chives, salt and pepper in bowl
(if using onions, sauté them in butter in large frying pan)
Apply medium heat to large frying pan, melt some butter and pour in egg mixture
Place cheese slices on top
Cook over low heat for a couple of minutes
Place under broiler until golden brown
Slide from pan to cutting board and cut into wedges for serving
Leftovers can be kept in fridge and reheated in microwave

Serve with bacon, sliced tomato and Hellman’s mayonnaise
Goes well with Franks Hot Sauce for added flavour

Yummy Tomato Sauce

I large can Italian tomatoes (make sure they are from Italy)
1 medium onion
2 cloves garlic
course pepper
chopped basil (fresh or dried)
olive oil

sauté onion and garlic in liberal amount of olive oil
add tomatoes, basil, pepper and heat for a few minutes (don’t overcook)
put in food processor and run until smooth
salt to taste

can be stored in freezer

Excellent Eggplant and Feta Appetizer

I medium eggplant
Feta cheese
Olive oil
Yummy Tomato Sauce

Cut eggplant into thick slices, toss with olive oil and grill until soft on BBQ (can be done in advance and stored in fridge)
Place cooked eggplant slices on baking sheet, cover with slabs of feta cheese and place under broiler until cheese is golden.
Spoon 1 – 2 T warm tomato sauce onto each plate and place 1 eggplant slice in sauce.

Makes a great appetizer or larger portion can be light dinner.

Faux Mashed Potatoes

1 large cauliflower
1 can Money’s mushrooms (or fresh mushrooms)
2 cloves garlic
1 small onion
1 cup cream
course pepper

Wash cauliflower, break into florets, steam until tender and drain.
Drain mushrooms and sauté with onions and garlic in liberal amount of butter.
Add drained cauliflower, cream, salt and pepper.
Place in food processor, mix until smooth.

Leftover Beef and Mushroom Ragout

½ – 1 lb cooked beef (from roast or leftover steak)
1 – 2 cans Money’s mushrooms (from Costco)
1 whole garlic
1 cup cream
course pepper

drain mushrooms and sauté in liberal amount of butter or olive oil, add
thinly sliced beef and chopped garlic
when mixture is warmed add cream and seasonings
cook over low heat for a few minutes and serve

Roasted Cauliflower

1 large cauliflower
olive oil
course salt

cut cauliflower into florets, wash and drain
toss with liberal amount of olive oil and coarse salt
place on baking sheet and bake at 350 F, tossing every 15 min. until tender (about 40 min)

Delicious Balsamic Asparagus

1 lb fresh asparagus
¼ cup balsamic vinegar
parmesan cheese

trim, rinse and drain asparagus
Melt butter in large frying pan and add balsamic vinegar
Add asparagus, cover and sauté until tender
Place on plate and cover with shaved parmesan

Creamed Spinach

2 packages frozen spinach (or equivalent fresh spinach)
small onion
3 cloves garlic
3 Tbsp butter
1 cup cream
1 cup grated parmesan
pinch of nutmeg

lightly sauté onion and garlic in butter
add spinach and stir over medium heat
add cream, parmesan, nutmeg and salt and pepper to taste
Process in food processor until smooth (optional)
Can be frozen for later use

Roast Cauliflower with Cheese

1 head cauliflower, cut into florets

2 cups heavy cream 

1/2 pound Monterey Jack cheese, coarsely grated 

2 cups grated Parmesan 

6 ounces goat cheese, cut into small pieces 

Salt and freshly ground pepper

Preheat oven to 400 degrees F. 
Layer the cauliflower, heavy cream, and the 3 cheeses in a medium casserole dish. Season with salt and pepper. Roast for 20 to 30 minutes or until the cauliflower is soft and the sauce has thickened slightly. Remove from the oven and let rest for 10 minutes before serving.

Low-Carb Chocolate Pecan Ice Cream

1 l. whipping cream
1/2 a vanilla bean (optional)
1 tbsp vanilla extract
9 egg yolks
5 packets Twin
5 packets Equal
3 tbsp unsweetened chocolate powder (I get mine from Capers)
1 cup pecans

cut the 1/2 vanilla bean lengthwise and toss it in with the cream
heat in a double-boiler or saucepan over low heat – don’t bring to a boil
chop pecans to peppercorn size and place in freezer
put the egg yolks into a food processor (chopper or blender)
add vanilla extract and chocolate and vanilla bean scrapings
spoon about 1/2 cup of the hot cream into egg mixture and process until smooth, stir mixture into remaining hot cream
continue to heat, stirring until custard thickens a little (don’t boil),
remove from heat and stir in artificial sweeteners
cool to room temperature then chill in freezer for an hour
pour into churn, turn on, set timer for 15 minutes (more, if needed)
add chilled pecans when nearly done
serve garnished with a sliced strawberry

For Maple Walnut flavour, omit the chocolate and pecans, add 1 tbsp maple extract to custard and, instead of pecans, use chopped walnuts sauted in butter, sprinkled with 1 packet of Equal and chilled in freezer.

Store in freezer in ½ cup Glad containers, or you’ll eat too much!
(I get them from Canadian Tire)
It is best to use an ice-cream maker that doesn’t require ice. I use a Cuisinart 2 qt. size that I got at the Bay for about $100

1-minute low-carb chocolate cake

1/4 cup ground pecans or almonds
2T butter
1 egg
3T granular Splenda or equvalent
1/4 t baking powder
1T unsweetened chocolate powder
1T water

In a 2-cup pyrex measuring cup or small microwaveable
bowl mix ground almonds or pecans, Splenda, baking powder and
chocolate powder.
In separate small dish, melt the butter in microwave. Mix the water
and egg with the butter. Add to dry ingredients and mix.
Cover with plastic wrap and make a couple slits in the top. Microwave
HIGH for 1min, 10sec or until done. Flip out of bowl onto cutting board to cool.
Will appear moist at first but will set up nicely in a minute.

Low-Carb Almond Cookies

2 c almond flour
½ c Splenda
½ c soft butter
1 t vanilla extract
1 t almond extract

preheat oven to 300F
place balls of dough on cookie sheet
bake for 5 minutes
press lightly with fork
bake for another 15 min
let cool

2-Minute Breakfast Souffle

2 eggs
2 oz cheese
2 Tbsp Cream
salt and pepper

chop cheese finely
whisk ingredients in small microwaveable bowl
microwave on high for 1-1/2 minute, stir and microwave for another 30 sec.