[MAD] Stressed with Planning Meals

[Good Cook]

Hello,
I started the Modified Atkins Diet 3 weeks ago. I'm having a tough time with a couple of things. I LOVE cooking and am not a picky eater at all. I thought that would make this easier for me, but instead it is having the opposite effect. There are so many meals I would like to make but I feel like I cannot since I am used to cooking with no recipe. How do you cook when you are on this diet and you are used to just throwing in a little bit of this and a little bit of that? And how do you figure out how many carbs are in a portion if you want to make a vegetable dish that has several veggies, such as a casserole? Are you restricted to only Atkins recipes in those cases, or are there ways I can make things that I have been making for a long time?

Secondly, how do you know if you are truely counting your carbs correctly? I was given a list of a variety of foods and their serving size and carb count by my dietician when I started, but didn't realize until after I left that the list was from 2011. I didn't think that would matter, but as I have been looking up random foods online that weren't on her list, I am finding that different websites vary the amount of carbs that are in a serving size. I want to make sure I am being as accurate as possible, and to me, if one site is saying 3 carbs and another site is saying 5 carbs, that could be a big difference at the end of the day if I end up going over with a few foods. Likewise, if I am counting something as 5 when realy it is 3, I want to know so that I feel free to have more carbs if I am hungry and have a craving.

If you have suggestions for ways to sneak in healthy fats too, that would be great! I hear coconut oil is a healthy one, but am having a tough time sneaking it in since I am used to olive oil and butter.

 

[KarenB]

Our son is on the Ketogenic diet (for over 2 years), which is stricter than the MAD, but similar. First, with regard to meal planning, I would ask your nutritionist if she could get you registered on the Ketocalculator (this is a free tool which will calulate out your protein, carbs, fats and calories for individual foods and for a complete meal. But a medical professional has to register you.)

We do use several veggies in a dish, and simply plug them all into the Ketocalculator. I have them all printed out now, on a chart in my kitchen, for meals we use a lot, so, for instance, I could use the full amount of zucchini, or 1/2 the amount of zucchini and 1/2 onion.

One reason you may be seeing different carb amounts for certain foods is whether it is total carbs or net carbs (net carbs are the total carbs minus the amount of fiber). Generally, nutritionists use the net carbs with the Atkins or Ketogenic diet. One tool I use frequently for myself in calculating out carbs (I'm not on Atkins but reduced carbs to control blood sugar) is this site http://nutritiondata.self.com/ -- it will give you the total carbs with the fiber listed just below, so you can calculate accordingly.

If you haven't bought a scale, I recommend doing so. That way you can get more accurate measurements than, say, 1 tablespoon or 1/2 cup. The Ketocalculator goes by grams.

Recommend two sites for the MAD and Ketogenic diets that are geared for kids but adults will find helpful as well -- Matthews Friends and the Charlie Foundation. They have recipes, research and helpful articles, and forums where you can get loads of info and support.
http://www.matthewsfriends.org/
http://www.charliefoundation.org/

Fats that we use on a daily basis are MCT oil (a derivitive of coconut oil that is digested differently and more efficiently and helps raise ketones), olive oil, butter, and cream.

Other good sources of fat that we use are avocado (a Haas avocado is 4:1 ratio of fat to carb/protein), mayo (look for brands that are sugar free, like Dukes or Hellmans), olives (green or black are both healthy fat sources), flaxseed meal (this can be used instead of flour -- for every carb gram it has one fiber gram, so has almost no net carbs -- and is good for any constipation problems), coconut milk (sugar free), and cheese.

Nuts (esp macademia and pecans) are high in fat and fiber and make good snacks. You can also grind them into a flour for cooking muffins, etc.

 

[KarenB]

Veggies like mushrooms and eggplant are great for soaking up oil. I saute them in olive oil and/or butter, and they will quickly soak up 10 grams or more of oil.

A typical breakfast for Jon would be an egg omelet w/ veggie. This is about 430 calories, less than 3 carbs.

52 g egg (about 1 egg)
20 g cream (half liquid, half whipped)
5 g flaxseed meal
15 g butter
6 g MCT oil
10 g olive oil
92 g zucchini

Alt: 37 g carrots, 75 g asparagus, 44 g broccoli, 56 g mushrooms

Beat egg w/ 10 g liquid cream, and flaxseed meal and MCT oil. Saute veggie iand cook egg in the olive oil and butter. We use the whipped cream to give him his meds.

The flaxmeal gives a sort of pancake consistency.

The meal can be calculated out without the flaxmeal. Also, if you prefer more veggies, you can eliminate the cream (which has some carbs), and just use butter and oil for fat.

Or, it can be recalculated as actual pancake by increasing the flaxmeal to 10 or 15 grams, and exchanging the veggies for low carb berries (strawberries, blackberries, or raspberries) which could either be cooked in the pancake or served on top w/ whipped cream.


I have about 5 recipes that I use all the time, and just exchange veggies/fruit for variety.

 

[KarenB]

Salads are your friend!

Lettuce has virtually no carbs, and can be used as a wrap for tuna salad, egg salad, chicken salad, etc. Mayo is a good fat source for these kinds of salads. I mix in olive oil with the mayo to up the fat.

Jon's favorite salad meal is avocado w/ mayo, cheese cubes, olives, and a low carb veggie or fruit (can combine a couple) like cucumber, cherry tomatoes, strawberries, blackberries or raspberries.

A big salad with lettuce, assorted veggies (bell pepper, cucumber, tomato, raw spinach, broccoli, etc. are all fairly low in carbs), and for protein you can use a combo (or just 1) of cheese, bacon bits, boiled egg, ham, chicken, and for fat you can use olives and high fat/low carb dressing like vinegar/oil or blue cheese.

 

[KarenB]

Beverages

1) Lemonade/Limeade -- juice of 1/2 fresh lemon or lime, 1 small packet Stevia leaves steeped in 1 cup of boiling water, and 6 cups water. Jon drinks this throughout the day. The citric acid in the lemon and lime, along with the Stevia leaves and the hydration from the water helps ward off acidosis, which can be a side effect of the diet.

2) I use Stevia for preferred sweetener in beverages, as zero carbs. It's VERY sweet, so a tiny amount is sufficient. The Charlie Foundation website has a chart for carb amounts of various sweeteners on their "resources" link.

3) You can make your own carbonated beverages by using plain soda water, the flavoring of your choice (like McCormick flavorings), and sweetener of your choice. You can buy carbonated, flavored water wiithout sugar in most supermarkets, but sometimes the artificial sweeteners have some carbs.

When on the MAD or Ketogenic diet, it's crucial to drink LOTS of water (or some sort of fluid) -- at least 8 cups a day -- to ward off kidney stones and acidosis.

 

[Good Cook]

Hi Karen,
I apologize for taking so long to reply. Thank you so much for all of your advice. I appreciate it a GREAT deal! I like your suggestion of mixing mayo and oil together. The websites you gave me are all very helpful too. The only time I have done the oil/mayo combo so far is when I use tuna packed in oil and mix it with mayo, but I can see it working other ways too, such as by creating a faux-salad dressing and putting it over a chef salad, or a wrap as you have suggested.

So far, its been a little less than a month that I have been on the diet. I haven't seen a change in my seizure pattern yet, but I am being patient. I was told I could have 30-40 grams of carbs, but I've been doing good with having more like 20-30 for the past week. I can't believe I haven't gotten sick of eggs for breakfast yet! The toughest things for me so far has been not being able to eat as much veggies as I would like, and making sure that I have enough fat at each meal (and especially sticking to healthy fats). The diet definitely does get easier week by week, little by little with the more research my husband and I have been doing to figure out what food options I have. We recently bought an Atkins cookbook which has the net carb grams and amount of fat on each page which makes planning meals SO much easier. I still struggle when I want to make something that I would have made prior to the diet, and can't figure out how many carbs are in it, such as a casserole. For now, I've been staying away from my old recipes, and I'm hoping that my dietician can give me some good direction about how to calculate carbs for them when I see her again in a couple of weeks.

I hope Jon continues to do well! It sounds like you are very organized and have a lot of options for him.

 

[KarenB]

It took about 6 weeks for the diet to kick in for Jonathan. In fact, he actually got really bad in the 5th week (had an ear infection/sinus infection) and went into non-stop seizures and had to be admitted to ICU for 3 days. But they got the seizures stopped in the hospital, and after that he was seizure free for a year -- even was able to wean off his meds.

Unfortunately, following a serious intestinal virus that got his whole system out of whack, he began having seizures again. (His doc thinks that he had malabsorbtion issues that would have been skewing the diet, if he weren't absorbing fats and such correctly). So...it took quite a bit of time to get that all sorted out, and he did go back on meds, but finally in January, he achieved seizure freedom again (through actually eliminating 2 of the meds and tweaking the diet, and adding in digestive enzymes and zinc, etc.), and has been seizure free now for 5 months.

Anyway, just wanted to encourage you to stick with it, because it sometimes takes up to several months to see results. And sometimes there's things that can be done to tweak the diet and raise ketones, like adding in MCT oil (this really worked well for us). Are you checking your ketone levels at home? What about your blood sugar?

 

[Good Cook]

Thank you. Wow, it sounds like you and your family have been through a LOT! I had been on a lot of various medications when I was younger (started having seizures when I was 8). I did the Ketogenic diet when I was 16 for 4 months, and it decreased the amount of seizures but didn't bring them down to zero. I also tried the VNS for 5 years at various settings and with different meds. Finally, Depakote worked for me for 6 years. Then, I got married and told my dr that I wanted to try to start a family. He switched me to Keppra due to the high risk of birth defects that Depakote could have on a baby. Keppra fortunately worked for 2 years. I started to feel like somethign wasn't quite right around late Dec/early Jan of this year. It was like instinct that I just knew something was going on with my brain related to my seizures. The feeling was all too familiar even though it had been so long since I had one. Sure enough, the seizures started up again within a week or so of having that feeling in my brain. It turned out I had built up a tolerance to the Keppra. My dr said even though I was on it for 2 years with no changes to my dose, he has actually seen that in patients where they have been on the same dose of a medicine for as long as 4 years. That wasn't encouraging to hear at all! I had to stop driving, turn in my license, and have been dependent on my husband for transportation. A video-EEG was done in Feb which showed nothing new, and an MRI was done in March which showed nothing new. In the past, I had only had absence seizures. I had one grand mal in Feb, March, and April. Nobody knows why.
Long story short with my meds over the past few months: I am now totally off of Keppra and back to almost my same dose of Depakote. It was a tough decision due to the risk of birth defects if I get pregnant, but I felt lost since no other med has worked for my seizures and/or has given me horrible side effects. Fortunately, my seizures are under MUCH better control than they were earlier this year. However, I will go for several days or even a week or two with no seizures, and then they come back and I have 4-7 in a day. My mother has encouraged me by putting it in the frame of reference that when I was younger, there was never a day where I would have so few seizures. It was usually more like 20+ in a day. It certainly makes me feel better, as well as when I think that was the case earlier this year. But, as I'm sure you've felt, I want to stop having seizures forever, and I want that moment to start now with a guarantee that they won't return again. Unfortunately it doesn't seem to be totally related to my menstrual cycle either. I feel like if it was, at least then we could pinpoint it to something. Its strange to me too that even though I am at pretty much the same dose (1,000 mg/day versus 1,125 mg/day), I still have them occasionally. So, the diet wasn't exactly my first choice since there are so many restrictions. I LOVE vegetables and probably miss them the most. Part of me wonders if things would improve if I went back to 1,125 mg/day of Depakote, but I am trying to be on the least amount of medication as possible. Fortunately I am on 4 mg of Folic Acid, and take a multivitamin. I can only pray that if I do become pregnant, baby and I will be healthy. I noticed that things got a lot better when I came off of Keppra and was back to Depakote, which I am so happy about because the main thing that got me to switch was the thought of "Now that I have had a few grand mals, what if I become pregnant, have a grand mal and fall during one?"

The MCT oil hasn't been suggested yet. Do you know if it tastes any better than coconut oil? I have been using coconut oil and olive oil as my healthy fats. I'm trying to use mayo sparingly and haven't used any butter in awhile. I check my ketone levels but not every day. Interestingly, they went up to Moderate within a week after starting the diet, but I started having seizures again as I was getting close to my period this month. I tested my ketones, and they had droped to Low. I have been wondering if it was the hormones, not having enough fat, or a combination of both. I have been having a tough time making sure I eat enouogh fat. (It sounds so weird to be saying that!) I haven't been told to check my blood sugar, but I went for a glucose test a couple of days after meeting with the nutritionist & dietician. Do you have to check Jon's blood sugar regularly? What do the results tell you about how he is doing with the diet?
Stay positive!