Good Veggies

by David Mendosa Patient Advocate

When I began to eat a very low-carb diet in December, I was in for several surprises. The biggie was how easy low-carb eating is for me. I had long thought -- and written -- that it was hard to be satisfied without a heavy load of carbs. Experience taught me otherwise.

Another surprise was how many veggies I eat now. Like most folks, I assumed that a low-carb diet meant going veggie-less.

This article won't go into my reasons for this huge dietary change, except to say that I wanted better control of my diabetes. Several of my articles here in the past couple of months tell how I was able to lose more weight on this diet.

I have indeed stopped eating any type and form of grains and lentils, which can be low-glycemic but are certainly not low-carb. Following a low-GI diet for the past dozen years, I had eaten almost no rice, no potatoes or other root vegetables like sweet potatoes and beets.

But the green leafy vegetables are very low-carb and nutritious. And I am learning that they can taste absolutely wonderful too. Some of my favorite vegetables are the salad and cooking greens, red peppers, artichokes, and okra. Now that I am low-carbing, I usually have a big salad for lunch and a side of cooked greens for dinner along with a quarter pound of fish, chicken, or grass-fed beef -- or just the greens.

Unless I go for a huge helping, none of these lead me to exceed my chosen carb quota of about a dozen available carb grams per meal. It is the available carbs -- in other words the starches and sugars but excluding fiber, which we don't digest -- that I pay attention to.

The late Dr. Robert Atkins likewise considered what he called digestible or net carbs in his books like Dr. Atkins New Diet Revolution.

So to do the Doctors Michael R. and Mary Dan Eades. They subtract fiber to get the "effective carbohydrate content" in The Protein Power Lifeplan. However, it wasn't clear to me after studying Dr. Bernstein's Diabetes Solution by diabetologist Richard K. Bernstein, M.D., whether his recommendations for no more than 42 grams of carbohydrate per day included fiber or not. So I asked him.

"I use total [carbohydrates], because I feel that the indigestible part actually participates in the Chinese Restaurant Effect, now known as the incretin effect," Dr. Bernstein wrote back to me. "Large meals will cause greater stretching of the intestinal cells that release hormones into the bloodstream when they are stretched, as after a meal," he wrote in his book about the Chinese Restaurant Effect.

Dr. Bernstein's allotment of carbohydrates for himself and his patients is low. He makes the point in his book that carbohydrates "are totally nonessential to your health and well-being....There is no such thing an an essential carbohydrate for normal development, despite what the popular press might have you believe."

Then, why eat any carbohydrates, which are of course the main culprit in raising the blood glucose level of anyone who has diabetes?

"The main reason I don't suggest that you avoid all carbohydrate," Dr. Bernstein writes, "is that there are many constituents of vegetables -- such as vitamins and minerals, but also many other non-vitamin chemicals (phytochemicals) -- that are only recently becoming understood, but that are nonetheless crucial to diet and cannot be obtained through conventional vitamin supplements." So, when I began to eat low-carb I simultaneously began to seek out the best veggies. To do that I consulted the best sources that I know.

First, is The World's Healthiest Foods, sponsored by the George Mateljan Foundation. That website lists 36 healthy vegetables. It's a start, but it includes several high-carb vegetables and doesn't say why the chosen three dozen veggies are the healthiest.

So, next I turned to an analysis of "The Healthiest Vegetables" according to "Nutrition Action Health Letter." It ranks 53 vegetables, scoring them for their carotenoids, Vitamin C, folate, potassium, calcium, iron, and fiber. But this list too includes several vegetables that are too high-carb for me.

From there, however, it was easy to make my own list. Why do this? Because I wanted to broaden my horizons to include vegetables that I had passed up before.

In fact, the healthiest of all vegetables, according to "Nutrition Action Health Letter," is one that I had never prepared before: collard greens, with a score of 461. Eventually, I learned how to simmer it for hours together with a ham shank to make something incredibly delicious.

The number 2 vegetable, spinach, with a score of 424, is one that I eat both raw and cooked. Like collards, and number 3 kale (score 410) and number 4 Swiss chard (322) all of these green leafy vegetables pair extraordinarily well with ham or bacon or other smoked meat and vinegar (a tip I picked up from Ruth Reichl's Gourmet Cookbook).

Then comes red pepper (score 309), which I usually add to my salad but is also great cooked. Skipping a couple of high-carb veggies, the list then goes to broccoli at 179.

Next in order are okra, 165; Brussels sprouts, 143; lettuce, 141; and asparagus, 84. I was surprised that tomatoes and avocados, two honorary vegetables (technically fruit), ranked at 76 and 71 respectively. Wonderful cauliflower ranked even lower at 64, cabbage at 44. Near the bottom of the list are cucumber, eggplant, mushrooms, and alfalfa sprouts.

These numbers are, of course, not gospel. They make a big assumption -- that the micronutrients that we know are the ones that we need, when in fact we are learning more about nutrients every day. We don't even have a Daily Value (DV) for carotenoids, so "Nutrition Action Health Letter" made up its own. It doesn't even consider the amount of omega-3 fatty acids, which is one of the main nutritional reasons to eat a lot of green leafy vegetables. But what this list did for me -- and can do for you -- is to focus more attention on them.

My attention went in that direction anyway after reading Michael Pollan's In Defense of Food. He notes there that when we largely switched from eating leaves to seeds (as in grain), the problems with the so-called "Western Diet" began. It is indeed striking how many of the top veggies are leaves.

"Leaves provide a host of critical nutrients a body can't get from a diet of refined seeds," Pollan writes. "There are the antioxidants and phytochemicals; there is the fiber; and then there are the essential omega-3 fatty acids found in leaves, which some researchers believe will turn out to be the most crucial missing nutrient of all."

To round out my list of the best low-carb veggies I went carefully through the 800-plus pages of The Complete Food Counter by Annette Natow and Jo-Ann Heslin to determine which ones have less than half a dozen available carb grams in a 1/2 cup portion. But then I realized that this book has some substantial differences from the authoritative source, the "USDA National Nutrient Database," which I use here instead to show the results for the highest ranking low-carb foods named by "Nutrition Action Health Letter:" Collards, cooked, boiled, drained, without salt, 1/2 cup: 2 grams of available carb Spinach, cooked, boiled, drained, without salt, 1/2 cup: 1 Spinach, raw, 1/2 cup: less than 0.5 Kale, cooked, boiled, drained, without salt, 1/2 cup chopped: 3 Chard, swiss, cooked, boiled, drained, without salt, 1/2 cup: 2 Peppers, sweet, red, raw, 1/2 cup chopped: 3 Peppers, sweet, red, cooked, boiled, drained, without salt, 1/2 cup chopped: 4 Brocolli, raw, 1/2 cup chopped or diced: 2
Broccoli, cooked, boiled, drained, without salt, chopped: 3 Okra, 1/2 cup cooked, boiled, drained, without salt: 2 Brussels sprouts, cooked, boiled, drained, without salt, 1/2 cup: 4 Lettuce, butterhead (includes boston and bibb types), cos, romaine, green leaf, or red leaf, raw, 1/2 cup shredded: less than 0.5 Asparagus, cooked, boiled, drained, 1/2 cup: 2 Avocados, raw, all commercial varieties, 1/2 cup sliced: 1 Artichokes, (globe or french), cooked, boiled, drained, without salt, 1/2 cup hearts: 1 Cauliflower, raw, 1/2 cup: 1 Cauliflower, cooked, boiled, drained, without salt, 1/2 cup: 1 Cabbage, (including Chinese (pak-choi or bok choy), cooked, boiled, drained, without salt, 1/2 cup shredded: 1 I grew up with some disdain of leafy vegetables as "rabbit food." Maybe we all did. The first reference to lettuce as rabbit food dates back at least to the 1930s. Considering how wrong everyone from the medical establishment on down has been about nutrition in general, it's not a surprise that we have also been wrong all along about leafy vegetables.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.