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Do you check your glucose?

For any of you who have never checked your glucose, maybe it’s worth a try. It is truly the only way to know how food directly impacts glucose.

Use a glucometer to check and monitor your glucose level. They can be purchased over the counter. For inexpensive ones, ask your local pharmacy about the least expensive to use over time. I believe Walmart has one that is fairly inexpensive; it’s the Relion meter.

I recommend testing first thing in the morning, and then after meals to determine how food impacted your glucose. Standard post-meal testing is at 2 hours. Some people, however are not textbook. I usually recommend testing after several different meals over a few different days every 30 minutes after eating to determine your personal peak… once you determine this time frame, you’ll only need to test before and after once. No need to test every single meal at first if you’re worried about costs of testing OR running out of fingers. 😉

But pick a few meals at different times of day. If costs are a factor in buying strips, it’s really important to test before and after different meals — example: test before and after breakfast on Mon, Wed, & Saturday for 2 weeks, before & after lunch on Tue, Thurs, & Fri for 1 week, and supper on Sunday, Tues, Thurs, Sun, for the 2nd week.

Once you’ve determined your personal glucose peak, you can then limit testing to before meals and around your peak.

To determine the impact of certain food on glucose level, test before and after at your personalized peak. Ideally, the readings should not be very different, but readings are allowed to be about 10 numbers diff.

Example: pre-meal is 97; post-meal highest should be about 107 for optimal glucose control.

Even non-diabetics can use meters and learn for themselves how food impacts glucose.

This is where we get the phrase, “eat to your meter.”

This photo COURTESY of the Facebook group, Type 2 Diabetes Straight Talk.

Testing glucose is the absolute best method for determining how foods impact your glucose. Knowing how food will affect glucose levels is very important for people on a low carb diet, especially those who take medicines to lower glucose directly. If glucose goes up more than 10 points, it’s probably not a good idea to continue eating that food.

If you’d like help learning to eat to your meter or learning how to eat low carb high fat to reduce the impact of disease on the body, please email me at ketonurses@gmail.com for more information.

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Keto Cauli-Taters

1 head of cauliflower, cut into florets

1/2 stick of butter, softened

3-4 ounces of cream cheese

1 cup grated white cheddar

1 tsp garlic powder

1/4 cup (or less) heavy cream ( optional)

Salt & pepper to taste

Preheat oven to 350 degrees, and grease or butter casserole dish.

Place chopped cauliflower into microwaveable bowl, cover & microwave on high for 6-9 minutes or until all florets are cooked though and softening. (You could steam if you prefer, but drain all water used.)

Add cauliflower, butter, & cream cheese to mixing bowl and mix well. (Sometimes, I throw some of the florets into the blender to get pieces even smaller. I do this before adding the butter and cream cheese.)

I only use the heavy cream when above mixture seems just a bit thick. Sometimes, I use it. Sometimes I skip the heavy cream. I think it depends on how much water is in each head of cauliflower. I don’t like runny taters, but I also don’t want them thick and pasty either. 😂

Add salt, garlic & pepper to taste. Stir in cheddar. Pour into the casserole dish and bake at 350 for about 20-25 minutes. During last 2-3 minutes, you can add a bit more grated cheddar or Parmesan cheese and finish baking.

<<
her options for finishing your taters include topping with chopped onions, bacon crumbs or even grilled chicken bits. You can also serve with a piece of avocado or dollop of sour cream.

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Keto Pepper Poppers

Just in time for the big game, we have a delicious low carb finger food to add to the table!

12 jalapeños, seeded and halved

8 ounces of softened cream cheese

3 tbsp. sour cream

1/2 cup grated cheese (any type or combo)

2 tsp minced garlic (More can be used)

1/2 tsp onion powder

Preheat oven to 375. Mix all in mixer until well blended. Spoon into pepper halves. Place in baking dish or on cookie sheet.

Bake for 9 minutes and then turn to broil for 3-5 minutes, just until tops begin to brown.

Serve.

Depending on the types of cheeses you choose, carb count is approx 1 gram per jalapeño half, or 1.5 -2 grams for every whole pepper.

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Creamy Keto Soup

This recipe is a great base for most any type of creamed soup you enjoy. I used frozen spinach in my batch, but sautéed Brussels sprouts,  mushrooms, or asparagus would work just fine instead.


Creamy Keto Soup

32 oz heavy cream

1 1/2 cup water or broth

6 oz cream cheese

1 cup shredded white cheddar

1 tsp minced garlic or 1/8 tsp garlic powder

1/4 tsp salt

1/4 tsp pepper

1/8 tsp cayenne pepper powder (optional)

Heat all ingredients in medium saucepan over low heat, stirring nearly constantly. Add additional seasonings to taste after about 20 minutes and all ingredients have melted and mixed well.

Add 1 – 1 1/2 cups of frozen chopped spinach or other veggie of choice. Most veggies will do best if sautéed or parboiled prior to adding to creamed mixture.

Heat thoroughly over low heat with frequent stirring; total cook time for my batch was about 45 minutes.  You can cook over low heat for a longer period of time, but remember that heavy cream will reduce down over time, creating a thicker Soup. Serve.
Makes approx 2 quarts of Soup, unless you cook it down to thicken it more. Keeps well for several days in the fridge. I also think it tastes even better the next day!!

This creamy soup base is totally awesome for cooler fall days! Let us see your version; post pics of your Creamy Keto Soup on our Facebook page.

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Measures of “Improving Health”

Recently, another health care provider mocked my use of the phrase, “improving the health of my patients”, saying that it’s vague and not measurable.
Her comments gave me pause, because the goal of every nurse I’ve ever met has been to help people improve their health. Ask any nurse why he or she became a nurse, and you will hear a variety of ways people say it. We nurses help people get well, better, or over a health obstacle. How is that measured?
First and foremost, there are many parameters used by health care providers to measure health. With diagnoses of diabetes and hypertension, we measure glucose and blood pressure, respectively. But we often have difficulty quantifying how people feel when they lower their glucose or blood pressure. When patients return for follow-up and I’m able to tell them their hemoglobin A1c dropped from 8.9 to 6.4 after weeks of diet changes and effort, people are thrilled. They grin from ear to ear. They clap. They shake a fist in the air. They “high five” me. Some even do a “happy dance.” What is measurable here? Yes, the glucose levels are numerical and easy to track. But how does anyone put a scale on happiness or joyfulness? Can the idea that diabetic complications no longer pose a looming hazard to health be measured? How is relief quantified when kidney damage has improved?


These feelings are not measurable, yet they are extremely evident in behaviors and attitude. Patients who work toward improving health exhibit gratefulness that good instruction is provided; is that gratitude measurable?
Measures are important in health care. Measurements of pulse or blood pressure provide vital information to us who render the care. I decided that some of you might be interested in knowing what measures we use for certain conditions so you can track your own progress over time.
With diabetes, one of the most important measures is glucose, of course; in addition, the hemoglobin A1c that tells us the average glucose levels over the past 90-100 days provides a good correlation to patient effort in managing the condition. While mainstream medicine will say that “good” diabetes control occurs when the A1c is around 7, many studies have shown that diabetic complications occur when the A1c runs higher than about 6.2 or so. Normal A1c levels run around 5 or less; why should people diagnosed with diabetes be forced to run glucose levels so high that we KNOW organ damage will occur? Is that going to help patients “improve their health”?
Elevated blood pressure is often associated with diabetes because high glucose levels cause thick, sticky blood; demanding that the heart pump thick, sticky blood to an overweight body will eventually result in high blood pressure. The heart will pump harder and with more force to move thick “syrupy” blood through tiny blood vessels, resulting in higher and higher blood pressure readings. When blood pressure increases, the heart muscle becomes compromised and weaker. Daily demands on the heart that continually exceed it’s designed capabilities can contribute to a multitude of vague symptoms which are not measurable, including headaches, fatigue, nausea, dizziness, or even mild swelling. While most of these symptoms have no quantifiable scale, patients will describe how much better they feel once blood pressure is lowered. While blood pressure is measurable, the feeling of lower and healthier blood pressure is described by patients as “improved health.”
If blood pressure remains untreated or poorly managed, heart failure and/or kidney damage begin to occur. Highly pressurized blood flow moving through the kidneys will damage the fragile vessels, reducing the filtering ability of the kidneys. Elevated glucose can also damage these tiny vessels, resulting in inflammatory responses by the body that are designed to patch and repair damage – but this natural response by the body can result in blood vessel blockages. Think scar tissue.

In this photo below, notice that cholesterol is serving as the patch, relating the damage to the blood vessel. Cholesterol isNOT the cause of clots; it’s part of the damage control/repair team of the body. In summary, how do we measure “improved health”? How can we quantify patient comments when they express gratitude for how they feel? How can we count the number of clinic visits these patients will NOT have? How do we track hospitalizations that do NOT occur for these patients? What evidence do we see when ER visits are no longer the norm for people with “normal” glucose or blood pressure? We can’t. But these numbers ARE real. These people ARE changing their lives and IMPROVING HEALTH!

If you want to take charge of YOUR health, email us for more info at KetoNurses@gmail.com

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What is Vitamin D & Why Do I Need It?

vit d pathwayVitamin D is called a vitamin; it’s often called a hormone. It’s often called a vitamin that acts like a hormone.  So, which is it?  It’s actually all of the above.  Vitamin D is a fat-soluble agent with a chemical structure similar to a steroid.  Which makes sense, as Vitamin D is one of the major ingredients of all steroid-based hormones produced in our bodies. Our bodies were created and designed to absorb sunshine via skin and then a variety of chemical reactions would occur so our bodies actually made its own vitamin D.  However, since the skin cancer scare of the 1970s, the general population applies thick layers of sunscreen and we rarely remove enough clothing to bare our skin for this natural process to occur.  This long-term lack of sunshine on our skin is producing entire generations of significantly deficient people in our society.

What happens when we are low in vitamin D? How does a vitamin D deficiency affect people’s health? Because vitamin D is vital to numerous human processes, it can be quite complex to discuss its actions, roles, and benefits to our bodies.  We will attempt to explain vitamin D as simply as possible, describing the intricacies and complex utilization of vitamin D.

 vit d image

The oldest known function of vitamin D is the role in bone growth and development; we’ve all seen photos of young children with rickets (legs bowing outward) because of a severe deficiency of vitamin D. Without adequate D in the bloodstream, bones cannot grow or develop properly.  For years, calcium was reported to be the “hero” of the skeleton.  People with weakening bones were urged to take high doses of calcium daily “to protect your bones” and prevent osteoporosis.  However, in recent years, that advice has been scaled back a bit; no longer is it general health advice to recommend calcium supplementation unless there is known osteoporosis or osteopenia.  Even where there is evidence, many providers won’t recommend it lightly; they take great care in explaining the risks/benefits and often encourage vitamin D in place of or at least along with the calcium.  So, just what does the vitamin D do for bones?  It’s most recognized benefit is that it aids absorption of calcium from the intestines; it’s the reason vitamin d is added to milk and other dairy products.  Milk/dairy products do NOT naturally contain vitamin D; it is added to promote calcium absorption into the bones for effective use in growth & development. Vitamin D helps keep bones strong and also helps prevent weak, brittle bones in the elderly.

In addition to bone health, vitamin D is recognized for its effects in the brain; it has been called “the depression vitamin” among health care professionals for many years because it is a vital component of neurotransmitters in the brain. Three major neurotransmitters in the brain requiring adequate amounts of vitamin D include serotonin, oxytocin, and vasopressin; serotonin is a neurotransmitter vital for transmitting nerve impulses. Serotonin is also important for mood regulation; pain perception; gastrointestinal function, including perception of hunger and satiety; and other physical functions. Oxytocin is released from the brain when it is needed for a variety of body needs, including labor & delivery at the end of pregnancy, during sexual arousal, and it is often referred to as “the love hormone” because of its impact on emotional relationships. Vasopressin is an anti-diuretic hormone that regulates fluid balance within the body and bloodstream. It works to prevent excess fluid loss and helps maintain homeostasis (normal internal chemistry) by maintaining the concentration of dissolved particles, such as salts and glucose, in the blood. Reviewing all 3 of these neurotransmitters and their major functions is vital to understand brain chemistry; can you see how a shortage of vitamin D would impact nearly all normal body functions and even our relationships, moods, and emotions?

Vitamin D’s impact on glucose has only recently been identified; multiple studies show conflicting data as this area is new to research. However, knowing that vitamin D is an essential ingredient of vasopressin, and that vasopressin helps maintain healthy glucose concentrations, does it not then make perfectly logical sense that a shortage of vitamin D will result indirectly or directly in elevated glucose levels?

In addition, a recent study shows that fasting glucose levels, insulin levels and insulin resistance all improved with vitamin D supplementation. Additionally, this study suggests that pro-inflammatory cytokines that are thought to contribute to insulin resistance were down-regulated with this vitamin D supplementation. Translation: with high carb/high sugar intakes, we are finding significantly elevated levels of inflammatory markers, like cytokines, that are more linked to heart disease, heart attacks and strokes than we ever imagined. Vitamin D supplementation appears to reduce that inflammation as part of the body’s normal healing/tissue repair processes.

However, let’s review again: former advice to take calcium for bone health came with advice to also take vitamin D to aid absorption of the calcium. Just as calcium needs vitamin D for absorption & effective utilization, so vitamin D needs some help. Magnesium and vitamin K2 are necessary for the absorption and use of vitamin D. Recent studies have shown even the very high doses of vitamin D prescribed by health care providers (50,000 IUs) as a weekly regimen barely raised vitamin D levels at all after 4-6 weeks, the usual recommended time frame for dosing. Once study participants added a magnesium and/or vitamin K supplement to their regular dosing regimen, vitamin D levels immediately began to rise. These studies are why we typically recommend vitamin D, magnesium, and vitamin K2 to most people with insulin resistance and type 2 diabetes.

Recently some reports are suggesting that vitamin D is integral to our immune system; some experts and studies are recommending to add or increase vitamin D supplementation during a variety of illnesses, including colds, flu, respiratory illness, asthma, and more.

What about doses of these supplements? There are limited studies and recommendations because this field is so new and mainstream medical providers are hesitant to make recommendations to patients without a large body of support. The Endocrine Society has stated that a deficiency of vitamin D exists when lab levels fall below 20 ng/mL; however, many reputable experts and organizations say that level should be 40 or even 50 ng/mL. Because of limited evidence, it’s difficult to specify a particular dose. Even more recently, various mainstream medical organizations like the Endocrine Society have stated that health care providers should not draw a vitamin D level on patients anymore, because we’re all deficient anyway, & the test is very expensive; most insurances won’t cover the costs either. So how are we supposed to know what dose to take? Well, the current recommendations for dosing are not clear and without a known vitamin D level, finding your perfect dose may be tricky, but many people find that 1,000 – 2,000 IUs daily is a good maintenance dose; some people just beginning to supplement find that taking 5,000 IUs daily for a few weeks is very helpful at reducing many vague symptoms that they often never connected to poor nutritional status. You can ask for the blood test to be done; you should also ask for the pricing of the test prior to having it drawn so you’re aware of the likely expense. Manufacturers of supplements are meeting the market demand by producing combinations of D, magnesium, vitamin K, and/or iodine for patient convenience.

One warning of NOTE: vitamin K1 is vitally important in blood clotting; if you are taking a blood thinner or have been told you SHOULD take a blood thinner, including aspirin, you should discuss adding this supplement with your provider BEFORE taking it. While vital for normal body processes, vitamin K can contribute to increased clotting within blood vessels; clots are known contributors to heart attacks and strokes.  

In conclusion, the general consensus on Vitamin D includes:

  1. Each increase of 4 ng/mL of vitamin D in the blood is associated with a 4% lower risk of type 2 diabetes.
  2. There is a significant and inverse relationship between blood levels of vitamin D and the risk of type 2 diabetes among a wide range of vitamin D levels and among a wide variety of populations, so that it is difficult to specify “normal” lab reference values and recommended daily dosing. Translation: The lower your vitamin D level is, the higher the risk of development of type 2 diabetes.

For further information about Vitamin D, it is recommended to ask your regular health care provider.

Here’s a link to a great study to reinforce our viewpoint: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/

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KetoNurses’ Grain-Free Fake Ziti

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KetoNurses’ Easy Fake Ziti

I recently saw a segment on “Rachael” the featured a White Ziti and I was intrigued immediately! I decided to tweak the ingredients just a bit in order to make a grain-free, low carb Ziti.

KetoNurses Grain-Free Fake Ziti Recipe

2-3 Tbsp olive or avocado oil

5-6 cloves of garlic (1 bulb works)

10-16 ounces thawed chopped spinach

ground nutmeg (optional)

salt & pepper to taste

2-3 zuchinni, sliced thinly

16-24 ounces ricotta

16-24 ounces grated parmiagiano-reggiano

16 ounces shredded mozzarella

Start by coating the baking dish with butter or oil and preheat oven at 350 degrees. Set baking dish aside while combining ingredients. Heat oil over medium heat, stirring in garlic, spinach, & nutmeg. Heat and stir for about 2 minutes, or until heated thoroughly. Salt & pepper to taste.

Add sliced zuchinni, ricotta, & parm.  Mix well and turn out into greased baking dish.  Top with grated/shredded mozzarella and bake in oven until some of the top begins to brown.  Using smaller quantities allows for smaller dish & less baking time; an 8×8 dish will be done in about 30 minutes, whereas a 9×13 dish will require about 50 minutes.

Options:  Brown 8-16 ounces of ground beef or pork sausage and add to heated mixture. I made my version with a pound of ground beef because my hubby refused to eat it without meat.  LOL

This dish is a very flexible base and I hope to try developing a few other options over the next few months.  It offers a power pack of nutrients including iron, protein & multiple vitamins essential for good health.

I have really enjoyed learning to use “zoodles” in place of grain-based noodles; using zuchinni in place of typical noodles also significantly improves nutrient content, & that is vital for improving health.  Zoodles are also a fun way to get kids to eat more vegetables!!

Fake-Ziti is quick and easy to make, and can be made ahead and saved in serving size portions for use later in the week.  Smaller portions also make terrific appetizers for pot lucks or parties.

Add a colorful salad and serve – so quick and easy to provide a highly nutrition meal for your family.

Rachael recommended a nice white wine to accompany her Ziti; I’m not much of a wine chic, so I’ll just have to take her word for it.  LOL

Please share your photos and experiences making our Ziti on our KetoNurses Facebook page or tag me on Instagram; I’m KetoNurseJen.

Happy Low Carbing!