A Guide to Keto-Friendly Meal Prep

 

Let's be honest. Changing our eating habits is hard. No matter how inspired and gung-ho we may feel when we first decide to go keto, inevitably, we will face temptations and frustrations. Whether you're brand new to the low carb or ketogenic diet or you've been following it for ages, adopting a meal prep habit can help traslate that initial enthusiasm into success. It can even save time and money along the way!

What is Meal Prep?

Meal prep is the practice of preparing a number of meals in advance, typically all at once on one day per week. I enjoy doing this on Sunday and trying to involve my kids as well! You can be flexible with this to fit your schedule. For instance, you can prepare and freeze an entire week of food, or make only certain meals or plan for only a few days at a time. 

Why Meal Prep?

It saves you time.

The more you prepare in advance, the less time you spend running to the grocery store, and my personal favorite, less day to day clean up! While yes, you prepare about the same amount of food, efficient meal prep typically relies on multitasking to significantly speed up the process.

It cuts your food bill, sometimes drastically.

Meal prep can save you a lot of money on food. How? Consider that the average U.S. consumer will dish out $5,400 on impulse purchases each year. Having a grocery list and sticking to it can dramatically decrease the likelihood that you will give into these types of impulse purchases. (anyone can make a list, but can you stick to the list? Seinfield reference anyone???) Also, preparing a week's worth of food at once makes it easier to buy in bulk, which is often more cost-effective. You'll also find it a lot easier to form your shopping list around sales when you're forced to plan in advance.

It helps you avoid impulse decisions about food.

When you're busy, it's very easy to give into carb-laden fast food temptations. When you're drained after a long day of work, you may think, Whi has time of energy to make dinner? That can lead to less healthy take out choices. Meal prepping helps you avoid this kind of impulsive decision because you'll always have a healthy meal ready for you at home. Just walk in the door, heat it up and viola, dinner is served.

It can facilitate your keto diet.

Since staying in ketosis depends on a certain percentage of macros each day, a meal plan can be invaluable. By planning your meals in advance, you can be certain that you won't get to the end of the day and realize you've gone way over your carb allotment. Meal prep makes it even easier to stick to your meal plan because you can reuse the same base components in multiple meals, making the macro calculations much easier. You're also less likely to deviate from a meal plan when the food is already in your fridge, ready to eat.

 

How to Start Meal Prepping

Getting Started

As with any lifestyle change, when you first start out with meal prep, it's important that you start slowly so that you don't overwhelm yourself. You don't need to prepare an elaborate menu with a different entreé each night. Instead, try the following steps to get acclimated to the habit.

  1. Start by picking two keto-friendly protein options that use different cooking methods. For instance, if one requires the oven, pick something that you can prepare stovetop for the other recipe. You may also pick a side dish or two if you'd like.
  2. Buy enough ingredients to make at least 3 servings of each recipe. You might also consider buying some extra meat and vegetables that you can prepare early and use throughout the week for lunches (think salads and lettuce wraps).
  3. Set aside enough containers to hold your meals for the week. You'll likely want to pre-portion the meals to keep your macros consistent, so you'll need one container per individual meal (Tip: glass is much better than plastic).
  4. On your chosen meal prep day, Sunday in my house, prepare your recipes. Be sure to prep your ingredients all at once and find ways to complete multiple tasks simultaneously. While your chicken is in the oven, for instance, you can be steaming or stir-frying some veggies.
  5. Cook any extra meat and vegetables as well, if you chose to purchase some. A slow cooker can be extremely useful here to free up your other kitchen appliances for your main recipes.
  6. Once you've finished cooking, portion out the meals into their containers. Consider freezing half of the meals to prevent any issues with spoilage. Put the extras into larger containers to portion out as snacks or side dishes.

Refining Your Routine

Throughout the first week, pay attention to the following questions:

  • Did I prepare the right amount of food? If you don't eat all the meals, consider cutting back. If you run out early or don't feel like you've saved yourself any time, consider preparing extra next time.
  • Am I bored with these meal options? If so, next time try preparing slightly different variations on the same recipe or add another entreé entirely.
  • Did meal prepping benefit me this week? Think in any terms you want: time, money, healthy decisions, etc.

It will take some trial and error to determine how often to meal prep and how much to prepare each time. Experiment with different schedules and menus until you are completely satisfied with the answers to these questions.

Keto-Specific Meal Prep Tips

Making meal prep work for any diet is all about planning, and keto is no different. The key is to prepare foods that will help you comply with the diet.

Add variety.

One of the main objections to meal prepping is that people don't want to eat the same meal over and over throughout the week. People who aren't following keto will often use a different carb with each meal to change things up. This isn't possible when following keto, unless you use alternatives such as spiralized or riced vegetables. If variety is important to you, consider one of the following ideas that take less time than adding a whole extra recipe to your prep day.

  • Prepare the same marinade, sauce, or seasoning, but use it on different proteins.
  • Stir-fry different combinations of vegetables with the same sauce or spices.
  • Portion your protein, vegetables, or both into sections and season each differently before baking or frying.

Don't skimp on snacks.

Pre-portioning keto-friendly snacks during your meal prep time can help ensure that you always have healthy options to keep you from dipping into the office candy jar, or in my case, snacking on the muffins and doughnuts in the doctor's lounge (I know that's absurd, but that is what they serve in the hospital!).

Label your food containers.

You should always label your food containers with the dish and date it was prepared. It's also helpful if you're following keto to mark the net carbs and other relevant macros in case you end up mixing and matching your recipes you can still stay on point.

With these tips, you should be well on your way to an efficient and effective meal prep routine. Once you see how much easier it is to follow the ketogenic diet with meal prep, you'll never go back.

 

Whole30 Mexican Salmon Cakes with Mango Relish

I am a big fan of Melissa Hartwig and her Whole30 program. First there is the general concept that how and why we eat are just as important as what we eat. Then there are her recipes. Some people feel it can get boring eating real foods, no added sugars or grains or processed food. Melissa's recipes show us that it is anything but boring. Try these Mexican Salmon Cakes with Mango Relish and you will drop the word boring from your vocabulary. I'm a spice wimp so I did it without the cayenne pepper and jalopenos, and I served it with sauted spinach and some leftover broccoli/carrots/cauliflower I had in the fridge. Deliscious!

Dessert- Who Needs it? Not Me and Not You!

I just had the most incredible family Passover Seder. We travelled to the east coast to see our cousins, and they treated us to a wonderful evening. We always have a fantastic time when we see them, which is not often enough.

 

Their company makes eating flattened cardboard (a.k.a matzah) almost worthwhile.

 

They also know how to feed us. A beautiful salad, matzah ball soup, steamed green beans, butternut squash “rice,” salmon, roasted chicken…my mouth is watering all over again just thinking about it. It was delicious and plentiful.

 

When dinner concluded, we pushed ourselves away from the table nicely fed, likely fuller than we needed to be (these things can happen when we get distracted by great conversation and connecting with our loved ones). If the evening had ended here, we would all have been more than satisfied.

                     

Trust me when I say no one would have gone home hungry.

 

But then it happened.

 

They brought out dessert.

 

We figured this would happen and tried to plan in advance by bringing a beautiful fruit tray that we picked up from a local grocer. Everyone remarked how lovely it was. Then they would sample one or two pieces of fruit and immediately turn their attention to the not one, not two, but three cakes that were beautifully displayed next to it.

 

Why three? Excellent question. I’m not sure as to the answer, but I noticed that most people felt compelled to take a piece of each one.

 

I was immediately struck by the complete lack of necessity for the cakes.

 

Was anyone still hungry or lacking for calories? No way. Dinner was more than enough.

 

Were we lacking in conversation and socializing so we needed an excuse to extend the evening? No way. The kids were getting restless and the adults were starting to yawn as it was getting late in the evening. We had all had a wonderful time, but it was clear the end was drawing near.

 

Our well-meaning hosts provided the array of desserts because that is what people do.

 

That is our unconscious action and belief about what a dinner party should entail.

 

I am sure (or at least I hope) that if we logically think about the need for dessert, we would see that it is almost always unnecessary. When we act in an unconscious manner, however, we simply provide dessert because it is what we do and what we feel our guests expect.

 

It turns out, studies have shown that we make 200 food and beverage decisions every day. 200! When I first heard that my initial reaction was, “No way. It doesn’t feel like that many at all.” 

 

That is true. It doesn’t feel like we make 200 decisions because most of them are unconscious decisions. They are habit, routine, automatic. They are less decisions and more natural reactions.

 

Our health usually suffers from those decisions. On the one hand, we could say it isn’t really our fault. Society inundates us with unhealthy junk food.

 

A prime example was on our flight home from the east coast. It is a minor miracle to get any food on an airplane nowadays. Our flight attendants were happy to announce that they provided free snacks for the flight. They proudly walked down the aisle holding their trays full of packaged cookies, chips, fake cheese and crackers, and the healthiest option….pretzels.

 

It was no surprise that all the kids on the flight immediately wanted one or two of everything. I was struck, however, by how many adults wanted to partake in the junk fest as well.  Was it their fault? There were no other options available. What else could they have done?

 

Plan ahead. My wife is the master at plan ahead food. We had a Tupperware of carrots, almonds, cashews, sweet potato, broccoli and cauliflower. We even had PB&J for the kids.

 

What if you can’t pack ahead? Just say no. Nancy Regan would be proud of you. If you have read my posts on intermittent fasting, you understand the importance of knowing that we are in control of our hunger, not the other way around. Going without snacks on a four-hour flight should not be a major challenge in our lives.

 

The problem once again lies in our unconscious decisions. We don’t actively think about our nutrition and don’t plan ahead to provide healthy choices. Until society does it for us (which seems unlikely on a mass scale in the immediate future), it is up to us as individuals to make the unconscious become conscious.

 

It isn’t always easy to question the automatic decisions. Trust me, I wanted to discuss the dessert issue with our host. I chickened out. She was incredibly gracious and warm to welcome us into her home and provide a wonderful meal. The last thing I wanted to do was insult her or make her feel badly about her decisions.

 

So, I let it go. In a way, I am an enabler for the next time. I admit that it is not always an easy thing to point out to others.

 

But it is an important thing to do. Our health depends on us taking responsibility for what we put in our bodies, what we make available for us and others, and how we make our 200 food and drink decisions.

 

We can start by reframing how we make our own decisions, and then can help others see how they make theirs. One by one, we can make the unconscious become conscious. Then we can give our health the priority it deserves.

 

ACTION ITEM:

At your next dinner party, birthday party, or other social gathering, do not serve dessert. Simply don’t have it. Don’t apologize for not having it. Don’t make a big deal about it. Don’t even mention it. Just go about as usual as if nothing was different. Over the course of the next week, ask those who attended if they noticed anything different or if they felt anything was missing. You may be surprised about what you find!

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Stevia- Sweetness for free, or same story different chemicals?

“I love your book but I have a big problem and a question for you.” Since this was coming from my favorite cousin, I knew she was obligated to say she loved the book. But she had a “big problem.” Was she about to attack a major premise? I braced for the question.

 

“Do I have to give up Stevia? I’m just not sure that I can.”

 

First off, I love this question. It is a very specific question. She can focus on this level of detail because she already eats predominately real foods, vegetables first with healthy fats, and with appropriate quantities of high quality animal sources. She already commits to regular exercise and physical activity and does her best with stress reduction and sleep.

 

Check. She gets the big picture. That’s 90% of my job when it comes to advising clients how to reframe their nutrition and lifestyle. The details may be harder to answer completely, but they are easier in the sense that the big picture is taken care of.

 

So, what about Stevia?

 

Stevia comes from the stevia plant, Stevia rebaudiana, and has naturally occurring glycosides which are extracted from the plant to concentrate the sweet flavor. Sounds great, right? It is a natural plant, what could be wrong?

 

It is the best of the sweeteners as it has no calories or absorbable carbohydrates.

 

It has been shown to have minimal effect of on glucose, a claim that artificial sweeteners cannot make. In fact, stevia proponents market it specifically for those with diabetes.  

 

Interestingly, stevia does increase insulin levels. Some promote this as a benefit. If it increases insulin without increasing glucose, then it could help treat hyperglycemia seen in diabetes. That assumes, however, that higher insulin levels are beneficial.

 

That is likely an incorrect assumption. Insulin is a pro-inflammatory fat storage hormone. Therefore, more insulin in the body can cause increased fat mass and increased inflammation. How much insulin is too much? That is very difficult to say. But it makes sense that we should all strive for optimal blood glucose control with the lowest possible amount of insulin in our bodies.

 

Stevia’s effect on insulin is small, especially when compared to sugar and artificial sweeteners, so it is unclear if this is “harmful” or not. As with most things, it is not a black or white answer. Shades of grey predominate.

 

In addition, some stevia products, such as Truvia, are highly processed versions of stevia that contain very little pure stevia extract. Remember, stevia has to survive on the store shelf, so manufacturers add chemical such as erythitriol or dextrose, plus added flavors.

 

Other versions, like Green leaf stevia, are less processed and more pure.

 

Stevia extract is much sweeter than sugar, so a little goes a long way.

 

Many have claimed even greater health benefits from stevia. However, claims for weight loss, cholesterol reduction, improved blood pressure, and even anti-cancer benefits are poorly researched and far from proven.

 

The Real Issue

 

The real problem with stevia is not with its chemical structure or its physiological effects on our blood sugar. The real problem is that Stevia reinforces our dependency on sweet tastes.

 

We can train our taste buds, for better or for worse. I see it time and time again. One sweetener becomes two, which then becomes three. Yet we don’t find the increased sweetener increasing the “sweetness.” That is because our taste buds adapt to the sweetness and require more.

 

As a society, sugar and sweet flavors have become an epidemic. We need to train our taste buds and our brains to not require sweeter and sweeter foods. That is where I see the big problem with stevia. It is too sweet and is a slippery slope to seeking sweetness in other aspects of our food and drink.

 

If you need a sweetener, and I encourage you to explore your definition of need, then stevia is likely your best choice.  If you can minimize the amount you use, even better. Remember, we can train our taste buds. We can require less sweet taste and can still enjoy our meals.

 

ACTION ITEM:

Go for a whole week without sugar or artificial sweeteners. That includes even the “natural” sugars like real maple syrup, honey and others. It’s just 7-days. You can do it. At the end of the week, if you feel the need to go back to your sugar or sugar substitute, cut it in half. You may find that your taste buds have adapted and half your usual amount is now just right.

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Can Eating Better Save 400,000 Heart Attack Deaths?

By now you have likely heard the news that poor nutritional choices cause almost half of all cardiovascular deaths. Wouldn’t it be amazing if by eating better 400,000 people would still be alive today? You bet it would.

 

While it’s no surprise that nutrition and heart health are directly related, causing half of all cardiovascular deaths is a dramatic finding that deserves further scrutiny.

 

The recent study, funded by the Bill and Melinda Gates Foundation, was presented at the 2017 annual AHA meeting. They retrospectively looked at years of observational data to correlate nutritional habits and the subsequent risk of dying. Instead of focusing only on the “bad” foods that people ate, they also looked at the “good” foods people did not eat. They concluded that Americans need to eat more nuts, vegetables and whole grains, and less salt and trans fats.

 

Yawn. That finding is hardly earth shattering as we have been hearing this for decades. Does this new study add anything to the current literature? I’m afraid not.

 

We have plenty of observational data suggesting the same.  In fact, another similar study published in JAMA at the same time provided more observational evidence that 318,000 out of 702,000 cardiovascular and diabetes related deaths are related to (in order of statistical strength), too much salt, not enough nuts and seeds, too much processed meats, not enough omega 3 rich seafood, not enough veggies or fruit and too many sugary beverages.

 

Bad Studies Yield Bad Data

 

Two studies with similar results. Does that sound conclusive? Not so fast. The problem is that all this data is observational, and therefore weak data. It can point out associations, but it cannot prove cause and effect (see chapter 2 in my book, Your Best Health Ever for a more detailed discussion).  What we need is a randomized, controlled trial investigating the question of nutrition and cardiac deaths, not more observational drivel (see my post on The Best Weight Loss Trial You Will Never See here)

 

As an example, processed food is high in salt. Fruits and veggies are low in salt. Can we say with certainty that the salt is the problem? Or is it the company it keeps, i.e. too much crackers, chips and baked goods instead of fruits and veggies? This study cannot determine between the two. Also, those who eat more veggies also tend to be more health conscious, more physically active, and have less dangerous habits (i.e. smoking). The opposite is true for those who eat more processed junk food. Again, observational studies cannot completely control for those variables (they can try, but statistics are imperfect for this).

 

Does this mean we need to throw out the study completely? Not necessarily. It raises important questions, even if it does not provide clear answers.

 

Instead, we should combine the findings with the higher quality, randomized trials to see what the science truly supports.

 

Good Studies Yield Good Data

 

The more conclusive studies are the randomized controlled trials. One such recent trial was the PREDIMED study (see more on this study and the Mediterranean diet here).  Briefly, this trial investigated a diet that included a “high intake of olive oil, fruits, nuts and vegetables; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation with meals.” This pattern of eating significantly reduced the risk of cardiovascular disease when compared to low-fat diet.

 

Since this was a randomized trial, there was no need to control for other healthy habits and self-selection bias. In addition, they didn’t measure surrogate outcomes like blood pressure, weight, or cholesterol. They measured the events we really care about- heart attack, stroke and death. In the end, a simple nutritional intervention reduced that risk.

 

This is an impressive study that tells us something conclusive about nutrition. I hope you can see the difference between this study and the throngs of poor-quality observational trials.

 

Do you see any similarities between the PREDIMED study and the recent observational trials?

 

Encourage nuts, veggies, and fish. Discourage processed meats and sweets.

 

In short, eat real food.

 

Can We Find A Common Ground?

 

After that, the science gets murky.

 

What about poultry? It was encouraged in the PREDIMED study and was not mentioned much in the recent observational trials. There doesn’t seem to be significant evidence to avoid it, and there may be reason to eat it. So be aware of your portion size and go for it.

 

What about salt? It wasn’t limited in the PREDIMED study. Some studies suggest increased risk with high sodium intake, and some studies suggest increased risk with low sodium intake. In the observational trials, it can be difficult to separate salt from processed foods, and therefore difficult to know if it is dangerous.

 

You may be thinking, if there is any question, why not just avoid it?  Is there a compelling reason to eat salt? You bet there is. Taste. Salt helps food taste better. If you are adding it to your cookies, white bread or potato chips, you aren’t doing yourself any favors. However, if you are adding a sprinkle of sea salt on your freshly steamed veggies or your roasted broccoli, then go for it. An observational study can’t tell the difference between those two circumstances, but trust me, your body can.

 

What about red meat? This is a big one. We don’t have any evidence that red meat reduces the risk of cardiovascular disease. However, all the evidence suggesting that red meat and animal protein increase the risk of cardiovascular disease is poor quality observational data. In addition, there is plenty of poor quality observational data that claims the exact opposite, that red meat does not increase the risk of cardiovascular disease. So again, we must ask, if there is controversy, should we just avoid it? Is there a compelling reason to eat meat? For some there is. Animal meat is the most efficient source of B-vitamins, iron and protein, it is filling and it tastes great.

 

Once again, the specifics matter. Are you eating a 16oz porterhouse steak with mashed potatoes? Or are you eating a fresh vegetable salad with 6-ounces of grass-fed steak on top? A study may not know the difference, but your body sure does.

 

Wrap It Up

 

Can improving what you eat reduce your risk of heart attacks and strokes? It sure can. The PREDIMED study showed that.

 

Do these new observational studies add anything new? That’s debatable.

 

We come back to the basics. Eat more real food. Eat more veggies and fruits. Eat less processed junk. Avoid manufactured trans fats. If you do that, you are doing 95% of the work (I made up 95%, but it seems right to me).

 

Spend all the time you want arguing about the remaining 5%. There is plenty of evidence to support your claim whether you are for or against salt, meat, eggs etc.

 

As for me, I am going to step out of the argument and go eat my spinach and kale salad with Brussel sprouts, cauliflower, squash, nuts and seeds, topped with olive oil and 4 oz. of wild salmon and a hard-boiled pasture raised egg. Heaven on earth. Bon Appetite.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com 

 

Action Item:

Look for ways to add veggies, nuts and seeds to your meals. Sprinkle pumpkin seeds on your oatmeal, eggs or salad. Ask for a double portion of veggies and half the protein when you go out to dinner. Watch our veggies and eggs video to see how easy it is to make a veggie-based breakfast. Focus on real food, veggies first. Try it today and see how easy and rewarding it can be!

Bret Scher, MD FACC

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