Top New Years Resolutions

Have you made any New Years Resolutions? According to two University of Scranton studies done ten years apart, two of the top New Years Resolutions are to lose weight and eat healthier. The study also found that those who made New Years Resolutions were 10 times more successful at changing their behavior in the short run than those who wanted to change their behavior but didn’t actually making a resolution. The bad news was that only a week into the New Year, 50% had already given up and by the end of January, that number had risen to 83%.

Unfortunately, only 8% of people are successful in achieving these types of New Years Resolutions on their own.

The reality is that it takes approximately 66 days to create a new habit (Lally et al, 2010). That’s more than 2 months. Having the professional support of a Registered Dietitian during this critical time can make all the difference!

Like many of my clients, you have probably lost weight before — perhaps by cutting portion sizes, going to the gym or eating ‘low fat’. You dutifully ate rabbit food, cottage cheese and skimmed milk and while the weight came off, you were probably hungry, grumpy and cold, but determinedly you pressed on. Or maybe you didn’t.

What if I told you there’s a much better, and easier way to lose weight and as importantly, bring blood sugar levels and blood pressure levels down and lower high triglycerides?

There is.

I not only teach it, I am doing it.

If you want 2018 to be the year you achieve your weight loss and health goals, then let’s do this together.

Please send me a note using the “Contact Me” form on this web page to find out more.

All the best of health and happiness to you and yours in 2018!



Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W. and Wardle, J. (2010), How are habits formed: Modelling habit formation in the real world. Eur. J. Soc. Psychol., 40: 998–1009.

Norcross, JC et al, Auld lang syne: success predictors, change processes, and self-reported outcomes of New Year’s resolvers and nonresolvers. J Clin Psychol. 2002 Apr;58(4):397-405

New Year’s Resolutions for 2013 – Changeology, Dr. John C. Norcross

Crisp Keto Pizza

This recipe is posted as a courtesy to those following a variety of low-carb and ketogenic diets (not necessarily Meal Plans designed by me). This recipe may or may not be appropriate for you.

I tried a few existing recipes for low carb pizza and was quite disappointed, as they were either more like omelettes, or gritty with coconut or almond flour.  The biggest strike against them was that they were limp – definitely not the crisp, yeasty finger food I was wanting!

I decided to invent one. I knew basically what ingredients I wanted to use (based loosely on my tempura batter) and that it had to have a yeasty ‘bread’ taste. I also knew it would have some cheese in the crust (like the infamous ‘fat head pizza’) and that it had to be so overwhelmingly ‘legit’ that someone who wasn’t eating low carb or keto would enjoy it. Finally, it had to be good cold, too – after all, who doesn’t like cold pizza?

To my delight, I practically nailed it on the first try.

If you’re like me and love pizza, I hope you will enjoy this one.


  • ½ cup (125 ml) + 2 Tbsp (50 ml) unflavored whey isolate powder
  • ½ tsp. (2.5 ml) baking powder, sifted
  • ½ tsp. (2.5 ml) salt
  • 3 oz. (100 g) Parmesan cheese, finely grated
  • 3 oz. (100 g) three cheese mixture (mozzarella, provolone, parmasan), finely grated
  • 2 oz. (30 gm) full fat cream cheese, softened
  • 1/2 tsp instant yeast, dissolved in 2 Tbsp warm water
  • 4 Tbsp. olive oil
  • 1 egg + 1 egg yolk


  1. Preheat the oven to 375 °F (190 °C).
  2. Combine the dry ingredients in a mixing bowl.
  3. In a smaller bowl, beat the egg and egg yolk and add the softened cream cheese. Drizzle in the olive oil as if making a salad dressing (so it is suspended in the egg / cream cheese mixture. Once the yeast has proofed (foamed), mix it into the liquid. Stir well.
  4. Pour the liquid ingredients into the dry ones.

    Note: The dough will a thick batter.

  5. Using a non-stick pizza pan (or a regular baking sheet lined with parchment paper), use the back of a spoon to smooth the dough into a 10-inch circle.
  6. Place a piece of wax paper or parchment paper on top and gently roll with a rolling pin.  When you remove the wax (or parchment paper), scrape any batter sticking to it onto the dough.
  7. Bake the crust for 10 minutes or until golden brown. Don’t overcook.
  8. Remove the crust from the oven and top with your favourite pizza sauce and toppings.
  9. Once the pizza is topped, return it to the oven to bake until the  cheese is melted and it is just beginning to brown.
  10. Allow to cool a few minutes, then slide the crispy pizza to a serving board, cut, serve and enjoy!

Keto Eggnog – for the holidays

This recipe is posted as a courtesy to those following a variety of low-carb and ketogenic diets (not necessarily Meal Plans designed by me). This recipe may or may not be appropriate for you.

What would the holidays be without eggnog? I’m not talking about the artificially yellow-coloured, carrageenan-thickened beverage from the supermarket, but real eggnog rich with egg yolks and heavy cream. That’s what I’m taking about!

Whether its for Christmas Eve or New Years, eggnog embodies the holidays.

According to Statistics Canada, during the 2014 holiday season, Canadians drank ~5.3 million litres of commercially made ‘eggnog’, but apparently a decade ago, it was closer to 8 million litres! Perhaps the mistaken belief that saturated fat is ‘bad’ for us has led to the decline, or maybe it is simply that the commercial-prepared substitute pales in comparison to real eggnog.

The National Dairy Code defines eggnog as;

“food made from milk and cream containing milk and cream which has been flavoured and sweetened. The food shall contain not less than 3.25 per cent milk fat and not less than 23 per cent total solids.”

Milk and cream?

Real eggnog is made from lots of egg yolks and cream – heavy cream and light cream. It is delicately flavoured with freshly grated nutmeg and some also add a hint of real vanilla extract (made from vanilla beans, soaked in vodka) and yes, it is often served liberally mixed with rum.

In days gone by, eggnog was made from raw egg yolks, but my recipe cooks the egg yolks over a double boiler then holds them at a high enough heat to make them safe. It is lightly sweetened and then blended with cream and spices and placed in a glass milk bottle, until well chilled.  Yes, it is enjoyed with real rum (carb free).

Here is my recipe for eggnog – just in time for the holidays!

Keto Eggnog

6 egg yolks, large (from free range chickens, bright yellow yolks)
1/2 cup heavy cream (whipping cream)
1/4 cup of Xyla® brand sweetener (erythritol)
1 tsp nutmeg, freshly grated
1 litre coffee cream (10% BF)

  1. In the top of a double boiler (not over hot water), whisk the egg yolks, heavy cream and erythritol sweetener to blend well.

  2. Bring water in the bottom of the double boiler to a gentle boil and place the top part, with the eggs on top.  From this point on, whisk constantly without stopping (otherwise you will have scrambled eggs).

  3. Whisk vigorously and constantly until the mixture is thickened and keep whisking until an instant-read thermometer inserted into the mixture reads 140°F for 3 minutes or longer.The mixture should be thick enough to completely coat the back of a spoon.

  4. Remove the top part of the double boiler and keep whisking the mixture a little while longer, as it begins to cool down.

  5. Add the freshly grated nutmeg (and splash of real vanilla, if using) and whisk another 2 minutes or so, as the mixture continues to cool.


6. When the mixture has reached room temperature, gently whisk in the coffee cream and place in a glass milk bottle or glass pitcher with a tight fitting cover, so the eggnog doesn’t absorb the smells of other foods in the fridge.Allow the eggnog to chill thoroughly before serving (with or without rum).


Merry Christmas and Happy New Year!




What is Ideal Protein®?

Recently, there has been a lot of buzz about a weight-loss program called Ideal Protein® which is often talked about as being a “low carb diet” so I decided to look into what this system is, and how it works. A local pharmacy is participating in this program, so I was able to obtain information directly from the pharmacist.

Ideal Protein®, in it’s weight-loss phase (called “Phase 1”) is both low carb and low fat diet – and is most significantly a calorie-restricted diet promoted for weight loss.


“Lifestyle Clinics”,  many of which are located at participating pharmacies are supervised by a pharmacist (or a nurse) who oversees the promotion of the Ideal Protein® line of products required for the diet, as well as the Natura® vitamin and mineral supplements and “Ideal Salt®“, which clients are instructed to use daily.

The designated pharmacist (or nurse) reviews the sign up, but “Ideal Protein® weight loss “coaches” are the ones who review weekly “food journals” that clients are required to keep, as well as records client’s weight, body measurements and fat % readings at their weekly “check-ins”.

Restricted Foods

In addition to limiting both carbs and fats, many foods are not permitted to be eaten by those on the Ideal Protein® diet until clients achieve 100% of their weight-loss goals.

For example, no cheese or dairy is permitted during the weight loss phase, except for 30 ml (1 oz) of regular milk in coffee or tea at breakfast. Natura® supplements are prescribed to clients to ensure adequate intake of calcium and magnesium.

The only vegetables permitted during the weight-loss phase of the Ideal Protein® diet during lunch and dinner are what are called “selected vegetables”  – which exclude green and wax beans, Brussels sprouts, eggplant, heart of palm, rutabaga, snow peas, tomatillo, and tomatoes. These are considered “occasional vegetables” and are allowed to a maximum of 4 cups per week.

*NOTE: I have been advised from a pharmacist that sells these products that these vegetables have “extra carbohydrates” and “slightly higher GI (glycemic index) for the most part“,  which is the reason they are limited.

Glycemic Index (GI) is a measure of the effect of carbohydrates on a person's blood sugar. I am more interested in a food's Insulin Index (II) which is a measure of the effect of a carbohydrate on a person's insulin levels.

Permitted “selected vegetables” are alfalfa, asparagus, bamboo shoots, bean sprouts, bell peppers, broccoli, cabbage, cauliflower, celeriac, celery,  chayote, chicory, collards, cucumbers, dill pickles, fennel, Chinese broccoli, green onions, jicama, kale, kohlrabi, mushrooms, okra, onions (raw only), hot peppers, radish, rhubarb, sauerkraut, spinach, Swiss chard, turnip, and zucchini / yellow summer squash.

Only unlimited “raw vegetables and lettuce” in the list below are permitted during the weight-loss phase (and only during lunch and dinner). These are arugula, bibb lettuce, Boston lettuce, celery, chicory lettuce, cucumber, endives, escarole lettuce, frisée lettuce, green and red leaf lettuce, iceberg lettuce, mushroom, radicchio, radish, romaine lettuce, spinach and watercress lettuce. All others raw vegetables and lettuce are prohibited.

Even in Phase 2, clients are instructed to only “eat the vegetables permitted” and to “continue to omit cheese and other dairy with the exception of 30 ml (1 oz.) of milk in coffee or tea only“.

Ideal Protein® “Meals”

During the weight loss phase (Phase 1), clients are instructed to have meals as follows;

BREAKFAST: 1 Ideal Protein® diet food product, with the option of having coffee or tea with 1 oz. (30 ml) milk, plus Natura® vitamin and mineral supplements.

LUNCH:Ideal Protein® diet food product, with 2 cups of “selected vegetables” and unlimited “raw vegetables and lettuce” from the above list.

DINNER: clients can eat 8 oz (225g) of lean fish / seafood, lean beef, skinless poultry, lean cuts of pork, veal or wild game meat and 2 cups of “selected vegetables” and unlimited “raw vegetables and lettuce” from the above list plus Natura® vitamin and mineral supplements and omega 3 plus.

SNACK: For a snack, clients eat another Ideal Protein® diet food product and more Natura® vitamin and mineral supplements.

In “Phase 2”, which occurs after 100% of weight loss goals have been achieved, the number of Ideal Protein® diet food products required to be consumed is reduced to 2 and clients can eat the protein choice they wish from the approved list at both lunch and dinner, for 2 weeks. The “selected vegetables” and unlimited “raw vegetables and lettuce” remains the same.

In “Phase 3”,  the number of Ideal Protein® diet food products required to be consumed is reduced to 1 and clients can continue to eat the protein choice they wish from the approved list at both lunch and dinner, for 2 weeks. The “selected vegetables” and unlimited “raw vegetables and lettuce” remains the same.

It is only in “Phase 4”, the maintenance phase” of the Ideal Protein® weight loss system where clients are allowed to eat “all whole foods, including protein and fats, and do not need to eat the Ideal Protein®  products”.

Additional Instructions

Clients are instructed to follow the strict carbohydrate and fat restriction until they achieved “100% of their weight loss goals” and to “eat no more / no less” than the amount of food listed for each meal and snack. That is, “Phase 1” last as long as necessary until a person loses all the weight they planned.

They are cautioned that during Phase 1 and possibly beyond that, six symptoms may occur – especially if they “don’t follow the weight loss method as prescribed”. These symptoms are hunger, headache, nausea, fatigue, constipation and bad breath.

Restricted Calories

Ideal Protein® provides only 850-1000 calories per day, which makes it a calorie-restricted diet.

Low Carb

The Ideal Protein meal replacement packets provide ~20 gm net carbs per day and the “selected vegetables” and “raw vegetables and lettuce“provide ~ 20 gm net carbs per day. Total net carbs are ~40 gm / day.

High Protein

In the Ideal Protein® system,   the meal supplements contain ~15-20 gm protein each and 3 of those are to be eaten each day, along with 8 oz of lean animal protein per day. From the ‘meal packets’, there are 60-80 gms of protein and anywhere from 56 gm of protein (lean ground beef) to 72 gms of protein  (chicken breast).  In total, the Ideal Protein system has people eating between 120 gm – 152 gm of protein per day.

According to Statistics Canada (, the average protein intake for an adult is 16.5% to 17.0%. Based on Ideal Protein® system having a caloric intake of 850-1000 kcals/day, and the 3 meal supplement packets providing 15-20 gm of protein each, plus the 8 oz of lean protein (another 56-72 gms of protein), the Ideal Protein® system supplies 53 – 67.5% of calories as protein. 


In terms of cost, it is ~ $500 to sign up to begin the Ideal Protein® diet, which includes a ‘coaching fee’, first round of supplements and 2 weeks worth of meal replacement and meal supplement sample products.

After sign up, the cost works out to ~$100 a week to purchase the Ideal Protein® products, plus supplements  i.e. each box of 7 Ideal Protein® “meal replacements” or diet food product (required to be eaten for meals and snacks) costs ~$30 and for weight loss, 3 boxes a week are required.

Each additional month is another ~$400.

Ideal Protein® – the company 

The Ideal Protein® company is headed by Dr. Randall Wilkenson MD, who has 20 years experience specializing in allergy and environmental medicine and who now works with his son Denver Wilkenson, whose experience is in managing a weight-loss clinic in Idaho for 3 years.

Ami-Higbee, RN serves  as Clinic Director and Mike Ciell, RPh, a registered pharmacist certified in geriatric pharmacy, is VP of Clinic Operations.

At the time of writing, no Registered Dietitians are listed on the team, but they do have a ‘chef’ from Quebec who designs their recipes, almost all of which include ingredients from their Ideal Protein® product list.

According to a local pharmacist that I spoke with, Ideal Protein® has over 4000 of these “Lifestyle Clinics” worldwide.

A few thoughts…

This diet is very popular, but it is not a “low carb diet” but is a “low carb, low fat, calorie restricted diet”.

It’s easy because people don’t need to think what to to eat and can buy meal replacement products to satisfy breakfast and the protein component of lunch.  For supper, clients are provided with recipes that use the special branded products that they already purchase to make cooking easy. A snack (deemed necessary, I presume) is another food replacement product. There is limited food preparation required.

The diet system promotes fast weight loss — where both carbohydrates and fats are limited.

Since it is overseen by a pharmacist or a nurse, it has the image of being healthy. But is it “ideal”?

As discussed in an earlier article, our bodies have an absolute requirement for specific essential nutrients; nutrients that we must take in our diet because we can’t synthesize them. These are listed in several volumes called the Dietary Reference Intakes (DRIs), published by National Academies Press. There are essential amino acids, fatty acids, vitamins and minerals – and it is necessary to take in adequate protein and fat, when carbohydrate is restricted.

In the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005) it reads;

The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed

… however, Ideal Protein® diet restricts both carbs and fats.

It restricts calories.

It restricts cheese and all dairy except for one ounce of milk per day.

It restricts which non-starchy vegetables can be consumed.

It allows no fruit.

It allows no nuts or seeds.

It offers vitamin and mineral supplements and food replacements in place of those real foods.

In the Ideal Protein® system, people are required to eat 4 times a day with carbs contained in the branded meal supplements on each occasion. Research supports that to begin to lower insulin release in insulin-resistant people requires periods of at least a 12 hour where no food is eaten, which naturally occurs after dinner before the first meal of the day breakfast). Having people eat a ‘snack’ would appear to be self-defeating.

Eating a low carb high healthy fat with 3 meals per day, with nothing between supper and breakfast supports the lowering of insulin release, improving the cells insulin sensitivity, in time.  Adding to this periods of intermittent fasting (which is not a total fast, but has no carbohydrates or significant amounts of protein) allows insulin levels to fall even further, which is often the goal of eating a low carb diet.

In the Ideal Protein® system, the meal supplements contain ~15-20 gm protein each and there are 3 of those per day and there is also 8 oz of lean animal protein per day. From the ‘meal packets’, there are 45-60 gms of protein and anywhere from 56 gm of protein (lean ground beef) to 72 gms of protein (chicken breast). In total, the Ideal Protein®  system supplies between 100 gm – 132 gm of protein per day. While carb intake in the Ideal Protein®  system is low, the body would synthesize glucose from the excess protein (called gluconeogenesis) resulting in insulin release. From my understanding, this appears to be self-defeating if the goal is to lower insulin release.

It would seem that the increased gluconeogenesis from the high protein intake in the Ideal Protein® system would not support increased insulin sensitivity as much as a low-carb-high-fat moderate protein diet, even without intermittent fasting.

Another factor is the $500 start-up cost for the first month, plus another  $400+ for each additional month to eat ‘meals’ comprised of largely of meal replacements and supplements, along with some real food.

Ideal Protein® makes it easy and promotes rapid weight loss, but is it really “ideal” for people who have made poor eating choices in the past — when they don’t learn how to make healthy meal choices while achieving weight loss? Weight loss may be quick, but weight loss also has to be sustainable.

Also, is it really “ideal” for people who are insulin resistant when it has them eating food with carbohydrate and protein 4 times per day?

I encourage my clients to eat a wide variety of real foods – foods such as dairy products including cheese,  domesticated and wild meat, poultry and fish, especially fatty fish that are rich in omega 3 fats, low-carb fruit and a vast array of low-carb vegetables. There are fats from all sources, including some healthy saturated fat, with most fat coming from healthy monounsaturated sources such as olives avocadosnuts and seeds. There are no food diaries to keep and no mandatory “weigh-ins” or “check-ins”.  My clients eat real food when they are hungry and don’t eat if they are not hungry.  Most significantly, they learn to make healthy food choices with whole, real food as they lose weight.

Each person needs to evaluate for themselves whether use of the Ideal Protein® system makes sense for them.

As I always do, I recommend that people consult with their own doctor before beginning any weight-loss program.

To your good health!



Note: Everyone's results following a LCHF lifestyle will differ as there is no one-size-fits-all approach and everybody's nutritional needs and health status is different. If you want to adopt this kind of lifestyle, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


A Dietitian’s Journey – 9 months since beginning LCHF

LEFT: March 16 2017, RIGHT: December 18 2017

The photo on the left is what I looked like when I started my weight-loss and health ‘journey’ on March 16, 2017, 9 months ago.  The photo on the right, is me today.

Based on my BMI, I was well into the  Class I Obesity  category 9 months ago. Based on my BMI today, I am just 15 pounds from my weight falling in the normal range. 

At the beginning of March, my blood pressure ranged between Stage 2 Hypertension  and Stage 1 Hypertension – sometimes being dangerously high. Now, my blood pressure hovers around 125/80 mmHg mark, and I am still on the ‘baby-dose’ of Ramipril for now, as it protects my kidneys.

My triglycerides  and my LDL cholesterol (“bad cholesterol”) were high, certainly well above what it should have been for someone who has Type 2 Diabetes and had family risk factors. Thankfully, my HDL was good, offering some protection.

In the past 9 months, my morning fasting blood sugar has dropped from ±12 mmol/L (216 mg/dl) to anywhere from 5.8 mmol/L (105 mg/dl) to 6.5 mmol/L (117 mg/dl) – with the occasional 8.0 mmol/L (144 mg/dl) for seemingly no apparent dietary reason. For my fasting blood sugar to be in the non-diabetic range, it needs to be consistently below  5.5 mmol/L  (99 mg/dl).

When I began this journey, my HbA1C was ~ 9.5% and during the last 30 days, I am averaging ~6.3% which is in the non-diabetic range. This has been entirely achieved without any medication to lower blood glucose.

I was determined to reverse the symptoms of Diabetes, high cholesterol  and high blood pressure by changing how I ate and by introducing short periods of intermittent fasting and I have certainly made significant progress.

Weight and Body Measurements

I’ve lost ~25 lbs so far, but the changes in my body and face shape are even more noticeable, as evidenced by the photo above.

So far, I’ve lost;

  • 1″ off my upper arms
  • 3″ off my neck (!)
  •  1″ off my thighs
  • 4 1/2″ off my waist

This week, I reached the “goal weight” that I initially set for myself, but in order to attain an ideal waist circumference that is 1/2 my height, I probably have to lose another 20-25 pounds, which means I am half-way there.

I am entirely convinced that this is realistic and attainable.

Change only happens when the pain of staying the same is greater than the pain of changing.

Want to start your own weight loss and health journey? Why not send me a note using the “Contact Us” form above.

Wishing you and yours all the best for holiday season!


Note: I am a "sample-set of 1" - meaning my results may or may not be like anybody else's that follows a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

Amazing Low Carb Mini Donuts with Eggnog Sauce

This recipe is posted as a courtesy to those following a variety of low-carb and ketogenic diets (not necessarily Meal Plans designed by me). This recipe may or may not be appropriate for you.

These delectable mini donuts are made with the finest ingredients; real creamery butter, fresh cream and eggs and the seeds of real vanilla beans. They are light, crispy and have that cake-like texture you want in a treat and are both low carb and gluten free because instead of flour, they contain whey protein and ground almond flour.

baked low carb mini donuts

They can be baked to golden perfection, because the butter and full-fat cream result in a lovely crispy texture…



…or for those wanting a deep-fried treat, they can be baked for slightly less time and then deep-fried.

Served with a rich homemade eggnog sauce, they are a wonderful treat for the holidays!

Happy Holidays!

Low Carb Mini Donuts

(makes 32 mini donuts)

1/2 cup of whey protein, unsweetened
2 Tbsp almond flour
2 tsp baking powder, sifted
1/2 tsp Himalayan sea salt
2 Tbsp Truvia© brand or Xyla© (erythritol) sweetener
interior of 1 vodka-soaked vanilla bean (or 1 tsp real vanilla extract)

8 Tbsp heavy cream
4 Tbsp unsalted butter, melted and cooled
1 egg

  1. whisk dry ingredients together in a medium bowl
  2. beat egg, add cooled melted butter and cream, mix well
  3. preheat oven to 350º F
  4. spray two trays of mini donut pans (12 each) with coconut oil spray (or use Pam©)
  5. When oven is hot, fill each well slightly less than 1/2 full with batter
  6. Bake for 8 minutes if planning to deep fry afterwards, or 10 minutes if eating baked


Eggnog Sauce


6 lg. egg yolks
1/2 cup heavy cream
1/4 cup Truvia© brand or Xyla© (erythritol) sweetener
1/4 cut unsalted butter, melted and cooled
1 Tbsp real rum (or rum extract, if liked)
1/4 nutmeg, grated

  1. set up a double boiler over a medium heat
  2. whisk egg yolks, heavy cream and sweetener into a small bowl.
  3. slowly whisk in cooled, melted butter (be sure butter is cooled or eggs will scramble!)
  4. add mixture to top of double boiler and whisk constantly until mixture thickens and instant-read thermometer reaches 140º F for 3 minutes (makes it safe).  Mixture should be thick enough to coat the back of a spoon.
  5. add real rum or rum extract and grate in the fresh nutmeg
  6. remove mixture from water and let cool. Serve warm or cooled.


Joy’s Low Carb Falafel

This recipe is posted as a courtesy to those following a variety of low-carb and ketogenic diets (not necessarily Meal Plans designed by me). This recipe may or may not be appropriate for you.

Falafel are the iconic ‘street food’ of Israel and elsewhere in the Middle East and are often eaten standing in front of the little shops that make them or sitting at picnic tables outside. Israeli Arabs and Jews often mingle at these little stands, enjoying their delectable, quick meal together. In this post, I’ll give you everything you need to know how to make delicious, authentic-tasting low carb falafel.

Joy’s Low Carb High Health Fat Falafel

For those unfamiliar with falafel, they are slightly “cone-shaped” balls of delicately spiced, ground chickpeas and/or fava beans that fried until their exterior is crispy, yet their interior remains moist, yet cooked.

falafel press

They are formed using a special falafel press, available in Middle Eastern stores or online, but a mini small ice-cream scoop could substitute, in a pinch.


falafel pita

Usually, falafel are served in a split pita with pickles (cucumber and beet marinated turnip), tahina sauce, cut fresh vegetables and sometimes a drizzle of an aromatic hot sauce called ‘harissa’. In my version, large washed and dried leaves from green leaf lettuce substitute for the pita and the mixture itself has the addition of ground, firm tofu to make it much lower carb! Since tofu is made from soya beans, its taste is indistinguishable in the aromatic mixture of spiced chickpeas and fava beans.

Another advantage to my recipe is that regular falafel require the addition of baking powder to make the texture light and soft inside, but this often leaves a slightly bitter aftertaste to the falafel.  In these low-carb falafel, the ground tofu makes the addition of baking powder totally necessary. The texture is just perfect!

At only 2.5 gm net carbs per piece  – and only 14 gm for the 4 falafel “sandwiches” below plus the carbs from the vegetables eaten, what’s not to love about these low carb high healthy fat falafel?

Joy’s Low Carb High Health Fat Falafel

Below is the recipe for this delectable treat!

Joy’s Low Carb Falafel Recipe

1 cup dried chickpeas, soaked overnight

1 cup of dried fava beans, soaked overnight

1/2 large onion, roughly chopped (about 1 cup)

4 tablespoons finely chopped fresh parsley

4 tablespoons finely chopped fresh cilantro (coriander leaves)

350 gm extra firm tofu

1.5 teaspoon salt

1/2-1 teaspoon dried hot Aleppo red pepper

4 cloves of garlic, crushed

1 teaspoon cumin, ground

2 tbsp sesame seeds

4-6 tablespoons chickpea flour

Falafel Garnish

leaf lettuce leaves, whole

diced tomato

sliced cucumber

sliced 1/2 sour dill pickles

large sticks of beet-pickled turnip (available at a Middle Eastern store, and easy to make homemade!)

chopped parsley

chopped green onion or milder round onion

Tahina Sauce

1/2 cup tahina sesame paste

1/2 cup warm water

1 clove garlic, crushed finely

juice of 1/4 lemon

1 tsp salt

1/4 cup extra virgin olive oil

Falafel Preparation


(1) This recipe works best when the mixture is made 1 day ahead and left to sit for a day in the fridge, covered.  This way, the falafel don’t fall apart when frying!

(2) I use a meat grinder attachment for a Kitchen-Aid stand mixture to grind mine, but a food-processor could work too provided the mixture is ground in small batches and remains course in texture.

  1. Put the chickpeas and fava beans in a large bowl and add enough cold water to cover them by at least 2 inches. Let soak overnight.
  2. When ready to prepare mixture the next day (a day or two before planning to make falafel), drain the soaked beans and rinse well with cold water.
  3. Put the drained, rinsed, uncooked chickpeas and fava beans though the meat grinder, being sure to use the smaller-holed press.
  4. Then, put through the extra firm tofu, onion, parsley, cilantro and garlic.

    If using a food-processor, process until coarsely textured, but not pureed!

  5. In the bowl that has received the ground mixture, mix in the salt, hot pepper, garlic, cumin and sesame seeds and sprinkle with 4 – 6 tablespoons of chickpea flour
  6. Cover bowl and refrigerate, covered, until the next day.
  7. When ready to cook, form the chickpea mixture using a falafel press or by hand into balls about the size of walnuts. Form one side into a slight cone-shape (gives more surface area when frying!).
  8. Heat 2 inches of coconut oil to 375° F degrees in a deep, heavy pot or wok and fry 1 ball to test. Once sure the oil is hot enough (not too hot, either!) fry 5 falafel at once for a few minutes on each side, or until golden brown.
  9. Drain on a layer of kraft paper lunch bags.
  10. Once all the falafel are cooked, assemble as desired, with vegetable of choice at the bottom, falafel on top and drizzle with tahina sauce, and harissa thinned with olive oil (if using).



How Much Carbohydrate is Essential in the Diet?

INTRODUCTION: I was asked a question recently on social media as to what is our body’s essential daily requirement for carbohydrate. This is a very good question – so much so, that I decided to answer it in the form of a short article. If you are considering a low carb high fat lifestyle, this is important to understand.

Our body has an absolute requirement for specific essential nutrients; nutrients that we must take in our diet because we can’t synthesize them. What these nutrients are and how much we require depends on our age and stage of life, our gender and other factors and are listed in several volumes called the Dietary Reference Intakes (DRIs), published by National Academies Press.

There are Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005), Dietary Reference Intakes for Calcium and Vitamin D (2011), Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000), Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (1997), Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005), Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998), Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001).

In these texts are listed the essential amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine) that must be supplied in the different kinds of protein that we eat.

These texts also establish that there are two essential fatty acids, linoleic (an omega 6 fat) and alpha-linolenic (an omega 3 fat) that can’t be synthesized by the body and must be obtained in the diet.

There are 13 essential vitamins (vitamin A, vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyrodoxine), B12 (cyanocobalamine), biotin, vitamin C (ascorbic acid), choline, vitamin D (cholecalciferol), vitamin E (tocopherol) and  folate) listed and essential minerals, including major minerals (calcium, phosphorus, potassium, sodium, chloride and magnesium) and minor minerals (chromium, cobalt, copper, fluorine, iodine, iron, manganese, molybdenum, selenium, silicon, sulfur and zinc).

But is there “essential carbohydrate?

In Chapter 6 of the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005) is the chapter titled “Dietary Carbohydrates: Sugars and Starches” (pg. 265), which indicates that the  Recommended Dietary Allowance (RDA) for carbohydrate,  considered to be the average minimum amount of glucose needed by the brain, is set at 130 g / day for adults and children.

Recommended Dietary Allowance (RDA) for carbohydrate

It is important to note that the Recommended Dietary Allowance (RDA) for carbohydrate is at 130 g / day based on the average minimum amount of glucose needed by the brain – with no consideration that the body can manufacture this glucose from both FAT and PROTEIN.

Just 10 pages later, in the same chapter of the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005) it reads;

The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed. 

The lower limit of dietary carbohydrate

That is, there is no essential need for dietary carbohydrate, provided that “adequate amounts of protein and fat are consumed”.

The text goes on to say that there are traditional civilizations such as the Masai, the Greenland and Alaskan Inuit and Pampas indigenous people that survive on a “minimal amount of carbohydrate for extended periods of time with no apparent effect on health or longevity“, and that white people (Caucasians) eating an essentially carbohydrate-free diet resembling that of the Greenland natives were able to do so for a year, without issue.

That is, the minimum amount of dietary carbohydrate required is zero provided that adequate amounts of protein and fat are consumed. Phrased another way, the “minimum amount of glucose needed by the brain of 130 g / day is made by the body from protein and fat provided they are eaten in adequate amounts.

In the absence of carbohydrate, de novo synthesis of glucose

On the next page (pg. 276) of the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005) it explains the process;

“In the absence of dietary carbohydrate, de novo synthesis of glucose requires amino acids derived from the hydrolysis of endogenous or dietary protein or glycerol derived from fat. Therefore, the marginal amount of carbohydrate required in the diet in an energy-balanced state is conditional and dependent upon the remaining composition of the diet.”

That is, even when minimal amounts of carbohydrate is eaten (not something I promote), the body will synthesize the glucose needed by the brain from the protein taken in through the diet (provided it is in adequate amounts) or from glycerol which is formed when fat is broken down. If the protein in the diet (exogenous protein) is inadequate however, the body’s own protein (endogenous protein) will be used.

So, no, there isn’t any “essential carbohydrate” requirement.

Even when a person is completely fasting (religious reasons, medically supervised, etc.) the 130 g / day of glucose needed by the brain is made from endogenous protein and fat.

When people are “fasting” the 12 hour period from the end of supper the night before until breakfast (“break the fast”) the next day, their brain is supplied with essential glucose! Otherwise, sleeping could be dangerous.

In previous articles reviewing long-term studies of low carbohydrate diets, safety and efficacy has been established with intakes as low as 20 gm of carbs for 12 weeks and 35 gm of carbohydrate per day for extended periods of time, provided adequate protein and fat is eaten.

I am of the opinion that in order to have a diet with the essential vitaminsminerals, amino acids and fatty acids, that a wide range of healthy foods with some carbohydrate content is required.  I encourage people to consume low carb fruit and dairy products and nuts and seeds, along with a wide range of meat, fish and poultry, eggs and even tofu, if desired. I design each person’s Meal Plan to meet their individual requirements, lifestyle as well as the foods they like and take into consideration whether they like to cook or prefer meals with the minimum of preparation required.

Have questions?

Please send me a note using the “Contact Me” located on the tab above and I will reply soon.

Note: Everyone's results following a LCHF lifestyle will differ as there is no one-size-fits-all approach and everybody's nutritional needs and health status is different. If you want to adopt this kind of lifestyle, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.



Low Fat Calorie Restricted Diet versus Low Carbohydrate Diet – a two year study

INTRODUCTION: To date, there have been 3 long-term clinical trials (2 years) published over the past 10 years involving “low carb diets”. In this post I review the third study which compares the effects of a low fat calorie restricted diet compared with a low carbohydrate diet and finding significantly better lipids at 1 year, before carbs were liberalized.

Purpose and Overview of the Study

The purpose of this randomized, controlled trial was to evaluate the long-term (2-year) effects of treatment with either a low-carbohydrate or low-fat, calorie-restricted diet on weight, cardiovascular risk factors, and bone mineral density — with the primary outcome being weight loss at 2 years.

All participants received comprehensive behavioral treatment to enhance weight loss associated with both diets and assessments were conducted at baseline, 3 months, 6 months, 12 and 24 months.

Inclusion Criteria

Primary inclusion criteria were age of 18 to 65 years, Body Mass Index (BMI) of 30 to 40 kg/ (m) x (m) and body weight less than 136 kg (300 pounds).

Exclusion Criteria

Exclusion criteria were participants with serious medical illnesses such as Type 2 Diabetes, lipid-lowering medications for dyspidemia, medications that affect body weight (including anti-obesity agents), blood pressures of 140/90 mm Hg or more (regardless of whether it was treated), and  pregnancy  or lactation.


A total of 307 adults (208 women and 99 men) with a mean age of 45.5 years and a mean Body Mass Index of 36.1 kg /(m) x (m) participated in this study.

Most (74.9%) participants were white; 22.1% were African American and 3% were of other race or ethnicity.

After a scripted phone screening, eligible participants attended an in-person screening during which the study’s purpose and requirements were discussed, eligibility confirmed and written informed consent was obtained.

Using a random-number generator, researchers randomly assigned participants (within each of 3 sites) to either a low carbohydrate treatment for 2 years, or a low fat calorie restricted diet for 2 years.

All participants completed a comprehensive medical examination and routine blood tests. There were no statistically significant differences between the two diet groups in any baseline variables.

The study, including recruitment and enrollment took place from March 2003 to June 2007.

Low Carbohydrate Diet

Approximately half of the participants (n = 153) were assigned to a low carbohydrate diet, which limited carbohydrate intake but allowed unrestricted consumption of fat and protein.

First 12 weeks of treatment

During the first 12 weeks of treatment, participants were instructed to limit carbohydrate intake to 20 g / day in the form of low–glycemic index vegetables.

After 12 weeks on very low carbohydrates

After the first 12 weeks, participants gradually increased carbohydrate intake each week by 5 g / day per week by consuming more vegetables, a limited amount of fruits, small quantities of whole grains and dairy products, until a stable and desired weight was achieved.

Subjects followed the guidelines outlined in Dr. Atkins’ New Diet Revolution, but were not provided with a copy of the book.

Participants were instructed to focus on limiting carbohydrate intake and to eat foods rich in fat and protein until they were satisfied.

The primary behavioral target was to limit carbohydrate intake.

Low-Fat Calorie Restricted Diet

Approximately half of the participants (n= 154) were assigned to eat a low fat diet which limited energy to 1200 to 1500 kcal / day for women and 1500 to 1800 kcal / day for men.

Approximately 55% of calories came from carbohydrate, 30% from fat and 15% from protein (comparable to the recommendations of Canada’s Food Guide for Healthy Living).

Participants were instructed to limit calorie intake, with a focus on decreasing fat intake, however limiting overall energy intake (kcal / day) was the primary behavioral target.

Group Behaviour Treatment

All participants received comprehensive, in-person group behavioral treatment weekly for 20 weeks, every other week for 20 weeks and then every other month for the remainder of the 2-year study period.

Each treatment session lasted 75 to 90 minutes.

Topics included self-monitoring, stimulus control and relapse management.

Group sessions reviewed participants’ completion of their eating and activity records, as well as other skill builders.

Participants in both groups were instructed to take a daily multivitamin supplement (provided by the study).

Physical Activity

All participants were prescribed the same level of physical activity (mainly walking), beginning at week 4, with four sessions of 20 minutes each and progressing by week 19 to four sessions of 50 minutes each.

Outcomes and Measurements

Body Weight— measured at each treatment visit on calibrated scales while participants wore light clothing and no shoes. The primary outcome was weight at 2 years.

Height — measured by a stadiometer at baseline.

The following measurements were collected at baseline and at 3, 6, 12 and 24 months:

Serum Lipoproteins — measured plasma high-density lipoprotein (HDL) cholesterol and triglyceride levels. Very-low-density lipoprotein (VLDL) cholesterol and low-density
lipoprotein (LDL) cholesterol concentrations were directly measured by β-quantification. Blood samples were obtained after participants fasted overnight (12 hours).

Blood Pressure— assessed after participants were sitting quietly for 5 minutes and using automated instruments with cuff sizes based on measured arm circumference.  Two readings of blood
pressure were obtained, separated by a 1-minute rest period with the average of the two readings used.

Urine Ketones— Bayer Ketostix were used to measure fasting urinary ketones and were characterized as negative (0 mg/dL) or positive (trace, 5 mg/dL; small, 15 mg/dL; moderate, 40 mg/dL; or large, 80 to 160 mg/dL).

Bone Mineral Density and Body Composition (percentage of body fat)—assessed using dual-energy x-ray absorptiometry at baseline and at 6, 12 and 24 months.

Attrition—There were no statistically significant differences between the two groups in terms of attrition; defined as not undergoing an assessment at a specific time point, independent of the reason.


Body Weight— participants in both groups lost approximately 11% of initial weight at 6 and 12 months, with subsequent weight regain to a 7% weight loss at 2 years . There was no statistically significant differences in weight loss at any time point between the low carbohydrate and low-fat calorie restricted groups, although there was a strong trend for greater weight loss in the low-carbohydrate group at 3 months.

Urinary Ketones—percentage of participants who had positive test results for urinary ketones was greater in the low carbohydrate than in the low fat calorie restricted group at 3 months (63% vs. 20%) and at 6 months (28% vs. 9%). Researchers found no statistically significant differences between groups after 6 months and they noted that the decrease from 3 to 24 months is consistent with liberalization of carbohydrate intake over time, as part of the study protocol.

Blood Pressure—Systolic blood pressure decreased with weight loss in both diet groups relative to baseline and did not significantly differ between groups at any time.  Reductions in diastolic pressure were significantly greater (2 to 3 mm Hg) in the low carbohydrate than in the low-fat group at 3 and 6 months with a strong trend at 24 months.

Plasma Lipid Concentrations—Most of the differences in plasma lipid concentrations between the two groups were observed during the first 6 months of the diets.

LDL cholesterol: Researchers found a significantly greater decrease in LDL cholesterol levels at 3 and 6 months in the low-fat calorie restricted group than in the low carbohydrate group, but this difference did not persist at 12 or 24 months. There may be reasons for this, discussed below.

Triglyceride levels: Decreases in triglyceride levels were greater in the low-carbohydrate group than in the low-fat calorie restricted group at 3 and 6 months, but not at 12 or 24 months.

VLDL cholesterol: Decreases in VLDL cholesterol levels were significantly greater in the low-carbohydrate group than in the low-fat calorie restricted group at 3, 6, and 12 months but not at 24 months.

HDL cholesterol: Increases in HDL cholesterol levels were significantly greater in the low-carbohydrate group than in the low-fat calorie restricted group at 3, 6, 12 and 24 months.

Total-cholesterol : HDL cholesterol: The ratio of total-cholesterol to HDL cholesterol levels decreased significantly in both groups through 24 months but did not significantly differ between groups at any time. There was a trend for greater reductions in the low-carbohydrate group at 6 months and 12 months.

Summary: The only effect on plasma lipid concentrations that persisted at 2 years was the significantly greater increases in HDL cholesterol levels among low-carbohydrate participants.

Bone Mineral Density and Body Composition— researchers found no differences between the two groups in changes in bone mineral density or body composition over 2 years.


  1. Neither dietary fat nor carbohydrate intake influenced
    weight loss when combined with a comprehensive lifestyle intervention.  That is, participants had similar and clinically significant weight losses with either a low carbohydrate or low-fat calorie restricted diet at 1 year (11%) and 2 years (7%). Researchers concluded that this demonstrates that either diet
    can be used to achieve successful long-term weight loss. if coupled with behavioral treatment.
  2. Researchers concluded that because both diet groups achieved nearly identical weight loss, a low-carbohydrate diet has greater beneficial long-term effects on HDL cholesterol concentrations
    than a low-fat calorie restricted diet.
  3. While researchers found a significantly greater decrease in LDL cholesterol levels at 3 and 6 months in the low-fat calorie restricted group than in the low-carbohydrate group, this difference did not persist at 12 or 24 months. Researchers  concluded that since assessment of LDL cholesterol concentration was without information on LDL particle size, no information was obtained in terms of coronary heart disease risk (small, dense LDL particles are more atherogenic than large LDL particles).
  4. The low-carbohydrate diet caused a decrease in plasma triglyceride concentration that was more than double the reduction observed with a low-fat calorie restricted diet at 3, 6, and 12 months however plasma triglyceride concentration returned toward baseline in the low-carbohydrate
    group, such that the two groups did not differ significantly at 2 years.
    [Note: The rise in triglycerides after desired weight was achieved may have been the result of the liberalization of the low carbohydrate diet by the inclusion of fruit, dairy and small amounts of whole grains which may have been responsible for driving triglyceride levels up.]
  5. The greater decline in directly measured VLDL cholesterol concentration in the low-carbohydrate at 3, 6, and 12 months was not sustained at 2 years. Researchers found no significant differences between the two groups in VLDL cholesterol. Researchers concluded that the close relationship and tracking  between fasting plasma triglyceride concentrations (which are primarily contained within VLDL) and VLDL cholesterol  concentrations supports a model in which during the first year of the study the low-carbohydrate diet (a) decreased hepatic VLDL secretion, (b) enhanced VLDL clearance, or both when compared with the low-fat calorie restricted diet.
    [Note: Again, the liberalization of the low carbohydrate diet after  desired weight was reached and the inclusion of fruit, dairy and small amounts of whole grains into the diet may have been responsible.]
  6. Plasma HDL cholesterol concentration increased by approximately 20% at 6 months in the low-carbohydrate diet group, which persisted throughout the study and was more than twice the increase observed in the low-fat calorie restricted diet group. Researchers concluded that the magnitude of the change observed in the low-carbohydrate diet group approximates that obtained with the maximal doses of nicotinic acid (niacin), the most
    effective HDL-raising pharmacologic intervention that was available at the time of the study (2010).


This 2-year, randomized control study of more than 300 participants found that both diet groups achieved clinically significant and nearly identical weight loss (11% at 6 months and 7% at 24 months) and that people who ate the low-carbohydrate diet had greater 24-month increases in HDL-cholesterol concentrations than those who ate a low-fat calorie restricted diet.

As well, an significant finding of this study was a very favourable lowering of LDL for the first 6 months and lowering of both TG and VLDL for the first year. It is unknown whether these results would have persisted and been sustained had the low carb group not been permitted to liberalize their diet by the inclusion of fruit, dairy and small amounts of grain products, once they achieved their desired weight loss.

These long-term data certainly provide evidence that a low-carbohydrate diet is both a safe and effective option for weight loss and that this style of eating has a prolonged, positive effect on lipid profiles – certainly while intake of carb-containing foods are restricted.


Foster GD, Wyatt HR, Hill JO et al, Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial, Ann Intern Med. 2010 Aug 3;153(3):147-57