Health. Lifestyle. Business. PREVENTIVE HEALTH

The low carb diet issue

THE KETOGENIC DIET CRAZE: WHAT CARDIOLOGISTS HAVE TO SAY

SIX DIET FAILS

WHAT IT MEANSTO “EAT A RAINBOW” AND WHY IT MATTERS

A DIETITIAN’S GUIDE TO LOW CARB MEAL PLANNING

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AN INTERVIEW WITH LEADING CARDIOLOGIST DR. IGAL SEBAG THE KETOGENIC DIET:

Dr. Igal A. Sebag is an Associate Professor of Medicine at McGill University and Director of Non-Invasive Cardiology at the Sir Mortimer B. Davis-Jewish General Hospital in Montreal. He is the Founder and Director of the Medisys Heart Centre in Montreal.

Conventional wisdom may suggest that in order to avoid getting fat, one should stop eating fatty foods. But is this right? Proponents of the ketogenic diet claim that the healthiest way to eat (and a great way to lose body fat) is to consume a high-fat diet – getting about 70% of ones daily Calories from fat (whether it’s saturated, unsaturated, or polyunsaturated fat). Interestingly, individuals following this seemingly backward way of eating are reporting both health benefits and weight loss. So what’s the deal? We’ve asked Dr. Igal Sebag, leading cardiologist at the Medisys Preventive Health Clinic in Montreal and Associate Professor of Medicine at McGill University, to weigh in on the ketogenic diet craze and to discuss who this diet might be right for.

…CLAIM THAT THE BEST WAY TO LOSE FAT IS TO CONSUME A HIGH-FAT DIET

Q: What is the ketogeic diet and how does it compare with a traditional “healthy balanced diet”?

A: To put it simply, there are three food sources of calories in the human diet: protein, fat, and carbohydrates (alcohol contains calories but is considered a drug not a food). The average Canadian today gets about 65% or more of their daily calories from carbohydrates, 20% or less from protein, and 15% or more from fat – including saturated and unsaturated. Unfortunately, the majority of Canadians eat mostly “bad carbs” (eg. sugar, refined wheat, processed foods, fruit juice, pop, French fries, pastries etc.) and not enough “good carbs” (whole fruit, legumes, sweet potatoes, whole grains etc.). Even more alarming, some reports suggest that many Canadians (especially kids) are getting about half of their daily calories from refined sugar! Consequently, the rates of chronic diseases like type II diabetes, heart disease, and obesity are rising dramatically in this country.

The traditionally accepted “healthy balanced diet” among the medical and dietitian community (although nothing is set in stone) typically includes about 50% good carbohydrates (focusing on vegetables, whole fruit, whole grains, legumes etc.), 30% protein (focusing on lean meats, nuts, seeds, eggs, and dairy products), and up to 20% fats (focusing on unsaturated and polyunsaturated fats and limiting saturated animal fats).

The ketogenic diet is a high fat diet where carbohydrate consumption is severely restricted (often to about 20 grams of total carbohydrates per day - or 5% of total calories); protein consumption is somewhat restricted and fats are eaten in abundance. The goal of the ketogenic diet is to lower glucose and glycogen levels in the body so that it is forced to burn protein and stored fat for fuel instead. In metabolizing fat and protein for fuel the body produces molecules called “ketone bodies”; a state known as “ketosis”. To achieve “ketosis”, the ketogenic diet often recommends that a maximum of 5% of your daily calories should come from carbohydrates, with the rest coming from protein (25-30%) and fat (65-70%). The ketogenic diet is somewhat similar to a conventional low-carb diet, in that both diets severely restrict carbohydrates. However, most low-carb diets (such as the Atkins diet) focus on eating more protein, whereas the ketogenic diet focuses on eating more fats.

Q: Why is the ketogenic diet controversial among Cardiologists?

A: For optimal cardiovascular health, the medical and dietitian community has typically encouraged limiting saturated animal fat intake to no more than about 7% of daily calories, (that’s less than 20 grams of saturated fat for a typical healthy adult consuming about 2000 calories/day) and < 200 mg/d of dietary cholesterol.

A number of peer-reviewed studies have confirmed that - with all other things being equal - limiting consumption of saturated fat and dietary cholesterol helps lower ‘bad cholesterol’ (LDL cholesterol) levels in the blood and helps reduce the risk of developing cardiovascular disease. The World Health Organization’s systematic review reported that healthy low saturated fat diets (eg. the Mediterranean diet, the MIND diet, or plant based diets) are associated with decreased combined cardiovascular events compared with high saturated fat intake diets. That said, individuals who follow a low-saturated fat diet but at the same time consume high amounts of refined carbs, do not achieve the same health benefits. Often individuals following the ketogenic diet do not distinguish between saturated animal fats like lard, chicken fat, duck fat, goose fat, butter, heavy cream, fatty red meat, cheese etc. and “healthy fats” like avocados, olive oil, small wild-caught fatty fish, nuts, seeds etc. Simply put, a high fat diet can be healthy but it’s still advisable to focus on healthy fats and limit unhealthy fats. This lack of distinction between good vs. bad fats among some individuals on the ketogenic diet may result in individuals consuming 10 times the daily recommended limit of saturated fat. This is a concern - particularly for individuals with certain cardiovascular disease risk factors or certain health conditions.

Q: Many people on the ketogenic diet report rapid and significant weight loss. Explain that.

A: Weight loss ultimately comes down to two things – Calories consumed and Calories burned. If you consume fewer calories than you burn by eating less – you lose weight. It’s important to note that based on the available data, almost all studied “diets” that focus on eating whole foods (vs. refined, processed foods) have been shown to induce weight loss as long as they result in an overall calorie deficit (burning more calories than one consumes).

The primary reason why most diets (or dieters) fail in achieving the level of weight loss they expect is because diets are hard to stick to, people give up. It’s better to make sustainable positive changes that you can stick to long term - changes like replacing juice and pop with water, or eating an extra serving of vegetables with every meal - than to continuously cycle through different diets that you can’t maintain. The ketogenic diet, the Atkins diet, the Zone diet, the Paleo diet, Weight Watchers, the Mediterranean diet, the South Beach diet, they’ve all actually been shown to induce weight loss if they are followed as directed. The interesting thing about the ketogenic diet, however, is that many dieters find it easier to stick to than other diets, and thus may be associated with higher rates of success.

Healthy carbohydrates and foods that are high in soluble fibre help the body absorb and retain water – which is important not only for digestion and bowel regularity, but also for other biological processes. When carbohydrates are severely restricted, as in the case with the ketogenic diet, often people lose water quickly which can give the illusion or appearance of rapid weight loss. This helps motivate people to stick with the diet until the actual health benefits and fat loss kick in. Whatever your goal, whether it’s losing weight, improving your overall health, or managing a specific chronic condition, it’s important to speak with a physician to understand which diet may be best for you based on your current health status and disease risk factors. In the case of the ketogenic diet, it’s also important to work with an experienced registered dietitian to help you ensure that you are eating the right foods to meet your daily micro-nutrient requirements.

Q: If all diets have the potential to induce weight loss, why is the ketogenic diet specifically becoming so popular?

A: The ketogenic diet isn’t just about weight loss - although weight loss is often a welcome consequence. The ketogenic diet has been investigated for its potential role in the management of numerous conditions from diabetes, to epilepsy, to mood disorders, to infertility and other health conditions. In my opinion, there is a healthy way and an unhealthy way to follow a high fat low carbohydrate diet. For people who love eating rich, heavy, satisfying foods that are not typically “allowed” on other diets, like mascarpone cheese and stilton, butter, bacon, pork belly, ribeye steaks, egg yolks, cured red meats, and whipping cream etc. - the ketogenic diet is popular because people often find it easier to stick to than other diets. However, even though these rich high fat foods may not break the “rules” of the ketogenic diet, they are still not healthy when consumed in large quantities. Also, if you are eating cheese and meat at the expense of any other healthy foods like vegetables, nuts, whole fruit, nuts and seeds, that can become an issue.

When it comes to weight loss, relative to carbohydrates, protein and fat are digested slowly and make you feel fuller for longer. Therefore, by design, the ketogenic diet may help suppress appetite making it easier to consume fewer calories in a day than you otherwise might, without the hunger. People like diets that don’t leave them feeling hungry, hence

the rising popularity. Consider the following example: let’s say you were on a Calorie restrictive diet and you wanted to limit a particular meal or snack to 400 Calories. For the purposes of illustration, here are four food options that would be within this Calorie budget:

For the purposes of illustration, here are four food options that would be within this 400 Calorie budget:

• High carb option – 100 grams of rice cakes (81 grams of carbohydrates, 3 grams of fat, 8 grams of protein)

• High fat option – 100 grams of bacon (1 gram of carbohydrates, 38 grams of fat, 12 grams of protein)

• High protein option – 25-30 egg whites (6 grams of carbohydrates, 1.5 gram of fat, 90 grams of protein)

• Healthy balanced option – Large spinach salad with avocado, grilled chicken, apple, roasted sweet potato, walnuts and an olive-oil based dressing (22 grams of carbohydrates, 24g of protein, 22 grams of protein)

Even though all options contain about the same amount of total Calories, the high carb option (the 100 grams of rice cakes) would likely leave you feeling hungry again after an hour or two.

Q: Explain ketosis and the potential risks of putting your body in a chronic state of ketosis.

A: Unless you restrict carbohydrate intake, glucose from carbohydrates are the body’s primary and preferred fuel source and is essential for central nervous system function. You can’t live without at least some glucose, period. When you consume carbohydrates, your body either breaks the carbohydrates down into glucose for use as immediate fuel, or stores the glucose as glycogen for later use. When your body runs out of glucose and glycogen stores (eg. when you are on a carbohydrate restrictive diet like the ketogenic diet) your body is forced to metabolize protein and fat as an alternative source of fuel. In metabolizing fat and protein, you create “ketone bodies”, putting your body into a state of “ketosis”. For healthy individuals who don’t have diabetes and aren’t pregnant, ketosis usually kicks in after 3 or 4 days of eating less than 50 grams of carbohydrates per day (the equivalent of about 1 and 1/2 bananas). Fasting also induces ketosis. Severe ketone body buildup can lead to a condition known as “ketoacidosis” which is a serious condition that can disturb pH levels, lead to bone loss, kidney stones, kidney disease, and liver disease - or, in severe cases, coma or death. However, this condition rarely affects people do not have diabetes (primarily type I diabetes). It’s important to speak with a physician to understand your personal health status and your risk factors before starting any severely restrictive diet.

Q: For individuals following the “ketogenic diet”, what would you recommend?

• Consult a Registered Dietitian to ensure your micronutrient requirements are met. High-fat, ultra-low-carb foods are often low in water content, vitamins, minerals, fibre, and disease-fighting antioxidants. If you aren’t careful, you may risk vitamin deficiencies, constipation, electrolyte imbalances, and dehydration. An experienced dietitian will work with you to ensure that you are eating the right foods.

• Before considering a highly restrictive diet like the ketogenic diet, consult your local preventive health clinic and speak to a physician that specializes in preventive health. Get your blood work done. Understand your risk of cardiovascular disease. At Medisys, a team of Registered Dietitians, cardiologists, kinesiologists, and primary care physicians work collaboratively with you to help you achieve your health and diet goals safely.

• Focus on healthy fat sources like nuts, seeds, avocados, small fatty fish, and olive oil and limit saturated fats and dietary cholesterol.

• Try to consume some fruits or vegetables from EVERY colour category EVERY day (red, purple/blue, orange/yellow, green, and brown/white) - focusing more on vegetables than fruit. This colour variety will help guard against micronutrient deficiencies. Also, include some cardio-protective foods in your diet like soluble fibre, high anti-oxidant foods, unsweetened cocoa powder, raw nuts and legumes.

• Stay properly hydrated. Drink lots of water.

Q: Is the ketogenic diet a healthy choice?

A: Short answer, yes, the ketogenic diet can be a healthy way to lose excess weight and an effective disease management tool, if done right, under the guidance of qualified health professionals. The ketogenic diet is not for everyone and that’s why we recommend seeking the advice of a physician and registered dietitian prior to trying the ketogenic diet. When discussing the topic of health and healthy lifestyle choices, I think it’s important to note that (according to stats Canada) the average Canadian really isn’t very healthy at all. More than 50% of Canadians are either overweight or obese, close to one third of the Canadian population is diabetic, and 90% of Canadians have at least one risk factor for heart disease and stroke. If it were so easy to only eat whole nutritious foods and consume only the amount of calories we needed to maintain our health, we wouldn’t have an obesity epidemic and a diabetes epidemic.

I recognize that most Canadians that are overweight or obese may really struggle to lose the extra weight. Some individuals claim that they’ve tried all types of other diets and that the ketogenic diet is the only one that has worked for them because it reduces their cravings for sugary and highly-processed, high carbohydrate foods. Excess weight, especially around the belly, substantially increases an individual’s risk of numerous health conditions such as diabetes, coronary heart disease, stroke, osteoarthritis, sleep apnea, several cancers, depression, and others - so for individuals with these risk factors, finding a sustainable healthy diet that works for them is important.

Q: What does the research say about high fat/low carb diets?

A mounting body of evidence does suggest that higher fat and lower carbohydrate diets may be associated with improved health outcomes and a lower risk of death relative to lower fat diets. For example, a recent major global study (the PURE study) led by researchers at the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences – which followed more than 135,000 individuals for over seven years, suggested consuming about 35% of daily energy as fat is associated with a lower risk of death compared to lower fat intakes. Also, the research demonstrates that diets low in refined sugar and refined carbohydrates lead to weight loss and other health benefits. The most important thing is to focus on health, not weight. Evidence overwhelmingly shows that low-risk health behaviors (achieving and maintaining a healthy body weight, eating a healthy balanced diet, getting regular physical activity, smoking cessation, limiting alcohol consumption, and getting sufficient sleep) are immensity powerful in the prevention of heart disease. In fact, results from large observational studies suggest that low-risk lifestyle behaviors are associated with a 60%-80% lower risk of heart disease.

DIET FAIL #1: POOR SLEEP HABITS

A whopping 30% of Canadians – including children and adolescents – get less than 6 hours of sleep per night. According to medical experts, that’s not enough sleep. A mounting body of evidence shows that chronic sleep deprivation is bad for brain health, bad for both physical and emotional health, and, not surprisingly, leads to weight gain. When it comes to weight management, sleep is an important hemostatic modulator and the reduction of sleep significantly decreases both glucose and fat metabolism while also inappropriately increasing appetite, leading to weight gain.

“Sleep plays an important role in regulating the hormones that influence hunger (ghrelin, cortisol, and leptin),” explains Medisys Registered Dietitian Richelle Tabelon, “that’s why sleep deprivation increases appetite and leads to overeating and weight gain.” To read more, click here.

Regular exercise and maintaining a healthy balanced diet will always be important components of weight management – but if you are exercising and eating all the right things and your diet still isn’t working, it may be time to look at other lifestyle factors that could be playing a role, like sleep.

SIX DIET FAILS:WHY YOUR DIET ISN’T WORKING

DIET FAIL #2: INSUFFICIENT HYDRATION

Drink enough water, yeah yeah, we’ve all heard it a thousand times. But it’s important to appreciate that how much water you drink matters, a lot. Sufficient hydration helps regulate hunger because your metabolism is directly linked to water consumption. Carbohydrates are broken into their component molecules by water through a process called hydrolysis. As such, insufficient water intake – regardless of what diet you are on – can result in slowed metabolism and lead to weight gain. In fact, one study found that drinking more water helped boost healthy men and women’s metabolic rate by nearly 30% (to read more about the importance of hydration, click here).

DIET FAIL #3: CONSUMING “ADDICTIVE” FOODS

Accumulating evidence has documented neurobiological and behavioural similarities between compulsive overeating and psychoactive drug dependence, leading researchers to use the term “food addiction” to describe this pattern of overeating. Studies suggest that not all foods are equally implicated in addictive-like eating behavior. Processed foods, that are both high in fat and glycemic load or foods that are high in sugar, are the most “addictive” – meaning they share pharmacokinetic properties (e.g. concentrated dose, rapid rate of absorption) with drugs of abuse. Even people who aren’t overweight or obese can be addicted to food, or have an unhealthy relationship with food. While all diets that result in a Calorie deficit (Calories burned exceed Calories consumed) will lead to weight loss – diets that include highly processed, high sugar foods are a lot more difficult to stick to. To read more about “food addiction” click here.

DIET FAIL #4: BEING DECEIVED BY HEALTHY-LOOKING MEALS

That super healthy-looking grilled broccoli goat cheese cranberry quinoa salad at your favourite lunch spot may actually pack a lot more Calories, carbohydrates, or sugar than you bargained for. Many restaurants fill their takeout boxes with rice, quinoa, or other grain product portions that are SIX to EIGHT times larger than the grain serving size recommended by the Canada Food Guide. One “serving” of grain products should be about half a cup, cooked. If you are curious how many servings of grain products are in your takeout order, pack a measuring cup in your brief case and do some detective work. To discover which “healthy” takeout meals contain more carbs than half a loaf of bread, check out our carb comparison guide.

Think green salads are guaranteed to be a safe bet? Think again. We’ve analyzed the nutrition content of several popular salads at leading Canadian restaurant chains and found some salads with more sugar than three slices of your average banana cream pie! When ordering takeout, or when dining at a restaurant, green salads and grain salads (made with whole grains) are often a healthy choice. However, just because something looks healthy doesn’t mean it is low in Calories or carbs. When it comes to takeout orders, be

mindful of grain portion sizes, and be weary of salads that are loaded with dried fruit, candied nuts, glazed or battered proteins, and sweet dressings.

DIET FAIL #5: TREATING FRUITS AND VEGETABLES LIKE EQUALS

Up to 80% of Canadians aren’t getting enough of the health-promoting, disease-fighting phytonutrients found in colorful fruits and vegetables. You should be eating a wide variety of fruits and vegetables from each colour group (eg. green, red, white, yellow, purple) every day, for a total of about 7-10 servings daily servings. One serving is about 1/2 cup of chopped raw fruit or vegetables, or one whole small fruit such as an apricot or a peach. However, just because fruit is good for you doesn’t mean you should eat the whole case of nectarines in a day! Fruits are higher in naturally-occurring sugars, and as such, when you are trying to manage your weight, it’s important to focus on eating more vegetables than fruit. Of your daily recommended fruit and vegetable servings, the split should be about 70:30, vegetables to fruit. A cup of chopped whole fruit contains about 120 Calories, whereas a cup of chopped green veggies contains about 10 Calories. Fruit is chalk full of disease-fighting compounds, vitamins, and minerals, so eat fruit and feel good about it. But, don’t treat fruit like a “free food” the way you may with celery, lettuce, collard greens, cucumbers, or other low calorie veggies. As a rule, before adding anything else to your plate at lunch and dinner, fill half of it with veggies.

DIET FAIL #6: FASTING

You may have fasted in the past and had short term success, but for most people, extreme dieting doesn’t work as a healthy, sustainable weight management solution. In fact, fasting is often counterproductive. You might lose some weight at first and gain more after. This is because starvation diets tap into evolutionary biological mechanisms that used to kick in when food was scarce. “During famine, our bodies respond to lower calorie intakes by slowing down the metabolism to not burn as much energy” says Dr. Farrell Cahill, Director of Research at Medisys Health Group. “Our bodies are regulated by a delicate balance of hormones and that balance gets disturbed when you starve yourself,” he continues.

YOUR DIET PROBABLY ISN'T WORKING BECAUSE, WELL, IT'S A

DIET. STOP GOING ON DIETS. INSTEAD, FOCUS ON LONG-TERM,

SUSTAINABLE LIFESTYLE CHANGES THAT YOU CAN COMMIT TO.

- DR. FARRELL CAHILL

The risk of micronutrient deficiency is an important consideration for those on a highly-restrictive diet, especially diets that severely restrict carbohydrate intake. Consuming only high-fat, high-protein, low-carbohydrate foods (if not selected carefully, with the support of a Registered Dietitian), may lead to inadequate consumption of vitamins, minerals, antioxidants, and dietary fibre.

Put your health first and try to include a variety of fruits and vegetables from each colour category every day. If you aretrying reduce your carbohydrate intake, opt for fruitsand vegetables that are higher in fibre, and lower in sugar and starch content – but be careful not to neglect any colour category in doing so. Need help? Consult your local Medisys dietitian for support, food-selection guidance, and meal planning advice.

WHAT IT MEANS TO “EAT A RAINBOW” AND WHY IT MATTERS

Phytonutrient Cheat Sheet

80% OF CANADIANS AREN’T GETTING ENOUGH of the health-promoting, disease-fighting phytonutrients in colorful fruits and vegetables. For optimal health, aim for two servings (1 cup) of fruits or vegetables from EACH colour group (eg. green, red, white, yellow, purple) daily, for a total of 10 servings every day. One serving is about ½ cup of chopped fruit or vegetables, or one whole small fruit such as an apple or a peach. Because fruits are higher in naturally-occurring sugars, focus more on vegetables than fruits eg. 6-7 servings of vegetables and up to 3-4 servings of fruit.

TWO 1/2 CUP SERVINGS PER DAY FROM EACH COLOUR GROUP:

REDTomato, watermelon,grapefruit,pomegranates,raspberries, walnuts*,persimmons, redcabbage, chilipowder†, cherries,papaya, cranberries,etc.

WHITE/BROWNGarlic, onions,apples, black tea,green tea, coconut*,parsnips, rutabaga,etc.

YELLOW/ORANGECantaloupe, carrots,sweet potatoes,squash, citrus fruits,pumpkin, peaches, turmeric†, ginger†, mango, corn,pineapple, etc.

PURPLE/BLUEGrapes, blueberries,blackberries, purplesweet potatoes, wine, beets, eggplant, prunes*, purplepotatoes, etc.

GREENGreen or black tea,spinach, kale, saladgreens, broccoli,collards, greenpeas, chard, parsley,watercress, greenbeans, Brusselssprouts, arugula,sugar snap peas,Chinese cabbage,legumes, etc.

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY

* For these foods, a single serving is 1/8 of a cup† For these foods, a single serving is 1 tspFor more information, and to check out the infographic that accompanies this cheat sheet, visit www.precisionnutrition.com/color-chart.

By Dusty Stevenson, Registered Dietitian, Medisys Toronto

If you are cutting carbs by reducing your consumption of highly processed foods and refined sugar, all the power to you! If you need some help, Medisys has developed a free 30-day-no-refined-sugar challenge, which may help you eliminate up to 7 pounds of sugar from your diet! If you are cutting carbs by swapping veggies and legumes with bacon and peperoni sticks, it’s time to re-think your grocery list! Here are 10 foods with less than 2 gram of net carbs per serving that are heart-healthy, nutrient-dense, and high in fibre!

1. Hemp hearts/raw shelled hemp seeds –

Virtually all of the carbohydrates in hemp hearts come from fibre, making them a zero net carb food. Each 3 tablespoon serving packs 10 grams of protein, 20% of your daily recommended intake of iron and numerous other vitamins and minerals. Hemp protein provides ten essential amino acids including arginine, histidine, methionine and cysteine. Hemp seeds are also an excellent source of omega-6 and omega-3 polyunsaturated fatty acids.

2. Unsalted nuts –

Research suggests that eating just 28 grams of nuts per day protects against heart disease, diabetes, cancer, and even premature death https://blog.medisys.ca/en-ca/company/resources/nuts-diet-may-help-live-longer-study-finds. If you are looking for low carb nuts, brazil nuts, hazel nuts, macadamia nuts, pecans and walnuts all come in at about 2 grams of net carbs per one ounce serving. In addition to healthy fats, nuts are packed with nutrients, minerals (such as magnesium and calcium), and phytochemicals.

3. Spinach –

A cup of fresh spinach contains virtually zero net carbs (and only 6 Calories). Spinach is a powerhouse of vitamins, minerals and antioxidants. It’s a rich source of iron, folate, vitamins A, C and K, potassium, calcium and magnesium. It is also a source of lutein, powerful antioxidant linked to eye health.

4. Wild caught salmon –

Salmon is high in protein, naturally carb free, and an excellent source of vitamins B6, B12 and niacin. It’s also packed with potassium, selenium and phosphorus and is one of the few foods naturally high in vitamin D.

5. Flax seeds –

Like hemp seeds, all of the carbohydrates in flax seeds come from dietary fibre making them a zero net-carb food. Flax seeds are an incredible source of alpha linolenic acid (ALA), an omega-3 fatty acid with cardio-protective benefits.

6. Olives and extra virgin olive oil –

Instead of loading up on saturated animal fats, eat more olives and extra virgin oil. A serving of 10 olives contains about 2 grams of net carbs. As well as disease-preventative monounsaturated fatty acids, olives and olive oil contain polyphenols, flavonoids and antioxidants.

7. Cauliflower –

A 1/2 cup serving of cauliflower contains less than 2 grams of net carbs. Cauliflower is a great source of vitamin A, folate, calcium, potassium and selenium, an immune-boosting antioxidant. Cauliflower is also famous for its high concentration of cancer-fighting chemicals called glucosinolates.

8. Asparagus –

Due to its high fibre content, asparagus is close to carb free. It’s an excellent source of vitamins A, C and K, folate and potassium. Research also suggests that the combination of phytochemicals in asparagus (including saponins, quercetin, rutin and kaempferol) make it a powerful anti-inflammatory food.

9. Mushrooms –

A 3 oz serving of mushrooms contains about 2 grams of net carbs. Mushrooms are a great source of selenium, an antioxidant mineral, as well as copper, niacin, potassium and phosphorous.

10. Zucchini noodles –

Love pasta? Try zucchini noodles! You can make your own using a kitchen gadget called a “spiralizer” or buy pre-made at your local grocery store. Half a medium zucchini contains about 2 grams of net carbs. Zucchini is low in calories but high in essential nutrients like potassium, manganese, and antioxidants like vitamin C and vitamin A.

BREAKFAST IDEAS

• Eggs baked in avocado halves • Smoothie made with shelled hemp hearts, flax seeds, all-natural unsweetened almond milk, and a handful of blueberries• Plain Greek yogurt with pomegranate seeds and hazelnuts • Omelet with shrimp, sautéed Portobello mushrooms, fresh thyme, and goat cheese• Homemade muesli of unsweetened coconut flakes, cinnamon, ginger, natural peanut butter, pistachios, chia seeds, pumpkin seeds, and sesame seeds topped with plain Greek yogurt or cottage cheese LUNCH IDEAS

• Crustless quiche (with eggs and whole milk) with a cucumber and avocado salad • Burrito bowl with shredded lettuce, grilled chicken or fish, shredded cheddar, jalapeno peppers, fresh tomato salsa, and guacamole• Dark leafy greens (arugula, spinach, or kale) with a scoop of egg salad or tuna salad (made with avocado instead of mayo)• Grain free wraps (made with chia-seeds, eggs, and cheese), filled with grilled fish, grilled veggies, and arugula • Wild salmon sashimi with a side wakame salad• Baby shrimp caprese salad – baby shrimp, sliced cherry tomatoes, fresh mozzarella, fresh basil, and olive oil SNACK IDEAS

• Homemade low-carb granola with chopped almonds, pumpkin seeds, sesame seeds, chia seeds, orange zest, shredded unsweetened coconut, cinnamon, vanilla, and almond butter• Soaked cashew “hummus” with crudités • Avocado deviled eggs DINNER IDEAS

• Shrimp or chicken stir-fry with broccolini, sesame seeds, and pine nuts• Zucchini noodles with homemade pesto, wild mushrooms, and seared sea scallops• Mussels cooked in white wine, chicken or vegetable broth, leeks, and lots of garlic • Oil-poached halibut with Brussels sprout and snap pea slaw topped with pistachios, sesame oil and grated ginger • Rosemary chicken with tahini-roasted cauliflower, garlic, and lemon DESSERT IDEAS

• Almond butter cups. Filling: all-natural almond butter and coconut flour. Outer coating: 85% dark-chocolate.• Avocado-Lime Cheesecake: Crust: ground soaked nuts, pureed dates, and butter. Filling: avocados, lime zest, lime juice, natural stevia extract, and vanilla.• Marscapone Sundae: a few tablespoons of marscapone cheese topped with fresh berries, chopped nuts, and lemon zest• Chocolate “fudge”: cream cheese, unsweetened cocoa powder, all natural liquid stevia or pureed apricots for sweetness, and melted 85-90% dark chocolate (blended and refrigerated)

For recipes and healthy low carb meal planning advice, contact Jessica Tong Jessica.Tong@medisys.ca

CUTTING CARBS? TRY JESSICA TONG’S LOW-CARB MEAL PLANNER

The flu accounts for $1 billion in lost productivity and up to 8,000 deaths in Canada each year. Medisys is Canada’s leading provider of corporate flu vaccination programs

https://blog.medisys.ca/en-ca/the-roi-of-wellness