Don’t get me wrong. Salads are okay, but maybe not for the reasons you thought. I recently began mentoring a newbie who was diagnosed a few months back as a frank Type 2 (A1c 7.0%). He was prescribed a long-acting insulin, glargine, when he wasn’t able to tolerate Metformin and then Januvia (a DPP-4 as monotherapy!). Another physician had prescribed a SGLT2, but cancelled it when he saw a counter-indication. So, I started by asking him what he ate, and when he got to lunch, he said, “chicken tenders and a small salad.”
When I said that the chicken tenders were dredged in flour, then breaded and deep fried in oxidized seed oils high in Omega 6’s, he nodded his understanding that I thought there might be a problem. But then I told him that salads were virtually all carbohydrates. That’s when he said, “I thought salads were good for you.”
And herein lies the problem. When I said, “Think about it. Not including ethyl alcohol (spirits), there are only three macronutrients.” “What’s a macronutrient?” he asked. That’s the state of our nutrition education! I told him, “The three macronutrients are protein, fat and carbohydrate. Everything in nature that you eat is essentially a combination of one or more of them, mostly of more than one. Let’s start with the basics.
The only “foods” I can think of that are 100% fat are the manufactured, refined, “vegetable” or seed oils (PUFAs) that I try hard to avoid. Most animal foods are a combination of mostly protein and fat. Most plant-based foods are almost 100% carbohydrates, although some contain some protein and even fat.
Of course there are exceptions. A Haas avocado, for example, is a plant food that is rich in “good” fats and high in fiber (non-digestible carbs). The fats are distributed as monounsaturated 71%, polyunsaturated 13%, and saturated 16% (15% total fat), 9% carb (mostly fiber), 2% protein, 2% ash, and 72% water. Avocados are a very good plant-based food. So is olive oil (EVOO), another so-called “monounsaturated” fat.
But a salad of leafy greens is almost 100% carb, albeit low-carb; but if your “small salad” had avocados, or hard-boiled eggs, or shredded cheese, or bacon bits, or all of the above, I would say it was a very good salad, because of the protein and fat. But watch out for the dressing. Unless it is just olive oil and vinegar or your own vinaigrette, it is made from one of those refined PUFAs, the manufactured “vegetable” oils – which are all bad for you. Store bought often has sugar added as well. . So, make your own vinaigrette or just use OO & V.
Returning to my mentee, I gave him three books to read while he took a vacation: “The Art and Science of Low Carbohydrate Living,” by Volek and Phinney, “The Obesity Code,” by Jason Fung, and “Diabetes 101,” by Jenny Ruhl. Since he apparently has a sensitivity to the oral anti-diabetic medications he had tried, and he really didn’t want to be an insulin-dependent type 2 for the rest of his life, I wanted him to understand the concepts and the logic behind the science of treating type 2 diabetes as a dietary disease. I knew that if he followed the precepts of low carbohydrate eating, he would quickly reverse his diabetes and get off insulin.
He was motivated, and he seemed to me to be the ideal candidate for a “dietary solution.” We agreed we’d meet again when he returned from vacation to talk about when and what to eat and not eat.
This is my area of expertise. I was never on insulin, or any of the new injectables that are frequently prescribed before insulin, but (in 2002) I was simultaneously on three different classes of oral anti-diabetic medications and would soon, my doctor and I both knew, be injecting insulin. My T2 diabetes was progressing (sadly, as mainstream and establishment medicine still says it will). Little did I (we) know that there is another way.Interestingly, my student said his caregiver (a NP masquerading as an MD) and her colleague, in another town (an internist masquerading as an endocrinologist), hadn’t mentioned a low carb diet as a self-management treatment. The NP just wanted him to follow orders, take his insulin, and return in 2 weeks for more tests.