Tips and tricks

Today, children's education is sadly lacking in most of the skills needed to live a healthy life. When my generation went to school, we were taught how to cook and how to manage and provide foods for a family. If anything is taught at all these days, it seems to be restricted to how to get a packet out of the fridge and put it in a microwave. This simply is not good enough, if only because it puts the population at the mercy of food-producing companies whose only real motivation is profit. For this reason, they will use the cheapest ingredients available; they will also include artificial flavours and flavour enhancers as cheap ingredients usually means 'bland'. And, as shelf life is an important consideration, these foods will also include preservatives. None of these additives is desirable in a truly healthy diet.

The most important tip
There is one tip that must come before all others. That is: Don't think of this plan as just another 'diet'. It's a way of life. But, if you are going live this way for the rest of your life, you must enjoy what you eat. For this reason, while you should stay within the general guidelines, pick foods that you like.

Tips to keep the cost down
Many people think that cutting down on carbs and replacing them with foods high in protein and fat is expensive. Indeed it can be, but it can also be as cheap, if not cheaper than the way you are eating now - especially if you deduct the price of slimming clubs, exercise gear, magazines and personal trainers. The tips in this chapter are all common sense, really, but it is as well to reinforce that. It is also invaluable for anyone used to eating only fast food. Let's face it, processed food has to be an expensive option because processing and packaging has to be paid for. So:

• Get back to basics Rather than paying someone else to cook, pack, advertise and then ship inferior food to you, it's much cheaper and certainly more nutritious to buy basic ingredients and make your own meals.
• Don't buy special 'low-carb' products These products are also far more expensive than similar things made from scratch. This way of eating does not require any special foods.
• Shop seasonally In the middle of winter you'll pay more for summer produce flown in from a distant corner of the world. It's always cheaper to buy fruit and veg produced in the UK when it's in season
• Don't be seduced by special offers Getting 20p off, three for the price of two, or 15% extra is great if it's something you need. But don't fill the cupboards with stuff you don't need just because it's on special offer!
• Cook in bulk It can be expensive buying a different set of ingredients for every meal. It can also be expensive to use an oven for a small dish for one person, when it has room for ten, so it's a good idea to cook up a batch of food. Divided up into meal-sized portions, cooled and frozen, meals can be microwaved later as required. But make sure you reheat the food until it's re-cooked all the way through.
• Watch your waste If you buy food that goes off quickly, plan your meals so it all gets eaten or frozen for future use.
• Use 'sell-by dates' Shops have to sell foods by their 'sell-by date'. If they have overstocked, there will usually be some items whose sell-by date has nearly expired and the item is being sold off cheap. Look out for these. Be aware that the sell-by or use-by dates are purely arbitrary and there is plenty of leeway for safety. I have often drunk cream more than a month after its use-by date has expired, and it has always been perfectly edible.
• Fatty meat is cheaper Most people today don't want fat meat - that's why it's not easy to find - but you do. This not wanting fatty meat can work to your advantage, because it is either cheaper so the shops can sell it more easily or, if you are cheeky enough and see a piece of nice fatty meat, you can usually get the price reduced. So ask for a particular piece of meat - but ask also for the price to be reduced because of the fat on it. It's amazing how often this will work. The only thing you have to watch is that the shop assistant doesn't cut the fat off, thinking that you won't want it!
• Offal - liver, kidney, heart, tripe, et cetera - has fallen out of fashion. This is a shame as it is these parts that are the most nutritious. But, for us, this is a godsend, for offal is remarkably cheap. You can get enough ox liver to feed a family of four for under a pound, for example (2005 prices).

Sources of foods
Fruit and veg
This is a low-carb way of eating, not no-carb. But there is no health benefit from eating more than two or three portions of fruit and veg each day - that's a total, by the way, not that much of each. As vegetables are much more nutritious than fruits, I recommend two portions of vegetables and one of fruit. Fresh fruits and veges are best but they could be frozen, tinned or dried. I don't recommend fruit juice as this is usually highly processed and one glass, which will contain the juice and sugars of several fruits, is too much.
To get the most out of vegetables, they must be properly cooked to break down the cell walls and enable the body to absorb the nutrients inside. But be aware that much of the vitamin content ends up in the cooking water. So cook them in as little water as possible and use the water in soups or gravy. You can also season it and use it as a drink. If you have the freezer space, try buying frozen vegetables. These are economical because you can take just what you need out of the freezer and then there isn't any waste.
Carrots and onions are among the cheapest vegetables around when bought loose although baby carrots can be expensive. Add them to soups or casseroles as they add colour and flavour as well as nutrients.
Frozen peas are inexpensive and easy. All you need is a pan of water to cook these from frozen in a few minutes. Adding a few spoonfuls to a meal is an easy way to boost your vegetable quota.
Proteins Eggs are undoubtedly the best source not only of protein but most other nutrients as well. And they are not expensive. Three large eggs, scrambled in butter, make a very filling meal for very little money. And you can cut the cost even further if you scramble them in lard. You could also make them into an omelette with leftover vegetables, or chop up hard-boiled egg to add to salads.

Canned meat and fish are also good and relatively inexpensive. Mackerel, tuna and sardines are good sources of protein. They are also good sources of omega-3 fatty acids if they are fresh, but the omega-3s are practically non-existent in some tinned fish: tuna is particularly fatless.

Fresh meat is better and should be cheaper. Cuts such as brisket are very cheap because they tend to be either fatty (which we want) or tough. But cooking them in a slow cooker or crockpot makes them marvellously tender and succulent. Put it on in the morning before you go to work and in the afternoon when you get home, yummy!
Chicken and bacon from supermarkets are a waste of money. They are both 'pumped' with water and a concoction of gunge. A 2003 news report found that as much as forty-five percent of the weight of supermarket chicken wasn't chicken! Bacon isn't much better. If you want bacon, it is better to cure your own, but you do need fridge space to do it. You will find instructions in the Recipes section. Alternatively, farmers' markets can usually be relied upon for dry-cured bacon.

Dairy products. Milk is a good drink at any time of day but it is expensive for what it has in it. It seems a waste to buy what is really mostly water. The most nutritious part of the milk is its cream. So why not just buy cream? This is a better and a cheaper option for drinks of tea, coffee or cocoa. And cheese is a better supplier of the other nutrients.

Offal. Liver, kidney, heart, faggots, liver sausage, and so on, are rich in nutrients and, as few people today eat them, fantastic value for money. Liver is the best multi-vitamin/mineral source I know.

Fats The cheapest fat is lard, which is clarified pork fat. This is only about one sixth the price of butter but contains the highest amounts of the anti-cancer vitamin D after cod liver oil. Beef dripping is also inexpensive. It too contains an anticancer agent - CLA. Both of these can be used for the frying you will do a lot of. If you have friends who can't kick the low-fat habit, ask for the dripping that they would otherwise throw away from a roast goose or duck. These fats are really nice, but expensive if bought from a supermarket.

General tips
Sugar and artificial sweeteners
There are going to be occasions when you do need to sweeten something, even when you have lost your sweet tooth. I believe in using real foods as much as possible. For all its faults sugar is still a relatively natural product. Don't get obsessive about the sugar. It might not be good for you, but it is still better for you than the artificial alternatives. One of my clients told me that she had discovered the oddest thing about sugar: she didn't crave sweet things after she ate a small amount of it - but she did when she ate artificial sweeteners.
There may be a good reason for this. It's a bit like waving a cigarette in front of somebody who is trying to give up smoking. If you eat sugar you satisfy the craving. But by using an artificial sweetener, you are giving your body the taste and reminding it of what it's missing, without satisfying the craving.
I have never stopped eating 'sweets'. And, although fruit is not healthy in large quantities (as Chapter 13 shows, '5 portions of fruit and vegetables a day' as the establishment tells us in UK, is too much), I see no need to give it up altogether unless you are diabetic.
The sweetness of most fruit is generally a mild sweetness which does not lead to addiction. I would also use sugar rather than artificial sweeteners to sweeten other foods - rhubarb, for example, or sweet desserts - but I wouldn't use much. The secret is to get your liking or 'need' for sweet things down to where this sort of sweetness feels right.
Another thought: Even if you crave sweeter things than this now, I guarantee that you can always cut the sugar in any 'normal' recipe by half and not notice the difference. The problem is that you can't do this with bought food. That is loaded with sugar to keep you addicted, so that you will continue to buy it.
So I would use sugar where necessary and cut the amount as low as possible. Apart from other health concerns, all the artificial sweeteners have a more intense sweetness that perpetuates the taste for oversweet things.
When buying prepared, packaged foods, beware of foods that boast 'no-added sugar', or 'sucrose-free'. Read the label carefully. Many foods, particularly jams and fruit drinks, are sweetened with concentrated grape or apple juice, or high-fructose syrups, which yield the same carb and calorie count as sugar, and have the same deleterious effects on your body.
But there is one aspect of sugar must be taken into account: sugar is addictive. Although other starchy foods may have a greater immediate effect on blood sugar levels than sugar, you are not likely to yearn after, say, a parsnip. But sugar, and foods that contain it in large quantity including sweet fruits, are craved. To ensure that you become addicted and your craving is maintained, food manufacturers now put sugar in just about everything that comes in a packet, tin or bottle. Just look at the labels even on tinned meat, for example, and try to find one that does not contain sugar.
A large part of learning to eat for health and weight loss is concerned with beating the sugar habit. When you can walk past the sweets at a checkout without the desire to buy some, you will be cured. It may take time, but it is well worth it.

Don't disguise the fat with carbs
Experiments show that our bodies are very sensitive to fat in the sense that, as soon as they have had enough, they switch off the appetite for it. Try to eat more fat and you will feel sick. And when the appetite for fat is switched off, it switches off the appetite for other things as well. In this way, eating fat controls the total amount of food eaten and, thus, it limits total calories eaten. On a high-fat diet, you cannot eat so much that you put weight on.
But there is a proviso. If you disguise the fat with a sweetener or other concentrated carb, this dulls your body's ability to recognise the fat. In this way, a sweetened, fatty food can be eaten to excess and you may gain weight.

Boring meals?
I have heard 'experts' say that eating this way is boring. It's nonsense spoken by people who have never tried it. But, don't worry about the food appearing boring in the early days: this is more perception than reality. Think of what you eat now. Most people generally tend to eat the same foods day in and day out - cereal for breakfast, sandwiches for lunch, and a few variations on dinner in the evening. When you switch to this plan, if you think it is boring and has less variety than your old way of eating, think about what you actually ate before and you will probably find that the old way of eating was not so varied after all.
Fatty foods are always more succulent than low-fat foods, and you can also jazz up your food with different spices, herbs, cream sauces, and so on. Select different vegetables and try cutting them in different ways; cook them in different ways with fats and cheese and cream. Look for different cuts of meats, fatty ones are best, and try to vary the ones you are buying. And don't forget that offal: not only does it really make a very nice change, it is far more nutritious and, thus, better value, than plain muscle meat.

Cravings
I said earlier that nothing is forbidden. I meant it. If you crave a food, have it. If you don't, you will continue to want it until that wanting becomes an obsession, a fixation that takes over your mind. So, if you really need to eat chocolate, for example, have some - but have only a small piece, not the whole bar. Nine times out of ten this will take the edge of your craving. Problem solved?
If not, try another approach: increase the thing you crave. For example, I had a woman client who craved bread. So I told her to eat only bread for two or three days - nothing else. It didn't take that long. By the end of the first day, she was so stuffed with bread she couldn't continue eating it any more. She now no longer wants bread.
It works with children too. When Diane's mother changed her chubby daughter's diet to low-carb some years ago, Diane kept on nagging for sweets. So I suggested to her mother that she let her daughter have as many sweets as she wanted - but that was all. While she had sweets she couldn't have any other food. Diane thought this was great. She stuffed herself with sweets for two whole days. On the third day, she asked her mother for a banana. It was refused. The bargain was she could only have sweets or real food, not both. On the fourth day Diane was pleading for food and was prepared never even to look at another sweet. She is now a lovely slim girl, the envy of her girl friends and much sought by the boys.

But it might not be easy at first
Be aware that sugar is addictive and other sweeteners prolong the addiction. As with any other addiction, you may suffer withdrawal symptoms. Here is an example of what may happen. Terry wrote to me:

'Just like to say thanks for the info about splenda, what an eye opener. I have to say that having been on low carbs for about 10 months, my last link to the old ways was to allow myself artificial sweeteners in my decaf coffee, chewing gum, and on raspberries and blackberries, all of which I consume daily. After your comments re getting rid for good of the desire for sweetness, I decided to bite the bullet and quit completely about 3 weeks ago. Well blow me, it was like going cold turkey, I have never taken drugs or smoked, but it is how I imagine it must feel. I became irritable and angry and had physical reactions ranging from headaches and neck/shoulder tension to palpitations and dizziness, and of course a strong desire for anything sweet. I persevered and am now sweetener free. The desire for sweetness has gone and I feel great.'

Don't eat your entire carb allowance at one meal
A question I am often asked is similar to this one which Polly asked me: 'Doctor, does it matter if I don't have many carbs during the day and eat most of them in the evening? I find that's when I want them, and I eat a big portion of veg and maybe some fruit for dessert. At breakfast or lunch I'm happy to just have meat, eggs etc.'
The answer is that it really depends on how much you are thinking of eating. Your body doesn't have the ability to look at the carbs and average them out over the day. It looks at the instantaneous level, and then produces the insulin needed to process it. Any excess will be stored as fat. It is this fat storing hormone that does all the damage. If you have a moderate level of carbs, three times a day, it is much better than a high level once a day, even if the total carbs in the one high-carb meal is less than the total eaten at three meals. That minimises the insulin spikes and you avoid storing glucose as fat.

How to get enough fibre
Jo told me: 'I find I just cannot get enough fibre in my diet. I am permanently constipated. This never used to be the case, only happened in the last year or so. I thought it would improve after my operation, but still struggling! Should I eat more wholemeal bread?'
Most people have been led to believe that only cereals such as wheat contain fibre. But fibre is found in all plant foods. If the muscles in your gut have not had to work because you have been stuffing large amounts of waste through, it can take a while for those muscles to start working again. A mild laxative or a warm water enema might help. But if you do feel the need to increase your fibre intake, eat more raw leafy veges rather than bran. That is much healthier. Increasing your water intake will also help.

Being one with the crowd in the office
You are sitting at your desk at the office and one of your colleagues comes in laden down with left over food from a lunchtime meeting he has just been to. There are sandwiches, biscuits, savoury pastries and cakes! Everyone is gathering round his table helping themselves and someone from the office next door has come in with a huge piece of cheesecake to share around. The problem is: How do you not accept what people are offering round without feeling like a total outcast? And even though no one may be pushing you to have anything how do you stop feeling left out?
If no one is pushing, there shouldn't be a problem. You can join in with a cup of tea, and not eat. Probably, no one will notice. If the temptation is difficult to overcome, just think of the food as 'leftovers' and maybe they will not be so tempting.
The psychology of being not one of 'the crowd' is quite another thing. We humans are not comfortable with being different. But, if you think about it, the greatest humans were those who didn't mind being different. Many years ago, my wife, Monica, and I shared a house with another couple. It was at a time when there was an expression 'keeping up with the Joneses'. It meant keeping up with the latest fashion or fad. Monica and I had never thought of even trying to do this; we just did what we liked and what suited us. One day, we were talking with the other couple and this topic came up. We said that we never tried to 'keep up with the Joneses'. 'You don't need to', said the other wife, 'you are Jones!'
I don't think we were; we just had never seen the merit of trying to be just like everyone else.
But, that aside, if you do feel uncomfortable in these situations, pick out just one scrumptious thing, something you feel is truly worth it, and eat a very small amount. Savour it thoroughly, then put it behind you (not literally) and get on with your normal diet.

Have you checked your thyroid?
Thyroid hormones control a wide spectrum of metabolic functions. If your thyroid isn't working properly, this can make weight loss more difficult, raise cholesterol levels, raise blood pressure; indeed there are a whole host of adverse effects. So check it. For this a doctor is not necessarily the best option in the first place. This is because a doctor will take a blood test, normally for TSH (Thyroid Stimulating Hormone) only and, if this is within a 'normal' range, you are okay.
Except you might not be.
The 'normal' range was determined many years ago by checking the thyroid hormone levels of people who visited their doctors with an illness. So, it is reasonable to assume that these were not healthy people. Thus, the question is: Is the 'normal' range also a normal range for healthy people? There is much controversy over this.
The easiest and quickest way to determine if your thyroid is behaving itself is to check your temperature. This should be 37 degrees C or 98.6 degrees F. If it is one degree Celsius or two degrees Fahrenheit below these figures, then your thyroid is definitely not working properly.
Two things that have a harmful effect on the thyroid are foods that contain soya and water and medications containing fluoride.

Miscellaneous tips

Don't have foods you shouldn't eat
To help you to stay with this way of eating, it is a good idea not to have any illicit foods in the house to tempt you. You cannot have biscuits with your mid-morning cup of tea if there are none in the biscuit barrel.
But that doesn't mean you can't have chocolate as a treat However, if you are going to treat yourself to a bar of chocolate at the weekend, don't buy it on the previous Monday - you are bound to be tempted to eat it sooner than you planned.

Shopping
When you shop, make a list and stick to it. If you are held up at the supermarket checkout, next to the sweets, don't be tempted. You will be less tempted if you aren't hungry. So have a good breakfast before shopping.

When eating
Be aware of the signals your body gives you. If you carry on a conversation over a meal you may not notice when your appetite is satisfied and it's time to stop. Then you may eat too much. You should stop when satisfied, not stuffed. And if there is some left at this stage, leave it. You can, perhaps save it to have later or freeze it for another day. But whatever you do, don't use your body as a dustbin.

Don't drink 'food'
There is one other signal that your body will give you that you should respond to in the correct way: when you feel thirsty your body is telling you it needs water - not food. When you are thirsty drink water or a beverage that contains no calories. Having a sweetened drink, fruit juice or alcohol is one of the best ways to put weight on - without apparently eating anything! Try to wean yourself off sweetened drinks, even the low-cal ones. Eating excessively sweet things is one habit you are better off without. You should reckon on drinking at around six to eight 8-ounce glasses of water a day, more if it is hot and you sweat, or if you get thirsty. The water in coffee, tea and other drinks counts towards this.
If you like sweetened tea or coffee there are two ways to kick the habit: the first is to cut down over a period of time until you can drink it unsweetened; the second is to go cold turkey.

Don't weigh yourself every day
Resist the temptation to weigh yourself daily. Your weight will fluctuate from day to day (and throughout the day), and for women, throughout the month. Weighing yourself once a week is quite sufficient. When you weigh yourself, do it on the same day, at the same time, and in the same clothes (or, preferably, no clothes) each time.

Have 'fast foods' in reserve

Don't be caught short on quick snacks when you have to go out in a hurry. Make sure you have some hard-boiled eggs made in advance for emergencies. Date them with a felt-tip pen - that will also tell you that they are cooked ones. They will keep for a week in the fridge.
Cheeses are also quick and easy. With a huge variety, cheese is an absolute must-have in my household.

For diabetics
Don't buy diabetic foods. They have no advantages; and in most cases they aren't suitable for diabetics. The following list is adapted from the British Diabetic Association's discussion paper on the role of 'diabetic' foods:[1]

• Most diabetic foods provide slightly, but not substantially, less energy than comparable non-diabetic products.
• In percentage terms, the greatest difference between diabetic and non-diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance, per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance.
• Diabetic foods cost between 1.5 and 4 times as much as their non-diabetic equivalents.
• The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that people with diabetes cannot eat normal foods.
• Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.

How to survive Christmas
My wife and I usually have goose at Christmas. It is a fatty meat and we get lots of goose fat to use for cooking. We have the goose with the usual trimmings but with limited root vegetables and a stuffing made without flour.* We don't have mince pies, but we do have Christmas pudding with cream and/or brandy butter.
In the evening we usually don't have very much: we have Christmas cake,* with cream as it isn't iced.
Because of the tradition of the occasion, we also have dark chocolates and nuts during the day.
If we have guests, we do very little different because it's easy to end up with lots left over and only us to eat it. The lack of mince pies isn't a problem as most people are full by that stage anyway. There will be plenty of green vegetables: Brussels sprouts, et cetera, but only one carrot, one parsnip and a couple of roast potatoes per person. Surprisingly, we always have some left over as some people have one but not the other.
If people drop in later, they have usually eaten and don't want much: a light salad, fruit and cream, and Christmas cake in the afternoon is plenty. We don't bother with crisps but there are usually nuts available.
Don't forget that food made with fat not only tastes good, it's much more filling and satisfying.

Other party tips

• When going to a party with friends, try to make sure you are the designated driver. This gives you the perfect excuse not to have lots of alcohol.
• Unless you know that low-carb foods will be available, have something to eat before you go.
• Where possible stock up on the chicken legs and cold meat, and give the potato salad a miss.
• If there are only carb-rich foods, pick an especially nice one and enjoy it - but make it last.
• If there is no way to avoid eating carb-rich foods without hurting your hostess's feelings, then eat them. Any weight you put on will soon be gone when you are back to eating properly.

References
1. Thomas BJ. British Diabetic Association's discussion paper on the role of 'diabetic' foods. Nutrition Subcommittee of the British Diabetic Association's Professional Advisory Committee. Diabet Med 1992; 3: 300-306.