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10 (or so) Warning Signs of a Half-Baked Diabetes Cookbook

For the past two months I’ve been scouring the library and bookstore shelves in search of practical guidelines for preventing and managing Type II diabetes with  diabetes-careful meal plans.

I have two goals for myself:

1. Get down to a healthier weight by eating less and exercising more–this is the big one with the best correlation to reversing prediabetes. And it’s going okay but slowly.

2. Eat balanced meals with somewhat less carb per meal, fewer free sugars and fewer calories overall than usual. This is the easier one generally…as long as I keep a food diary. Luckily, I know how to cook and I’ve been doing meal planning for a Type I diabetic child for four years now, so I know how to count carbs. And when I don’t, I have a copy of the American Dietetic Association’s handy, simple and cheap $3 or so guide on the shelf. And a link to the USDA nutrition database for the exotic occasional items like chestnuts in the shell (note to self, about 5 grams apiece).

But I still wondered if the diabetes and weight loss cookbooks I see around are solid and I’ve just been too lazy, arrogant or impatient to take them seriously all these years. Hence the trips to the library.

Because no doubt about it, the diabetes cookbook scene is burgeoning. There are loads of good-looking cookbooks out with pretty, gourmet-looking recipe photos and promises of perfect blood sugar management amid the desserts on the cover.

Here’s the short version of this post: a read through most of these books is NOT encouraging. All the popular diet book gimmickry of the past 40 years seems to have been transferred to a lucrative new target (read: gullible victim) market, complete with bright, shiny new drug company advertising and sponsorship potential on the coordinating web sites.

Considering that there’s no precise required diet for diabetes, just guidelines for budgeting meal carb totals and keeping some kind of commonsense balance between starches, fiber and sugars, even the premise of prescriptive diabetic cooking guides is a little shaky to start with. But what’s actually being presented as guidance in these popular books is far from that approach.

Even cookbooks affiliated with or endorsed by organizations like the American Diabetes Association and so on fail some pretty simple commonsense tests for honesty, accuracy, consistency, or relevance to standard public health guidance on preventing, managing and reversing Type II diabetes by way of diet. And if you don’t already know your way around carb counting and portion size measurement, they’re extremely confusing. Sometimes even on purpose.

So here are the main common flaws I’ve discovered in most of these books, with a few books singled out for personal ire and bemusement. You might want to consider these as warning signs if you’re looking for actual guidance to get you through.

10 Warning Signs that Your Diabetes Guide Cookbook is Half-Baked

1. The Dessert First approach to diabetes management. Telltale sign: does it show cake or ice cream on the cover? About half the books I scanned do. They treat desserts and snacks as a top priority, as though that were what diabetes control is all about. As though sweets were somehow necessary at every meal, or even every week. None of them ever say, “just stick with a small apple or orange most days. No recipe required.” Actual endocrinologists recommend keeping desserts occasional and snacks un-glamorous and limited in carb.

1b. Aside: Many of the dessert-first books show cheesecake on the cover, usually a 1/8 to 1/10 cake portion–a pretty hefty wedge by any standards. This is a come-on–cheesecake is usually high in fat calories, so it’s rarely a good pick for anyone attempting to lose weight (the main strategy for preventing Type II), but it’s not all that sweet and it contains a minimum of flour in its bulk. So it’s usually low in carb grams per weight compared with frosted standard cakes, and often per volume of a given portion size as well.

2. (or maybe just “1c” because we’re still on the dessert-first issue here…) Heavy use of Splenda and similar artificial sweeteners in desserts even though it doesn’t generally result in very big total carb reductions from standard recipes with sugar, and it’s a lot more expensive. Worse, probably, is the use of agave syrup as though it were sugar-free. Both are used to justify desserts that are actually pretty serious diet or carb-budget busters.

3. Food glam aspirations. Are the pretty pictures distracting you from  noticing the lack of any attempt at menu planning (see pet peeve#7 below), guidance for weight loss, and carb counting? In many of the cookbooks I found, the restaurant-style food preparations and plating seemed to be the most important information conveyed. The authors–often doctors–seem to be in competition with their favorite leading food glossies at the newsstand–many of the recipes are high-end-expensive, with 20-ingredient lists like those of the now-defunct Gourmet magazine, and no discernible guidance on how to plan a day’s worth of balanced meals with them.

4. Carbohydrates–ie starches and sugars–included where they probably shouldn’t be. NOTE: This is a personal preference of mine as the mother of a diabetic kid. You might not mind this, but you should at least be aware of it when you look through the recipes. If you see a lot of recipes with added breadings, stuffings, sweetened sauces, and so on for normally carb-free main dish proteins–meats, chicken, fish, cheese, tofu and eggs–or for nonstarchy vegetables, you know the authors have forgotten they’re supposed to be teaching you carb-counting skills and making it easier, not harder, for newcomers. It’s just easier to figure out what each dish is worth by eye and keep the total carbs for the meal on track if you keep the hard-to-guesstimate and variable carby additions away from the non-carb items at dinner (or lunch, or whatever). Because even though most of the recipes aren’t literally high-carb as a result, adding 10 grams or so of carbohydrate-containing additions per serving is enough to blow a diabetic’s insulin calculations, especially if they’re unaware of it.

5. Faulty nutrition information–overemphasis on sugars without considering total carb per serving, failure to present nutrition stats at all, overemphasis on glycemic index without presentation of total carb, faulty comparison of “before” and after” recipe revamps–e.g., never showing the original recipe, substituting high-fat (sometimes high saturated fat-) ingredients in supposedly low-carb recipes. Also in some cases, failure to specify a serving size or number of servings, so you don’t know how much is reasonable or what the calorie and carb counts are likely to be.

6. False, misleading or unsubstantiated nutrition and health claims, whether intentional or simply misinformed-but-enthusiastic. Things like claiming that agave syrup is sugar-free (it has the same amount as most other syrups including honey), or that some specific, very-long-named micronutrient is the secret key to the dieting and blood glucose control universe, that you’ll shed pounds eating chain-restaurant food nonstop… Or that glycemic index is the same from person to person–in practice, some diabetics find particular foods, like ripe fruits or granola or pizza, spiky and hard to calculate for while others have no trouble with them.

7. Vague and unprescriptive advice, if any, about dietary targets for preventing and managing diabetes. The standard diabetes prevention and dietary advice, much of which is responsibly repeated from national health expert sources, usually appears in the intro or first chapter–and nowhere else. Once you get to the recipe section, you’re usually left hanging when it comes down to making a plan that can get you where you need to go. How many grams of total carb per meal? How many calories per day? Few of the books commit to a target and fewer provide sample menu plans for achieving specific dietary targets. Those that do provide menu plans are often prescriptive about specific recipes rather than about the carb grams or calorie counts for the meal or day.

8. Scattershot approach to “healthy” recipes and advice. Watch out for multiple contributors, editors, etc. Even if all of them are registered dietitians and other certified or board-licensed experts, their advice or selections can easily contradict whatever another contributor presents or whatever’s in the introductory guidelines.

9. Heavy tie-ins with magazines or diet web sites. A careful read of most of these cookbooks reveals that the recipes are not so much carefully designed to help you craft a diet with targeted carb counts and calories as they are a hodgepodge of whatever recipes the magazine or site has already published elsewhere and is attempting to resell in a new package with some kind of eye-catching new dieter’s rationale. Actually, a casual glance through the web sites of Prevention, Shape, Men’s Health and other weight loss cookbook-spawning magazines reveals the same inconsistent approach to fitness and diet, plus a spurious reliance on magic-bean ingredients , promises that you never have to exercise to shed pounds, and one supposed caloric no-no substituted handily by upping another. Many of them mysteriously feature either models (the fitness pubs) or cupcakes and other goo-fest desserts (the cooking mags) on their front covers and tons of diabetes drug ads inside.

10. Following on from Flaw #9, and my top, absolute top, hate: upselling, a way of leading you, the hapless advice seeker, from the book (inexpensive or free from the library) to the web, the mag, or…the subscription membership to the exclusive online diet plan.

Awful or deceptive or self-deceptive

[we pause for this brief announcement from our sponsor]

11. Hey! I think I’ve just found my 11th pet peeve! My best advice is avoid anything with an exclamation point in the title! I mean it! Really! Your wallet will thank you! Here are two I’m not happy about.

Flat Belly Diet! Cookbook, assembled by the editors of Prevention magazine. This one, or at least the “Flat Belly Diet!” book that started it all, has been reviewed less than complimentarily on webmd.com and I have to agree. What’s in the cookbook?

MUFA. Sounds like an abbreviated swear word, which I elaborated into its full form as I flipped through it. Actually it stands for monounsaturated fatty acids, which Prevention‘s editor/cookbook author Liz Vaccariello swears by (not at) as a secret key to weight loss. Not calorie counts. Not carb counts–an important part of knowing where you are as a diabetic or prediabetic. Portion sizes? Weight loss scheme? Predictably, the cover is filled with sloppily frosted yellow cupcakes. Along with a tapemeasure. Yeah. What kind of diet do you think you’re going to get if you go around eating cupcakes? If you are what you eat, this is what your belly’s gonna look like, is the only promise I get out of this book.

Oh–and pet peeve #12. Smoothies.

And #13: Snacks, snacks, snacks.

For example….breakfast is smoothies, very popular with the never-have-to-chew-your-food crowd–a sure way to overeat. Very very easy to overdo the calorie count with a 20 oz. “serving” that could run 400-500 calories, rather than an 8-ounce glass of skim milk plus a half-cup of high-fiber bran cereal (not exotic enough or expensive enough, but only about 150 cal total). There are an awful lot of calorie-packed snacks in here as well. And now Prevention magazine’s web site is offering an online subscription-based Flat Belly Diet! plan with trackers and suggestions and so on. Tell me how the $22-ish a month or so introductory offer (goes up to about $45) is “better” than the $25 or so single-payment cover price of the book? You’ll lose weight…in your wallet.

Eat This, Not That! By two writers for Men’s Health. The pictures in each pair of chain-restaurant foods–the “eat this” is on the left page, “not that” is on the right–are nearly identical. The only clue to tell them apart visually is the brand name of the menu items. So unless your memory’s phenomenal for chain restaurant menus, you have to remember to take this book with you.  The explanations for which choice is the better bet are generally sketchy and idiosyncratic. Sometimes calories are the key issue, sometimes fat or carb,sometimes sodium. That makes it hard to learn from this book, even if you could tell the difference between the left and right side of the page by eye. And most of the “Eat This!” options for each chain’s menu are just as screamingly high in sodium as the “Not That!” ones. And still horrible. This book is meant well, I suppose, so it’s better by a lot than Prevention‘s Flat Belly Diet!, but it greatly overstates the likelihood of you being able to see, much less bend over and tie, your shoes again anytime soon if all you ever eat is what’s in the book. Assumes you never eat in.

Haphazard approaches

Diabetes cooking 101–Dessert’s on the cover, as for almost every other diabetes-targeting cookbook I could find. The one real plus: specifies that prediabetes prevention diet is typically 30-45 grams of carb per meal. Thank you. Finally someone committed to a specific recommended number! But that’s all in the intro tips section, all very sensible. The recipes don’t really reflect that approach, or any particular approach, to meal planning.

Two big problems: the desserts and the main dishes. I’ve already picked on the dessert-first approach, and desserts here rely heavily on Splenda…in fact, much of this book looks like a vehicle for Splenda. And the carb counts still aren’t very impressively low. Worse, the sugars are listed but not the total carb, so some of these may actually contain much higher total carb than what’s listed, and on a quick carb-calculating scan of the ingredients, some of them do.

The problem with the main dishes is that main dish meats and fish that should generally be carb-free or very low (5 g/svg or so) are given the breaded, sugared, sauced, or stuffed treatment as in Pet Peeve #4 above.  They may be low by the author’s standards but those are never given for comparison, and seem to vary widely among the many nutritionist authors or co-authors–Pet Peeve #8…

Cook yourself thin faster, by Lauren Bank Deen. No great explanation for how–Pet Peeve #7. All the introductory chapter tips for better nutrition are not really tied into the rest of the book. Dessert portions are sometimes high in carb, definitely high in sugars. It’s not obvious how that cuts calories. And of course, this second book of popular diet cooking features dancing cake slices on the cover behind the “little black dress”.

Joslin Diabetes Center Gourmet cookbook: Food glam recipes, pretty photos, expensive ingredient lists, Pet Peeve #3. Surprisingly, this book contains NO dietary guidance section OR nutrition stats for the recipes. Or menu plans. Very surprising for a book that actually comes from a diabetes clinic allied with Harvard, and whose clinic web site actually contains some pretty good, solid information for patients.

DK The Diabetes Cookbook: What to Eat & What to Cook to Treat Type 2 Diabetes, ed consultant Amy Campbell, MS, RD, LDN, CDE. Pretty pictures, pretty food, emphasis in the front section on glycemic index (fast “spiky” sugars vs. slower-digesting carbs). Recipes are rated with a little label at the top for low, medium or high GI, calories, saturated fat, and sodium, which is probably helpful, but made me want to check the nutrition stats down at the bottom…good thing I did. Some serious mythology here–Campbell says cherries are low GI, but even if that’s true, does it really matter? Like grapes, they’re about 2/3 to 1 gram of sugar apiece, and the total carb is what’s going to count an hour or so after you eat them. Moreover, the main and side dishes have some oddly high calorie counts with a lot of added fat. Calorie and carb claims in the recipe intros are also better than reality–one chocolate ice cream recipe made with milk, bar chocolate and full-fat yogurt (why? why?) claims to have fewer calories than regular ice cream but…266 calories per serving? that’s superpremium territory, thank you, and so’s the saturated fat at about 8 g/serving. And 30 grams of carb, 26 of them sugars. That’s fully twice what you’d get in a half-cup serving of Dreyer’s or Edy’s “1/2 the fat” chocolate ice cream. So think hard about ingredients and serving sizes.

Just What the Doctor Ordered Diabetes Cookbook by Joseph D’Amore, MD and his nutritionist (not RD but you can’t have everything) daughter. At least this one has a main dish with vegetables on the cover. Sensible-sounding intro, as for most of the books (other than Flat Belly Diet!). However…no specific recommended intake numbers, whether for calories or carb grams per meal. Sometimes the nutrition stats section contains only zeroes where the obvious (from the ingredients) carb counts etc. should be and were obviously meant to be entered in before going to press. This looks like a simple proofreading error rather than any attempt at being misleading or self-deceptive, but it means you need to look through the ingredients and estimate carbs and calories for the total recipe yourself if you want a handle on the stats.

Almost Decent

I was surprised. This one still has some flaws, but it’s going in the right direction at least.

Rocco DiSpirito’s Now Eat This! Diet: Surprisingly, this one makes some sense and attempts to be frank about calorie counts and meal prescriptions for weight loss. That’s actually helpful. If you follow the recipes and serving sizes, the color-coded calorie-range categories should help. DiSpirito is an enthusiastic young chef (on the Food Network circuit, I think?) who talks openly and at some length here about exercise as a necessary component of weight loss for cardiovascular health and “reworks” recipes to reduce the calorie counts.

Of course, that seems impressive until you realize the book doesn’t compare those reworked recipes with the original versions, which I suspect were probably designed by Paula Deen. Certainly some of his “fixes” are still just the normal level of fat, carb, sugar, salt etc that you might expect in a non-“superpremium” version. And some still contain more fat or carb than what I’d do.

His emphasis on smoothies–well, young guys think they’re great for being “on the go”, but if you’re not actually forced to drink your meals in five minutes, you probably should just eat the separate parts in saner quantities and chew your food. His desserts are like most of the others; they don’t look terrible but don’t look great either. They’re limited in portion size, which is a plus, but they’re also likely, if you make a whole pan of his brownies or whatever, to lead to snacking and seconds, which is bad.

DiSpirito is also young enough that I suspect he’s not taking into account any but a young man’s ability to shed extra weight easily at the gym. How well I remember my husband blithely (or not so blithely, actually; he was eating too little at lunch and then getting crabby until I caught up with him about it) lost 50 pounds in only two months at the age of 26. It’s a little harder when you’re over 50. Really. Trust me. For both of us.

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