Published on February 27, 2019

Beyond Keto…

Teresa Farrell, RD, LD Essentia Health St. Joseph’s-Brainerd Clinic

As a follow-up to last month’s article on the keto diet I thought I would talk about low carb diets this month. Low carb diets are similar to keto diets, but not nearly as restrictive in carb and protein intake. A low carb diet does avoid bread, pasta, rice, and cereal, among other grain foods. It also limits your intake of starchy vegetables such as potatoes, fruit and milk/yogurt. As with the keto diet people following a low carb diet do lose weight. As do people following many other types of reduced calorie diets.

Low carb is an off shoot of the Atkins diet that was popular several years ago. There are many variations of low carb diets. Some allow you to eat all the bacon and fatty meat you desire. Others are a bit more moderate, recommending lean meats and protein and an overall moderate protein intake vs being a high protein diet as well as low carb. This is more prudent, as the evidence shows saturated fat raises LDL cholesterol and your risk of heart disease. Saturated fats are found in animal fats, and tropical oils that are solid at room temperature (such as coconut and palm oil). Many people who lose weight on a low carb diet (or other diet) do bring down their cholesterol, which may be due to the weight loss itself, not because of eating bacon cheeseburgers (no bun of course!)

Depending on the source, carb intake recommendations can vary from 100 grams, 50 grams and as low as 20 grams a day, and anything in between! Most often the goal is to basically go as low as possible. To help you visualize how restrictive this is, a small apple has 20 grams of carb, 1 slice of bread has 15 grams, 1 cup of milk has 12 grams, and 1 cup of plain yogurt has 20 grams. One of these foods would basically be your carb allowance for the day on a 20 gram carb diet. So, the question becomes: what can you eat?! Basically, meat and low carb vegetables. Before embarking on this type of diet, ask yourself if you can stick with it for the rest of your life to sustain the weight lost? There are many different options for weight loss, and different approaches work for different people.

When carb intake is so low and entire food groups (3 of the 5) are limited so drastically, nutrient intake is also limited. A multivitamin and mineral supplement is recommended, with additional supplementation of calcium, and folic acid if they are not included. For adequate fiber, at least 5 servings of low carb vegetables should be eaten each day.  It’s also important to drink plenty of water to help prevent constipation and dehydration. The lower the carb intake the greater the risk of dehydration.
With such a limited diet you may also be missing out on prebiotics, probiotics and phytonutrients. There is still so much to be learned about nutrition and its impact on health, so it’s best to eat a wide variety of healthy foods each day.

Philly Cheesesteak Cabbage Wraps
8 large green cabbage leaves
2 Tbsp olive oil, divided
½ large onion, thinly sliced
2 large bell peppers, thinly sliced
1 tsp dried oregano
Black pepper
1 lb. skirt steak, thinly sliced
6 slices provolone cheese
Optional: salt and other seasonings


  1. In a large pot of boiling water, use tongs to dip cabbage leaves in water for 30 seconds to blanch. Place on a paper towel-lined plate to dry.
  2. In a large skillet over medium heat, heat 1 tablespoon of oil, then add onion and bell peppers. Season with oregano, pepper, and salt if desired. Cook, stirring often, until onions and peppers are tender, about 5 minutes. Remove from skillet and add remaining tablespoon oil to skillet.
  3. Add steak in a single layer and season with salt and pepper. Cook until steak is seared on one side, about 2 minutes. Flip and cook until the steak is seared on second side and is cooked to your liking, about 2 minutes more for medium.
  4. Add onion and peppers back to skillet and toss to combine. Top mixture with an even layer of provolone and cover skillet with a tight-fitting lid. Cook until cheese is somewhat melted, about 1 minute.
  5. Place a scoop of steak and peppers mixture onto center of a cabbage leaf. Fold short end of leaf over mixture, then roll up the long way, like a burrito. Repeat with remaining ingredients.

Serves: 4
Nutrition facts:
Calories: 495
Carbs: 10 grams
Protein: 40 grams
Fat: 30 grams
Fiber: 3 grams
Sodium: 745 mg

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