Cookbooks for Special Diets



Special Diets

People restrict their diets for a host of reasons. Sometimes it is to lose weight. Sometimes it is to lower cholestrol. Sometimes it is to eliminate foods that cause or promote illnesses such as celiac disease or diabetes.

For centuries food has been seen as a pillar of health. Was it not the great Greek physician Hippocrates - the one that wrote the oath that every physician recites - who said "let food be your medicine?" The whole idea of pharmacology descends from the notion that certain plant and animal products produce unique restorative reactions in those who cosume them. And much of pharmacology in the past and present has looked to foods for useful chemicals to solve specific physiological problems

How ironic it is that today the medical profession which is trained to view treatment in terms of pharmacological methods (i.e. 'yes, we have a pill for that') guffaw whenever someone suggests that people have adverse reactions to food. The problem is less severe than it was twenty years ago, but it is still there.

Millions of people have food allergies. Celiac disease - a disease that causes painful and dangerous degeneration of the digestive system - is a result of an allergy to wheat and other grains with gluten. Nearly two million Americans suffer from it. Lactose intolerance is another problem that causes problems for tens of millions. Main-stream book publishing is just beginning to address some of these issues.

Each time the world discovers that one sort of food or another causes a health problem I ask "is this a macrobiotic food?" And almost invariably the answer is "no." If one eats only for health and not for pleasure, then it is the macrobiotic diet that probably offers good nutrition with the fewest bodily insults. But no diet is quite so bland or difficult to follow. Nor will mainstream nutritionists endorse its tenets. But most of its fundamental ideas are good - fresh, whole, seasonal foods, no processed foods, no white foods, low fat, low sweeness, low salt, and so on.

Most of todays special diet cookbooks are aimed at how to live without one or a handful of foods that cause specific problems: sugar and diabetes, carbohydrates and overweight problems, saturated fat and cholesterol problems, gluten and celiac disease, and a host of allergens and food allergies.

The information offered below is garnered from a wide variety of sources believed to be credible; it is not, however, meant to be construed as health care advice. It is not written by or reviewed by a physician.


Diabetes is a growing problem; it threatens tens of millions of Americans. Millions have it and do not know it. It used to be that diabetics would have to make radical changes in diet. Today, however, there are a lot of recipes that produce low sugar and reduced carbohydrate foods even in baked goods. Diabetics can once again enjoy many of their favorite foods, including many desserts. It would be a mistake to think that this means eating habits should not change,they should; but sometimes change is easier to make when one knows one is not giving up ones favorite foods forever.

Exercise is central to controlling diabetes. But this site is about food. The central problem one is trying to deal with in controlling diabetes is to try to match the rate at which sugar enters the blood stream to the rate at which it is used by the body. Introduce sugar too quickly and blood sugar rises dangerously; introduce it too slowly or use too much insulin and blood sugar gets dangerously low. The means by which this regulation has traditionally taken place is that people have eaten whole grains and beans which release sugars into the bloodstream slowly. And of course, exercise has always been central to man's existence.

The problem is that a large meal of pasta or potatoes is too easy to digest, this causes the digestive system to dump huge amounts of sugar into the blood stream within about an hour of eating. Potatoes, bread, pastries, pretty much everything fun to eat has the same problem.

One alternative is to eat more meat. Neither the protein nor the fat in meat cause the same sugar problem. Fats take longer to digest, so they release energy into the bloodstream more slowly.

Anther approach is to eat foods that contain carbohydrates that require more work to digest. Beans may be the best example. The carbohydrates in garbonzo beans, for instance, require very much time and effort by the digestive system to turn them into sugar. As a result, the sugars produced by eating garbonzo beans are released into the blood stream slowly. Whole and coarsely ground grains are release sugars faster, but they do it more slowly than sweet foods or white foods

A measure of how fast this process occurs is called 'Glycemic Index.' Foods with a high glycemic index go in the mouth and right into the bloodstream. Those with a low glycemic index release sugars over a much longer period of time, more nearly matching the body's demand for sugar with its supply.

Here are a few simple rules of thumb to keep in mind.

Diabetics should judge cookbooks for diabetes not just on whether they have eliminated sugar from a recipe, but whether they have managed the entire carbohydrate load. Cookbooks should take all of the above ideas into consideration. For instance; one can make pancakes with garbonzo bean flour. These will, presumably, have a lower glycemic index than those made with white all purpose flour.

The big idea then, is to eat foods that do not produce big sugar instabilities in the blood. The ultimate way of determining whether a food is a good one to eat is to test blood sugar after eating. And if a food causes high sugar levels, to either eliminate it from the diet or to east much less of it.

Remember, it is not the case that lower is better, rather it is the case that steady is better. Thus eating smaller amounts but eating more frequently may sometimes be a good practices. Read good books, use common sense, and follow the advice of your physician.


Low Carbohydrate Reducing Diets

There are a number of health and nutrition risks associated with certain low carbohydrate regimens, but one reason for their perennial popularity is that they work. The fundamental reason is that the body tends to be a little imprecise in its regulation of blood sugar: in some individuals it overshoots. When you eat carbohydrates and they are digested, the body responds by generating insulin to carry that sugar from the blood into cells. But the body can easily respond too much. This causes the blood sugar level to fall lower than it was before eating, triggering a desire to eat.

The net effect is that eating sugars and simple carbohydrates makes you hungry. There are two fundamental approaches to combat this problem.

The Atkins diet, the Zone diet, and the South Beach diet all use one or both of these techniques to get dieting to work.

Because of the strong links between diabetes and heart disease and obesity and heart disease, it seems likely that in the near future more effort will be spent on using low carbohydrate diets to control diabetes and weight instead of focusing on fat and cholesterol.


Every day we hear more and more doubt cast on the notion that cholesterol intake plays any role in heart disease. And the general advice against eating fat has been replaced with advice to eat unsaturated fat. There is some evidence that polyunsaturated fats - the kinds found in olive and safflower oil can actually improve cholesterol. If your doctor has you controlling your cholesterol, you should do what he says. But if you are not under a doctor's care for cholesterol, the best advice is to eat sensibly. Bear in mind that the South Beach Diet was designed by a heart specialist precisely to aid patients in restoring their circulatory systems to good health.

Standard advice is to avoid beef fat and dairy fat. Try to minimize fat intake from most other animal sources, except: eat foods rich in omega-3 oils such as salmon and other cold water fish at least once a week. Eat foods that contain lecithin such as mustard and eggs. Eat polunsaturated fats such as those found in olive oil. Eat foods with much soluable fiber. Oat bran is full of soluable fiber. Apples and apple sauce are relatively good sources of fiber. Beans of all sorts are a super source of fiber. And, of course, prunes.

Interestingly, there is also some evidence that eating tofu at least once per week will help lower cholesterol and help prevent heart attacks. Before you say "yuck," please remember that tofu is not a final food; it is a food ingredient like white flour. If someone gave you a spoonful of white flour, you' d probably say "yuck," but if they mixed it with water and egg and made a pancake, you might say "yum."

Fruit pectin is another source of soluable fiber, but its most concentrated form is jelly, and most jelly contains dangerous amounts of sugar. Avoid eating too much sugar or simple starches. Be aware that diabetes increases ones' chances of heart disease by a large amount, so eating in ways that would help avert diabetes can increase your odds of averting heart disease. Take modest amounts of vitamin E, A, and C supplements.

Get plenty of light exercise daily. And finally, if you are not taking other medication and have not stomach problems, consider taking 81 mg of aspirin daily. It has two salutory effects: it thins the blood which improves circulation to the heart, and it retards inflamation which can choke the heart of vital blood flow during a heart attack.

Low-Fat Reducing Diets

In the early nineteen eighties it was assumed that eating fat was bad. By the early nineteen ninties we knew better, but the damage was done. "Light" cooking was everywhere. There is much to be said for choosing to eat sensibly. And much of the "light" cooking fad is sensible. Those sensible parts are:

Where low-fat diets fall down is where they substitute sugar and simple starches for fats, especially vegetable fats. The substitution can put one on the sugar roller coaster. You could end up eating a lot more because you feel hungry a lot more frequently. In short, a low-fat reducing diet could make you fat.

My own personal rule is that if I require a tablespoon of butter with my three servings of zucchini, cabbage, broccoli, cauliflower, green beans, etc., that is the nutritional price I must pay to eat these vital foods. I can afford to make this choice, I believe, because I eat very little red meat. And when I cook I generally use olive oil istead of butter.

The French, who eat much more butter than we Americans, enjoy much lower levels of heart disease. Some attribute it to the red wine. Others might attribute it to the shorter work week. Whatever the case is, rest assured that most people will find that eating a little more butter or vegetable oil - especially when it replaces calories from sugar and simple starches - will cause no health problems. In fact, there is evidence to suggest the opposite.

Celiac Disease

Just thirty five years ago American Physicians insisted that celiac disease did not exist. And there are still a lot of physicians who are completely unwilling to entertain the notion that food - excepting for sugar in diabetics and beef fat in people with high cholesterol - can have any adverse effect on anyone. "that's why they call it food..."

The gluten in wheat causes a kind of autoimmune reaction in the gut which causes the cilia - the little protrusions in the gut that absorb nutrients - to shrivel up and die. The consequence is that food nutrients are not properly absorbed and the digestive system ceases to function normally. If it gets bad enough it can be a life-threatening disease.

The cure seems simple enough - avoid gluten. The problem is that gluten is a part of almost all grains except rice and corn, and that almost every processed food in the grocery store contains at least one of these grains. Most canned chicken stocks, for instance contain it. And when you eat out, almost every sauce will contain it.

In short, if you have celiac disease and must treat in aggressively, it means cooking everything from scratch and/or being ruthless about reading labels. In 'Against the Grain' the author recommends carrying cards in many languages saying, in effect, 'I am deathly allergic to wheat. Please be certain that nothing you prepare for me contains it.' and in America 'and if I get sick I will hold you personally responsible for all hospital bills.' Whenever she orders at a restaurant she explains her problem and hands the waiter a card. She suggests that this really works.

The good news is that Southeast Asian cuisine is delicious and except for a few dumplings and noodles, it is completely free of wheat. In additon to Gluten-free cookbooks, look for Chinese, Japanese, Indian, and Vietnamese, and Mexican recipes. There's a lot of great food to be found in these traditions. According to Aunt Jemima, corn does not contain gluten so one can eat corn tortillas with impunity. Between corn and rice flours, most of the common baking needs can be met.

Food Allergies & Sensitivities

Some decades ago food allergies were considered with about the same skepticism by US doctors as anti-gravity pills would be considered by todays physicists. But it turns out that the medical profession was wrong. People have food allergies, and they can devistate lives. Celiac disease is but one of a large number of food allergens. Peanut allergies cause acute symptoms in thousands of people. But not all negative reactions to food are so clear cut as the worst peanut allergy.

In one model a food allergy is anything that provokes an adrenal response. Whenever the body detects something in the bloodstream that it thinks should not be there, it produces an adrenal response. It's the same response that you get from a tight spot in a good video game or a thrill in a good amusement park ride. Some people get it from fighting, and provoke arguments just for the buzz. People get it from watching action movies and sports events.

The problem with getting it from food is that the adrenal gland is like any other organ of the body; it can grow fatigued. When this happens, you feel tired or 'washed out.' Eating foods that provoke an adrenal reaction will get the heart pumping a little faster, and produce a feeling of well being for a short time, but it also draws down the reserves of the gland. You will soon feel tired.

When the adrenaline is gone, you crave more of the same food to get that rush again. One of the surest signs of a food sensitivity, in fact, is a food craving. If you have a favorite food that you absolutely must have every day in order to feel okay, you probably have a food sensitivity to that food. And it is stealing away your vitality. That's the other clue to food sensitivities, you feel tired soon after eating.

It turns out that the list of suspect foods is fairly long. Some of the most common foods to which people have sensitivities are:

Many people have sensitivities to many of these items. Some to all of them. Cooking to avoid these items is no easy task, believe me. My wife will eat only four items from this list. But setting them aside once and for all can be a life-transforming event. Twenty five years ago she did not have the energy to swim the length of an olympic pool. Today she swims an hour at a time and goes on forty mile bike rides. Changing her diet to eliminate these foods played a major role in giving my wife the energy to do this and to attend Columbia's business school and graduate at the top of her class.

The good news is that there are now a few books out there designed for people with food allergies. None cover all the ground, but if you also look for ethnic foods that happen not to contain your own taboo ingredients, you are likely to find lots of delicious food out there. And when in doubt, eat rice cakes an hummus.

Macrobiotic & Ayurvedic

Macrobiotic cooking descends from Bhuddist monks who, on the trip to nirvana eliminate foods that cause physical harm and mental distraction from their diets until at last they are eating only steamed brown rice. It is interesting that except for soybeans, every item on the list of common food sensitivity items is also forbidden in macrobiotic eating. Macrobiotic cooking eliminates red meat, poultry and spices. Fresh fruits are rarely eated because of their high sugar content; and cooking oils are not used because they are not "whole foods."

The result is food whose chief culinary attraction is subtlety. But unless macrobiotic cooking is handled expertly, it is more often considered bland. Eating a macrobiotic diet can be a transforming experience, especially for people who suffer from migraines, food cravings, overweight, high blood pressure, diabetes, heart disease, digestive problems, or a lot of other health problems of 'civilization.'

What ever your special dietary needs:

Eat well and prosper.



Copyright S.R. Brubaker 2002 - 2006.