Lemon Tahini Dressing

This, right here, right now, is a pretty exciting time for anyone who's trying to eat better- whatever "better" means for them. And I say this for two reasons. First, we are seeing a revival of home cooking and an enthusiasm for "real" food, so that any kind of diet change is more likely to involve tasty, wholesome food and less likely to involve some kind of package with a manufactured low-calorie concoction. Second, there are hundreds of books, blogs and websites out there with recipes and ideas for almost every kind of diet one can think of. So if you're looking to make a change, there are resources out there to help you.

In my case, eating better means eating in a more carb-conscious way, because I have insulin resistance and my body struggles to metabolize carbohydrates. I'm making this change while eating the way I've chosen to for the last 20 years- a lacto-ovo vegetarian diet.

My desire to cut down sugar and limit carbs overlaps with many of the popular diets of our time- Paleo, Whole 30, South Beach and others. My desire to eat a more plant-based diet overlaps with those who eat a vegan or raw food diet.

I don't have to follow any of these diets. I don't have to embrace any of them (in fact, some of them irritate me with their pseudo-science) or agree with all of their features. But I can use ideas and recipes from people who are on these diets. The important thing is to keep meals interesting, tasty and varied within my new food rules, such as they are. Because that's what will help me stick to the plan.

So I've been busy bookmarking new recipes to try. I don't need to watch my fat intake- in fact, fat keeps me feeling full and satisfied, so creamy salad dressings are definitely on the menu. Apart from the Caesar salad dressing, I've been making an avocado yogurt dressing, a lemon caper olive oil dressing and a tahini lemon dressing. I've started stocking the fridge with a jar or two of dressing and a bowl of prepped salad. Add some cooked beans, lentil dal or pan-fried tofu and a good meal is just seconds away.

This tahini lemon dressing recipe came from a cookbook I found at the library, Oh She Glows by Angela Liddon, a book that came out of the blog of the same name. Angela has a knack for making vegan recipes that sound very hearty and tempting. I picked up several ideas from the book- the favorite being falafel bites- baked falafel served in lettuce cups with a cucumber-tomato chopped salad and a tahini dressing. Doesn't that sound good?

The lemon tahini dressing recipe is at the bottom of this post on Oh She Glows. You simply blend the ingredients in a food processor: tahini, lemon juice, nutritional yeast, minced garlic, salt and pepper, adding some water and olive oil to thin the dressing as needed. Pour the dressing into a jar and store it in the fridge. It is a bold, flavorful dressing, with a cheesy flavor although there's no dairy in it at all. Lila begs me to lick the spoon and will eat the dressing straight-up with a spoon if I let her.

So our supper last night was a bed of greens with cooked green lentils, olive tapenade and a good bit of lemon tahini dressing. It is amazing how much my tastes have changed in a few short weeks. I would have sworn up and down that a salad plate like this is a skimpy dinner that would never leave me satisfied. But it left me fully satiated when I ate at 6 PM yesterday, and kept me so full through the night and morning that my first meal today was at 10 AM. Color me shocked.

The dressing is also wonderful over roasted vegetables, by the way, especially roasted cauliflower and roasted eggplant.

So my three simple tips for today:

1. If you think salads are dull and boring, try a zippy dressing and you just might change your mind.

2. Keep raw veggies prepped and ready in the fridge and you'll start reaching for them when you need a snack.

2. Explore recipes from vegan, paleo, low carb (and other diet-based) blogs for fresh ideas to eat more of the things you want to be eating. And also to change your mind-set that leaving out the rice, tortillas, noodles and pasta means there's nothing good left to eat. Don't be deterred by labels. We can take different paths to get to the same goal. 

Stumbling Into an Exercise Habit

The first 6 weeks of 2015 were, on the face on it, very ordinary ones in my life. But underneath it all, it has been a time of profound transformation for me. Of small changes that led to big realizations. One of the biggies was the start of an exercise habit.

I hardly need to repeat the benefits of being active- there are too many to list and we are all aware of them- but it is one of those things that is definitely easier said than done. I've been trying to embrace an exercise habit for so many years, and I've failed repeatedly. By last year, I wasn't even really trying any more.

Then one thing led to another. It started last April, when our neighbors across the street came over for a meal. Neighbor lady said, hey, how about we start going for walks around the neighborhood after dinner? It sounded like a good idea- low key, low commitment. And it was. Since then, we've been walking a few times a week, sometimes more and sometimes less, depending on our schedules and the weather. Our neighborhood is hilly, so there is some exertion involved. But the important thing is that I felt like I was doing something active. Of course, going on long walks is also therapeutic as you get to have a heart to heart chat with a friend.

When May rolled around, this neighbor told me about an outdoor pool in town that is only open during the summer months. I loved to swim as a child, but hadn't been in a pool for almost 2 decades. She urged me to go check it out. I already owned a swimsuit that I'd bought years ago for a beach vacation. So I gathered up some courage and went to the pool. And saw men and women of all different ages and all different body types and body sizes swimming gracefully. I swam several times a week last summer. A cool dip in the pool in the hot Georgia summer, with blue skies overhead, surrounded by shady trees- my lunch-time swim was the highlight of my days. At the end of the swim, I often felt a wave of exhilaration- the exercise "high" that I've heard about. On swimming days, my sleep was deep and sound.

I can swim laps easily and stay afloat indefinitely but my swimming technique is not great. Basically, I keep my head above water- and if you've seen good swimmers doing the freestyle stroke, you know how they submerge their faces and come up for air every few seconds. My poor technique was straining my neck and slowing me down. By the end of summer, I made a promise to myself to take some swimming lessons so that by the time summer 2015 rolled around, I would know how to swim "properly" once and for all.

After summer came our trip to India and there was very little time or opportunity while we were there to get any real exercise. Back home, I knew I wanted to get moving again. The pool was closed and it was getting too cold and dark for regular post-dinner walks (although we still go a couple of times a week). I found this post with some free home workout ideas and tried some of them. I was doing one of the routines (a YouTube video) every other day for a couple of months and it was OK but I wasn't too excited about it.

Meanwhile, a friend gave me the phone number of her occasional babysitter, a young nursing student who also works as a swim instructor. In Jan, I texted the instructor and set up a 30 minute swim lesson at a community gym with an indoor pool. She turned out to be a wonderful instructor- she knew how to teach the right technique of breathing during freestyle swimming plus she was very sweet and reassuring. The first time I dipped my face in the water, I started spluttering and choking. It feels very unnatural for a land-dwelling mammal to put their head underwater. But I was told that the whole inhale-outside-exhale-underwater cycle comes with practice.

I might not love to exercise but I LOVE to learn. I feel alive and happiest when I am learning something new. And as an "obliger", I want to please my teacher so I work hard for the praise. Granted, most times, I'm learning something that requires mental skills (knitting a lace pattern, using a new computer program), but still, I embraced this physical challenge of learning to breathe correctly while swimming. I needed access to the pool to practice, so I got a 30 day membership (it was super cheap, since it happened to be January, the month of enticing gym discounts). I went to the pool 2-3 times a week and did my best to practice what the instructor taught. It was hard but in a matter of weeks, I'm about 75% of the way there. It turned out that wearing swim goggles made a huge difference in being comfortable with putting my face underwater. And it is exciting to feel like I will soon be a "real proper swimmer" zipping through the water quite effortlessly.

When I got the gym membership for the pool access, the person at the front desk told me that all classes come free with the membership. Well, if I'd sort of already paid for the classes, why not drop in and see what they are like? The first couple of classes weren't ideal- the first one was too crowded with about 25 people jammed into the room, and in the second class, the teacher kept chatting about sports and politics during the class, which I did not enjoy. Then I found a twice-weekly class that is quite perfect- at a good time (in the morning after I drop off Lila), with a half hour of stretching and a half hour of strength training. It has all the ingredients of being perfect for a beginner- an enthusiastic and welcoming instructor, 5-7 people in the class, upbeat music, workouts that are not too easy and too not hard for my out-of-shape self. Again, this taps into my true nature. I am not inclined to exercise on my own at home, but I am very good at showing up on time for a class and obediently doing whatever the instructor says to do.

For the last month, I've been swimming twice a week, and doing these classes twice a week. And to my utter disbelief, this is all a lot of fun and I look forward to it. It is a small and basic community gym, with friendly and mostly older patrons, so I don't feel out of place and intimidated like I might in a swanky gym surrounded by picture perfect bodies. I've paid for another 3 months of gym membership.

And then a couple of weeks ago I went down two floors to see a colleague about something, and she was standing at her desk. She gave me a spiel about how sitting long hours is terrible for our health. For a lark, I found some boxes and thick books to put under my monitors and keyboard and rigged up a standing desk for myself. And then I loved it/got too lazy to remove the boxes and so I've been standing (more like fidgeting around on my feet) the whole time during my working hours. I only work 3 days a week, but still, it feels great to not be trapped in a chair. The office manager did order an anti-fatigue mat for me to stand on which makes it much more comfortable.

Walking, swimming, exercise classes, standing at my desk. That's a whole lot of changes in a short time. None were planned but I am so grateful that things started to fall in place. Only time will tell if I continue to stay this excited about exercising, but I definitely have a good feeling that this time it is different and maybe the habit is clicking for real. There's a sense of relief that maybe I'm not the hopeless couch potato that I thought I was. "The best exercise is the one you do", it is said, and I am glad that friends have encouraged me to start doing something and not keep waiting for the perfect moment and the perfect workout.

If you have any tips for an exercise newbie, send them my way! I'd love to hear about how you're fitting exercise into your life, or if you're struggling to fit it in.

Book Synopsis: Dr. Bernstein's Diabetes Solution

This 500 page volume is subtitled The Complete Guide to Achieving Normal Blood Sugars. The gist of the book is this: The damaging effects of diabetes are due to high (and fluctuating) levels of sugar in the blood. By keeping blood levels normal and steady, the complications of diabetes can be prevented and reversed.

The author, Richard Bernstein, provides a highly detailed and comprehensive picture of all the ways in which blood sugars can be kept at normal levels in both Type 1 and Type 2 diabetics, including the use of diet, exercise and medications. As well as being a physician whose practice is solely devoted to diabetes treatment, Dr. Bernstein has Type I diabetes himself.

Here is my chapter by chapter synopsis of Dr. Bernstein's Diabetes Solution. Chapter titles are in bold. Quotes from the book are in italics.

My Life with Diabetes
This is a pretty incredible story of how a patient refused to let his disease dictate his fate and took matters into his own hands. Bernstein was diagnosed with diabetes at the age of 12 in 1946. He writes an eye-opening essay about what it was like to be a diabetic in those days, using a test tube and alcohol lamp to test his urine, injecting himself with large doses of insulin slowly and painfully using a large syringe. For him, diabetic complications started in his twenties and thirties. At the time, he was an engineer working for a biomedical company. Reading a trade journal, Bernstein came across an ad for a blood sugar meter. It was only sold to doctors and hospitals, not to patients, so he got his physician wife to order it for him in her name. He started testing his blood sugar and saw that it fluctuated wildly. This led him to read the scientific literature on diabetes and he saw that diabetic complications can be reversed in animal models by normalizing blood sugars. He started experimenting on himself, measuring his blood sugar and making small changes in his diet and insulin, retaining whatever changes improved his blood sugar. "I had the new sensation of being the boss of my own metabolic state, and began to feel the same sense of accomplishment and reward I had in engineering when I solved a difficult problem. I had taught myself how to make my blood sugars whatever I wanted them to be and was no longer on the roller coaster. Things were finally under my control".

Bernstein's findings went against conventional wisdom. In his mid-40s, he quit his engineering career, entered medical school and became a physician.

Before and After: Fourteen patients share their experiences
"You're the only person who can be responsible for normalizing your blood sugars. Although your physician may guide you, the ultimate responsibility is in your hands. This task will require significant changes in lifestyle that may involve some sacrifice. "

This chapter has patient stories and I found them very interesting and inspiring. They provide different perspectives on coping with life with diabetes. People write with complete honesty that the changes are not always easy but they become easy to stick to once you see and feel the results.

Diabetes: The Basics
Although diabetes is still an incurable, chronic disease, it is very treatable, and the long-term "complications" are fully preventable.

Certainly everyone has to die of something, but you needn't die the slow, torturous death of diabetic complications, which often include blindness and amputations. If one aggressively monitors and normalizes blood sugar levels, there are dramatic reductions in diabetic complications.

This chapter has a good, easy to understand overview of  diabetes, both Type 1 (thought to be an auto-immune disorder in which immune cells attack and destroy the beta cells of the pancreas that produce insulin) and Type 2 (insulin-resistant diabetes, though some Type 2 diabetics have an auto-immune component also). There is a good explanation of the vicious circle of insulin resistance and its relationship to body fat, especially belly fat. Type 2 diabetics are resistant to the blood-sugar lowering effects of insulin but not to its fat-building effects.

Tests: Baseline measures of your disease and risk profile
This is another important chapter. It details tests that can help a person in understanding the extent of their disease, to provide a picture of their health status and to give a baseline against which to measure improvement once changes in diet, lifestyle and medication are made.

The next three chapters in the book are geared towards those already diagnosed with diabetes: Your diabetic tool kit, How and when to measure blood sugar (this chapter explains the importance of blood sugar self-monitoring and also how to do it painlessly), Recording blood sugar data.

Strange Biology: Phenomena peculiar to diabetes that can affect blood sugar
Sometimes, even when you think you're doing everything right, your blood sugars may not respond as you expect. The purpose of this chapter is to acquaint you with some real phenomena that can confound your plans, but which you can frequently circumvent if you are aware of them.

The Laws of Small Numbers
Big inputs make big mistakes, small inputs make small mistakes. This chapter emphasizes how it is easier to keep blood sugar stable with small "inputs", whether the inputs are the carbs one eats or the insulin doses being injected.

Establishing a Treatment Plan
This chapter provides different levels of treatment plans that increase in complexity depending on how severe the person's disease is. For instance, level 1 can be treated with diet, while level 2 has diet plus exercise, and levels 3 and 4 add oral medications and insulin respectively. He also discusses how to set a blood sugar target and goals for treatment.

The Basic Food Groups
This chapter talks about how specific kinds of foods affect blood sugar. The calories we consume fall into three groups: proteins, fats and carbohydrates. Carbohydrates affect blood sugar most profoundly. Proteins can also be converted to blood sugar, but rather slowly and inefficiently. Fats cannot be converted to blood sugar at all.

The sub-chapter on fat attempts to make a distinction between dietary fat and body fat. It used to be thought that dietary fat led to body fat, which was the rationale for low-fat diets that are popular even today. However, body fat primarily comes not from dietary fat but from carbohydrates, which get converted to blood sugar. And then via insulin, the fat-storing hormone, whatever blood sugar is not burned off gets converted to body fat. Diabetics do not need to fear or unnecessarily restrict dietary fat.

The sub-chapter on carbohydrates explains the obvious thing- which is that this is the food group with the most relevance for diabetics, since diabetes is a disorder of glucose control, and carbohydrates are broken down to glucose. Bernstein further explains the relationship between carbohydrates and obesity. Much of this obesity is due to "pigging out" on carbohydrate-rich snack foods or junk foods, or even on supposed healthy foods like whole-grain bread and pasta. It's my belief that this pigging out has little to do with hunger and nothing at all to do with being a pig....certain people have a natural, overwhelming desire for carbohydrate that doesn't correlate to hunger. These people in all likelihood have a genetic predisposition toward insulin resistance and diabetes. 

Diet Guidelines Essential to the Treatment of all Diabetics
No matter how mild or severe your diabetes, the key aspect to all our treatment plans for normalizing blood sugars and preventing or reversing complications of diabetes is diet...the single largest "input" you can control is what you eat. 

Bernstein advocates a severely carbohydrate-restricted diet. On his "strict no-no" list are all fast-acting carbs, including sugars (desserts, candy), grains (bread, rice, pasta, breakfast cereals), milk, vegetables like beets, corn, carrots, potatoes and tomatoes.

So What's Left to Eat is the next sub-heading, a very apt one. This list includes non-starchy vegetables, meat, poultry, eggs, seafood, tofu and meat substitutes, cheese, butter, cream, yogurt, nuts, and assorted other things like tea, coffee, spices, herbs, sugar-free jello and what not.

Bernstein is nothing but fanatically single-minded about foods and blood sugar levels. I mean, for good reason and all that. He goes so far as to say: Onions are high in carbohydrate and should only in small amounts for flavoring. He's not so concerned about processed/non-processed food. Whatever doesn't raise blood sugars is in the diet. Whatever does is out. End of story.

To be sure, Bernstein's been following this diet for decades himself; he even mentions that he hasn't eaten fruit since the 1970s. Here's the ending of the chapter: How do people react to the new diet? Most of my patients initially feel somewhat deprived, but also grateful because they feel more alert and healthier. I fall in this category myself. My mouth waters whenever I pass a bakery shop and sniff the aroma of fresh bread, but I am also grateful simply to be alive and sniffing. 

Creating a Customized Meal Plan
This chapter starts with a caution to diabetics that when they switch to a low (or lower) carb eating plan, they should monitor their blood sugars and adjust their medications to avoid their blood sugar from dropping too low, since the diet usually causes a dramatic and immediate drop in blood glucose following meals. Then some specific meal ideas are discussed.

Weight Loss- If You're Overweight
Obesity, especially abdominal obesity (the familiar belly fat) is a important contributor to insulin resistance and type 2 diabetes. Weight reduction can make one more insulin sensitive and can even reverse glucose intolerance in some cases. Bernstein emphasizes that it is difficult to lose weight if you don't understand why or how you are overweight or obese.

When I see a very overweight person, I don't think, "He ought to control his eating". I think, "He has the thrifty genotype". This is the phenomenon where those with "thrifty genes" can store fat and have a survival advantage during famines. But in modern societies that don't see famines but instead see endless feasts in the form of overflowing supermarkets and buffets and spacious fridges, these people now find that their genes make them chronically obese. What was once an asset is now a serious liability.

Many of the people who follow our low-carbohydrate diet find that their carbohydrate craving ceases almost immediately, possibly because of a reduction in their serum insulin levels. 

Bernstein recommends very gradual weight loss in which you follow a weight-reduction diet that matches as closely as possible what you'll be eating for the rest of your life.

How to Curb Carbohydrate Craving or Overeating
Bernstein reports that 25% of his Type 2 diabetes patients find it very difficult to stay on a low-carb diet. For them, he recommends self-hypnosis (!) or some newly developed medications.

Using Exercise to Enhance Insulin Sensitivity
This chapter lists the wide-ranging benefits of exercise- physical, mental and social. A lot of details are given about the effects of exercise on blood glucose (it is more complicated than I had thought it was). Bernstein recommends daily activity, with progressive exercise, meaning it gets more intense with time (be it weeks or years).

Insulin resistance, which is the hallmark of type 2 diabetes, is enhanced in proportion to the ratio of abdominal fat to lean body mass. One of the best ways to improve this ratio in order to lower your insulin resistance is to increase your lean body mass. Therefore, for most type 2 diabetics, the most valuable type of exercise is muscle-building exercise. 

The next few chapters are all about medications and medical care for diabetics: Oral insulin-sensitizing agents, Insulin-mimetic agents and other options, Insulin: the basics of self-injection, Information about various insulins, Simple and intensive insulin regimens, How to prevent and correct low blood sugars, How to cope with dehydration and infection, Delayed stomach emptying (gastroparesis), Routine follow-up visits to your physician.

What You can Expect from Virtually Normal Blood Sugars
This is a chapter full of hope for those who are starting to make changes, often very difficult ones, to bring their blood sugar levels to the normal range. Bernstein reports that his patients feel more alert and are no longer chronically tired, those with numbness in their toes feel their sensation return, there are vision improvements and improvements in cardiac risk factors. They are not doomed to die prematurely or suffer from disabilities and complications.

I have long maintained that diabetics are entitled to the same blood sugars as nondiabetics. But it is up to us to see that we achieve this goal. 

The final chapter has recipes, followed by informative appendices on foot care for diabetics and polycystic ovarian syndrome.

After I wrote this post, I realized that portions of this book are available here on the author's website.

The diet prescribed in this book is very strict and wouldn't work for me, as it excludes beans and legumes and severely restricts vegetables. However, I get the principle of the diet and realize that cutting down carbs is helping me cope with insulin resistance.

What I loved about this book:
It is packed with incredibly detailed practical tips for diabetics- such as how to test blood sugar as painlessly as possible.
It treats diabetes as the very serious disease that it is, but emphasizes the options that the patient has to control it.
It has a good perspective on medication, especially insulin- that it can be used judiciously to supplement diet and exercise. Medications are not to be feared but to be used wisely as needed. 

Jan 2015: Reading, Watching, Listening to...

This week marks the 10 year anniversary of One Hot Stove. A whole decade, you guys! I can't believe I'm still here. I certainly can't believe you're still here. I wouldn't be out here talking if you weren't here listening, so thank you, thank you for being part of my life.

Today, this blog is more important to me than ever, because I'm using it as my ally in establishing some crucial new habits. My personality tendency is that I'm an obliger, and the external accountability of posting my experiences on the blog is just the push I need to stay committed to my new Nupur 2.0 habits.

On to today's post...
I typically discover things 4.5 years after everyone else discovers them and so it is with podcasts. They are old news for everyone else but I only just got into listening to them. My friends Bala and Shankar (and their sweet puppy Kalki) drove through our town on their way to and from a beach vacation and it was a pleasure to spend two evenings with them. They're dog people through and through. Shankar taught Duncan to give a high five in a matter of minutes! And they taught me to like podcasts.

When V and Lila and I took a road trip to St. Louis over New Year's Eve, podcasts made the journey go by quickly. In town, I don't have much of a commute but I like listening to them while I'm cooking and doing chores around the house. The NPR podcasts are definitely my favorite ones- Wait Wait...Don't Tell Me and Ask Me Another. I found this list of food podcasts and enjoyed a couple, including America's Test Kitchen radio. I also listened to Serial, a 12-episode podcast about a real life murder mystery- a very puzzling and unfortunate story involving high school students.

Over on the Netflix side of things, I've been watching a few reality TV shows, Chopped, Restaurant Impossible, Flea Market Flip, Income Property. All total time-pass while knitting. 20 years after everyone else, I watched the British rom com Four Weddings and a Funeral. Underwhelmed. V and I like to watch Midsomer Murders together, and now the new Barnaby is on and I like him (and his wife) better than the old one! I stumbled on a vintage mystery series Columbo, named for the clever but bumbling detective who is the lead character. It is interesting to watch something from the 70s- the decor and the clothes. And the mysteries are a little different too- they start with the murder and show who the murderer is so there's no whodunit element, and the story is all about how the murderer is finally caught.

And some favorite books from recent weeks...

Roz Chast's graphic memoir, Can't We Talk About Something More Pleasant? The back cover of the book says "it is a story of an only child watching her parents age well into their nineties and die". Sounds grim, doesn't it? It is much more than that, though. It is honest, relatable, funny and a case study of family dynamics and aging. Chast says of her parents, They were a tight little unit. Her mother's response- "Codependent"? "Of course, we're codependent. Thank God!!!"

Then, I read the latest installment of the Alexander McCall Smith's No. 1 Ladies' Detective Agency series, The Handsome Man's De Luxe Cafe. It is a cozy and heart-warming novel as ever, my literary comfort food. This time, Mma Ramotswe investigates the baffling case of an Indian lady who can't remember who she is or where she came from. Mma Makutsi gets into the restaurant business. Mr. Maketoni has staff troubles, but all is well in the end.

From the Mixed-Up Files of Mrs. Basil E. Frankweiler by E.L. Konigsburg. Written in 1967, this is an adorable story about a 12 year old girl and her 9 year old brother who run away from their home in the suburbs and hide out in the Metropolitan museum in New York City.

I started reading Where'd You Go, Bernadette? by Maria Semple but couldn't get past the first dozen pages. Right now, I'm finding it it too irritating to read about whiny, over-privileged people, even if the novel is written in a witty tone.

There were two good non-fiction reads last month, both narratives that piece together history and modern events. The Ghost Map: The Story of London's Most Terrifying Epidemic - and How It Changed Science, Cities, and the Modern World by Steven Johnson is a fascinating account of Victorian London and the beginnings of modern public health. Frozen in Time: An Epic Story of Survival and a Modern Quest for Lost Heroes of World War II by Mitchell Zuckoff is a gripping account of plane crashes and human endurance in the 1940s. I don't typically read books about military planes and such, but this was interesting for many different reasons.

What are you reading, watching and listening to these days?