by Westman, Dr. Eric C. ; Phinney, Dr. Stephen D. ; Volek, Dr. Jeff S.
THE BASICS OF PRE-MAINTENANCE
Now that you’re in Phase 3, you’ll still follow pretty much the same drill you have until now to stay in a fat-burning mode. You must know it by heart by now: count your carbs, and be sure that 12 to 15 grams of your total daily Net Carb intake is made up of foundation vegetables. They’ll continue to be the platform upon which you build as you add back new carbohydrate foods. Also, keep eating the recommended amounts of protein and sufficient natural fats to feel satisfied at the end of each meal. Continue to drink plenty of water and other acceptable beverages, consume enough salt, broth, or soy sauce (unless you take diuretics) if your Net Carb intake is 50 grams or less, and take your supplements.
So what’s different? You’ll slowly increase your daily Net Carb intake in 10-gram increments as long as weight loss continues and follow the Pre-Maintenance meal plans in part III. In effect, you’re swapping the pace of your weight loss for a slightly higher CLL. But if this brings your weight loss to a grinding halt or you gain back a pound or so that remains longer than a week, simply drop back 10 grams. Stay there for a couple of weeks, and if slight weight loss resumes, try increasing your carb intake by 5 grams to see if you get the same reaction you did with a 10-gram increase. You may wind up remaining at the same CLL that you were at in OWL, even as you reintroduce some of the acceptable foods for this phase. Once you exceed 50 grams of Net Carbs, you need not continue to consume salty broth, soy sauce, or a half teaspoon of salt each day.
ACCEPTABLE FOODS FOR PRE-MAINTENANCE
In addition to the foods you can eat in Induction and OWL, the following foods are acceptable in Pre-Maintenance—if your metabolism can tolerate them. You can also add small portions of whole milk (4 ounces contain almost 6 grams of Net Carbs) or buttermilk, but not skim, nonfat, or low-fat types. If you’re lactose-intolerant, you can have lactose-free dairy products or buttermilk (also in 4-ounce portions). Eat nothing that isn’t on these three lists unless you know the carb count and the ingredients (including added sugars). Follow the carb ladder (page 120), starting with legumes, unless you’ve already reintroduced them in OWL—as vegetarians and vegans almost certainly have.
LEGUMES
Though legumes are relatively high in carbs, they also contain lots of fiber and contribute protein to meals. Introduce them one by one and in small portions. If you love a bowl of lentil soup on a chilly day, a side dish of steamed edamame, or a snack of hummus, this step will make you a happy camper. If beans are not your thing, simply skip this group of carbohydrate foods. (For a list of legumes with carb counts, see page 125.)
OTHER FRUITS
Assuming you didn’t have trouble reintroducing moderate portions of berries, cherries, and melon in OWL, you can now experiment with other fruits. As you’ll see below, carb counts vary significantly. Remember that all fruit is high in sugar and should be treated as a garnish. Start by introducing portions of no more than a half cup of such relatively low-carb fresh fruits as plums, peaches, apples, tangerines, and kiwis. One small ripe banana, on the other hand, packs about 21 grams of Net Carbs and its close relative, the plantain, even more. Avoid canned fruit. Even fruit packed in juice concentrate or “lite” syrup is swimming in added sugar.
Continue to stay away from fruit juice, other than lemon and lime juice. A cup of unsweetened apple juice, for example, racks up 29 grams of Net Carbs, and orange juice (even freshly squeezed) is a close runner-up. Without the fiber to slow its absorption, fruit juice hits your metabolism like a sledgehammer. Likewise, drying fruit, including apricots, raisins, prunes, and apple slices, concentrates the sugars, elevating their carb count. But as you can see in this table, there are lots of fruit choices that come in at less than 10 grams of Net Carbs per portion. The following carb counts are for fresh fruit.
Fruit
serving size
Grams of Net Carbs
Apple
½ medium
8.7
Apricot
3 medium
9.2
Banana
1 small
21.2
Carambola (Star fruit)
½ cup sliced
2.8
Cherimoya
½ cup
24.3
Figs, fresh
1 small fruit
6.4
Grapes, green
½ cup
13.7
Grapes, purple Concord
½ cup
7.4
Grapes, red
½ cup
13.4
Grapefruit, red
½ fruit
7.9
Grapefruit, white
½ fruit
8.6
Guava
½ cup
5.3
Kiwi
1 fruit
8.7
Kumquat
¼ fruits
7.5
Loquat
10 fruits
14.2
Lychee
½ cup
14.5
Mango
½ cup
12.5
Orange
1 medium fruit
12.9
Orange sections
½ cup
8.4
Nectarine
1 medium fruit
13.8
Papaya
½ small fruit
6.1
Passion fruit
¼ cup
7.7
Peach
1 small fruit
7.2
Pear, Bartlett
1 medium fruit
21.1
Pear, Bosc
1 small fruit
17.7
Persimmon
½ fruit
12.6
Pineapple
½ cup
8.7
Plantain
½ cup
21.0
Plum
1 small fruit
3.3
Pomegranate
¼ fruit
6.4
Quince
1 fruit
12.3
Tangerine
1 fruit
6.2
Watermelon
½ cup balls
5.1
STARCHY VEGETABLES
Vegetables such as winter squash, sweet potatoes, and root vegetables such as carrots, beets, and parsnips have their virtues. All root vegetables are rich in minerals, and brightly colored ones are full of antioxidants. But the flip side is that these same vegetables are significantly higher in carbs than foundation vegetables are. You’ll want to keep your portions of these starchy vegetables small unless you have a very high tolerance for carbs. Even within this grouping, carb counts vary greatly. Carrots and beets, for example, come in well below corn on the cob and potatoes. And a single serving of cassava exceeds the total carb intake for a day in Induction, with taro a close runner-up.
Vegetable
Serving Size
Grams of Net Garbs
Beets
½ cup
6.8
Burdock
½ cup
12.1
Calabaza (spanish pumpkin), mashed
½ cup
5.9
Carrot
1 medium
5.6
Cassava (yuca), mashed
½ cup
25.1
Corn
½ cup
12.6
Corn on the cob
1 ear
17.2
Jerusalem artichoke*
½ cup
11.9
Parsnips, cooked
½ cup
10.5
Potato, baked
½ potato
10.5
Rutabaga
½ cup
5.9
squash, acorn, baked
½ cup
7.8
squash, acorn, steamed
½
cup
7.6
squash, butternut, baked
½ cup
7.9
sweet potato, baked
½ potato
12.1
Taro
½ cup
19.5
Yautia (arracache), sliced
½ cup
29.9
Yam, sliced
½ cup
16.1
*All vegetables are measured after cooking except for Jerusalem artichoke.
WHOLE GRAINS
This is usually the last food group to reintroduce (if at all), and with good reason. Ounce for ounce, grains are generally the highest in carb content of any whole food. You’ll note that we refer to this category as whole grains, not simply grains. Oats, buckwheat, brown rice, and other whole grains are good sources of fiber, B vitamins, vitamin E, and minerals such as zinc and magnesium. But they and products made with them—whole grain bread, for one—come with a high-carb price tag. Even for people with a relatively high ACE, these foods could bait the metabolic bully. Introduce them with care and, if tolerated, consume them in moderation.
Whole Grain
Serving Size
Grams of Net Carbs
Barley, hulled
½ cup
13.0
Barley, pearled
½ cup
19.0
Bulgur wheat
½ cup
12.8
Cornmeal*
2 tablespoons
10.6
Couscous, whole wheat
½ cup
17.1
Cracked wheat
½ cup
15.0
Hominy
½ cup
9.7
Kasha (buckwheat groats)
½ cup
14.0
Millet
½ cup
19.5
Oat bran*
2 tablespoons
6.0
Oatmeal, rolled*
1/3 cup
19.0
Oatmeal, steel cut*
¼ cup
19.0
Quinoa
¼ cup
27.0
Rice, brown
½ cup
20.5
Rice, wild
½ cup
16.0
Wheat berries
½ cup
14.0
*With these exceptions, all measurements are for cooked grains.
PROCEED WITH CAUTION
Refined grains and processed foods made with them are a very different story. Their high carb count is accompanied by scant nutritional value. As much as possible, continue to stay away from refined grains such as white flour and bread and crackers made from them. Refined grains, including white rice, have been stripped of their valuable bran and germ (the seed embryo, which is rich in antioxidants, fatty acids, and other micro-nutrients).
You’ll note that the list of Acceptable Foods for Pre-Maintenance doesn’t list processed foods such as bread, pasta, pita breads, tortillas, crackers, breakfast cereals, and the like, as carb counts vary significantly from one manufacturer to another. While you should continue to check the Nutritional Facts panel on all processed products, foods that incorporate grains particularly qualify as minefields. In addition to avoiding foods with trans fats and added sugar, watch out for white or “enriched” flour. Baked goods made with whole wheat or other whole grains—look for 100 percent whole grain—tend to be higher in fiber and thus lower in carbs, as well as higher in micronutrients. If white flour is the first item on the ingredients list, followed by whole grain flour, forget about it.
SMALL CHANGES, BIG IMPACT
Even if you’re able to incorporate most or all carb foods into your diet, here are some tips to avoid sparking weight regain and the return of symptoms indicating sensitivity to carbs.
• Instead of rice or pasta as a base for sauces, curries, and other dishes, use shredded lettuce or cabbage, mung bean sprouts, grated raw zucchini or daikon radish, spaghetti squash, or shirataki noodles (made from soybeans and a nonstarchy yam).
• Eat carrots raw instead of cooked, which pushes up the carb count.
• Certain fruits are lower in carbs before they’re fully ripe. A few slices of a green pear make a tart addition to a tossed salad without adding too many carbs. Grated green papaya makes a great slaw dressed with unsweetened rice vinegar and sesame oil.
• Wrap sandwich fixings in nori, the sheet seaweed used for sushi, instead of wraps or tortillas. Avocado and either salmon or sliced chicken are a natural combo, as are tuna salad and shredded lettuce.
• Regard half a baked potato as a portion. Slice the potato lengthwise before baking, and when it’s done, mash the pulp with blue cheese, pesto, or herb butter.
• Some whole grain flat breads are high in fiber and relatively low in Net Carbs, making them a good choice for open-faced sandwiches. Scandinavian bran crisps are even lower in carbs.
• Make your own muesli or granola with rolled oats, chopped nuts and seeds, and ground flaxseed. Serve a half cup portion with plain whole milk yogurt, some berries or half a chopped-up apple, and some sweetener, if you wish.
• Sprinkle small portions of barley, bulgur, buckwheat, wheat berries, or wild rice onto salads or soups for a texture treat without much carb impact.
WHAT DOES PRE-MAINTENANCE LOOK LIKE?
As before, you’ll add the acceptable new foods gradually, one group at a time as long as you can handle them, and one food at a time within each group. It’s important to continue to record in your journal how you respond to each new food because you’re now entering territory full of foods that may have triggered cravings and possibly binges in the past. So let’s look at three scenarios of how your first several weeks of Pre-Maintenance might go.
SCENARIO 1
Say that you’ve left OWL with a CLL of 50.
• Week 1 : You move up to 60 grams of Net Carbs a day, sampling a few different kinds of legumes over the week, during which you lose another pound.
• Week 2 : You move to 70 grams of Net Carbs and reintroduce small portions of new fruits. You lose no weight and struggle with cravings for more fruit.
• Week 3 : You drop back down to 60 grams of Net Carbs and continue with small portions of fruit, being sure to have them with cream, yogurt, or cheese. The cravings diminish, and you lose half a pound over the week.
• Week 4 : You remain at 60 grams of Net Carbs and reintroduce small portions of carrots, sweet potatoes, and green peas on alternate days. You lose another pound by week’s end.
• Week 5: You move to 70 grams of Net Carbs and cautiously introduce tiny portions of whole grains every other day, shedding a half pound by week’s end.
• Week 6 : You move to 80 grams of Net Carbs and continue to carefully try different fruits, legumes, starchy vegetables, and occasionally whole grains. By the end of the week, you’ve lost another half pound.
SCENARIO 2
Again assume you had a CLL of 50 upon leaving OWL.
• Week 1 : You move up to 60 grams of Net Carbs a day. You couldn’t care less if you ever eat another legume again, but you sample a few different kinds of fruit over the week. Your weight is unchanged at week’s end.
• Week 2: You remain at 60 grams of Net Carbs and find yourself craving more fruit, so you make sure to always combine it with cheese, cream, or yogurt, and you manage to lose a half pound.
• Week 3 : You move to 65 grams of Net Carbs and reintroduce small portions of carrots, sweet potatoes, and sweet peas on alternate days. By week’s end, you’ve regained a pound.
• Week 4 : You drop back to 55 grams of Net Carbs and continue to cautiously consume both fruit and some starchy vegetables. Although you don’t regain weight, you don’t lose any either.
• Week 5: You move up to 60 grams of Net Carbs but back off the starchy vegetables. By the end of the week, you’ve lost half a pound and wonder whether you�
��re getting pretty close to your ACE.
• Week 6: You continue at this carb level and hold off on the starchy vegetables, losing half a pound that week.
SCENARIO 3
Now let’s assume that you left OWL with a CLL of 35.
• Week 1 : You move to 45 grams of Net Carbs, adding small portions of legumes. Although your weight remains stable, by the end of the week, you’ve had some ravenous episodes and feel bloated.
• Week 2 : You drop back to 35 grams of Net Carbs and back off the legumes. Your weight loss resumes, and the bloating and cravings disappear.
• Week 3: You’re feeling good and slowly losing weight, so you decide not to push your luck and remain at 35 grams of Net Carbs for another week.
• Week 4: You move up to 40 grams of Net Carbs and try reintroducing small legume portions. You continue to feel good and lose another half pound.
• Week 5: You move up to 45 grams of Net Carbs and add small amounts of fruit, which produce cravings and stall weight loss.
• Week 6 : Understanding that feeling good and in control is more important than trying to push things, you back down to 40 grams of Net Carbs, experimenting with new foods in small portions, until you’ve achieved your goal weight.