Back to Modified Atkins Diet

When we began diet therapy for Nora, we started out easier with the Modified Atkins Diet (MAD). We could see that it helped, but didn’t completely control her seizures at the time, so we kept stepping up the ratio over several months until she was on a 3.5:1 ratio ketogenic diet. Now we are through the wean and back to Modified Atkins again. We just keep taking steps and all is well. Still seizure-free, growing and full of energy!

In early December her ratio was lowered down to 1:1, which is Modified Atkins Diet, but we were still calculating and weighing all of her food. When the kids got out of school for winter break we took another step: we are only calculating and weighing the carbs that Nora eats, but giving her any protein and fat that she wants. Although we are still using the gram scale, we spend a lot less time working out each of Nora’s meals and she is happy to eat cheese or nuts when she wants to.

We also moved her up to 40 grams of carbs, just another baby step up, but it has allowed her to have yet more fruits and vegetables.

Eventually we will be estimating all of her foods, even the carbs. But after calculating and weighing to the gram for so long, we realized that we really don’t know portion sizes! We weigh things without really looking at how much is there. We are using this time as a chance to re-learn portion sizes so that we can eyeball meals that will be a good balance for Nora.

Ted reconfigured the spreadsheet that we use to calculate meals for our latest step. Now we enter the number of carbs we want to give her from various available foods, and the spreadsheet tells us how many grams of each food to serve. It’s pretty sweet. He color coded it so that we learn which foods are “danger zone,” “caution,” and “almost-free.” The coding is based on the number of carbs per calories in the food. For example, if she were to eat her whole 40 g of carbs from raisins in a day, she would only get 13% of her day’s calories and would need a lot of other foods. If she got her hands on the raisin box and went to town, she would stuff way too many carbs into herself before she was full. But if she ate her whole 40 g allotment of carbs by eating macadamia nuts, she would get 379% of her calorie needs in the day! In other words, she would naturally stop eating macadamia nuts before she could get close to 40 g of carbs because she might explode. Ted is so clever.

There are several foods that fall into the “almost free” category, which we may just remove from the spreadsheet altogether soon and make them free. Macadamia nuts, walnuts, cream cheese, string cheese, avocado, flacker. Of course, any carb-free food is free too. As long as we get some of these “almost free” and carb-free foods with fat into her every day, we have no problem keeping her at a 1:1 ratio. During the first several days of estimating we double-tracked it using both of our spreadsheets. We calculated her carbs and estimated her meat, cheese and fat portions, then weighed them and put the amounts served into our old spreadsheet to find the ratio over the day. We were easily at or above a 1:1 ratio as long as we were mindful about the basic ratio of each food.

Our Foods by Ratio post has helped us to keep her ratio on track. The big danger-food in that list, in my experience, is cottage cheese. Even full-fat cottage cheese has a very low ratio. During one of our MAD transition days, I gave her a meal of cottage cheese, turkey, and applesauce. I knew immediately that it would be very low fat, so supplemented with some tea and cream and added cream to her cottage cheese too. She actually prefers her “soupy” cottage cheese anyway!

Transitioning her to a more normal diet has been interesting. She loves having more banana and a bit of honey with her peanut butter. Now she eats her MAD About Granola every morning with whole milk! The granola is over 1:1 ratio, so adding whole milk at a 0.4:1 ratio can balance it out to 1:1. Whole milk is still pretty carby; it is in the “danger zone” category of foods but she loves it.

Other new foods get surprising results. I offered her a bit of rice, maybe a tablespoon, equal to around 5 grams of carbs. She wouldn’t eat it! She had a big bowl of edamame instead, and some sweet potato. Another night I offered her a fried Korean dumpling, 6.6 g carbs per dumpling and most of her dinner allotment for carbs. She took one bite and didn’t want any more. It is interesting how her tastes have changed, or maybe she is just nervous about trying too many new things, which is expressed in disliking the food. I’m not in any hurry as long as she is happy.

Although it is supposed to be easier than the ketogenic diet, I remember feeling like MAD was harder because Nora couldn’t eat all of the protein. It is 2-3 times the daily protein requirements for a child her age. Now that she is free to eat or not eat the protein that we serve, she seems happier. Although I still don’t understand how a child can refuse her whole serving of our Christmas ham (honestly, “do I have to eat the ham?” what the heck?). She does not refuse bacon, however.

IMG_5239For Christmas brunch I made the basic waffle recipe from The Joy of Gluten Free, Sugar Free Baking with minor modifications. I was able to use whole milk and the whole family ate it. No more 2-recipe mornings for pancakes or waffles for us!

 

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Nutrition facts for 1 mini-waffle, 29 g of batter. Nutritional analysis by www.caloriecounts.com

Hazelnut Waffles or Pancakes
110 g (1 cup) Bob’s Red Mill Hazelnut Flour
110 g (1 cup) Bob’s Red Mill Almond Flour
2 tsp baking powder
100 g (2 large) eggs
110 g (1/2 cup) Organic Valley Whole Milk

Mix the dry ingredients in a medium bowl and the wet ingredients in a small bowl. Combine and mix very well until the batter has a uniform consistency. Alternatively, you can put all ingredients in an electric mixer and mix on medium for about 3 minutes, stopping to scrape down the bowl. If you are making large waffles, whip the batter well until it is foamy and aerated.

Cook as pancakes or in a waffle iron as usual.

If you like, you can add a no-carb sweetener, cinnamon or nutmeg for flavor. After weighing and cooking some for Nora, I added maple syrup to the batter to make pancakes for the rest of the family.

We made mini-pancakes and waffles, 29 g of batter each, as shown in the nutrition facts. Then each pancake has 2 grams of net carbs and a 1.5:1 ratio. We paired it with ham, a dollop of cream cheese, and blueberries with a touch of maple syrup (wow!). Nora is all about Celestial Seasonings Country Peach tea with cream these days, a nice way to add a little decadent fat as a treat.

Nora’s MAD About Granola!

Last week we took Nora’s ratio down to 2.5:1 and she is still doing great! We are getting ready to go back to North Dakota and Minnesota to visit friends and family for the first time since starting the diet, so we stepped her down a little earlier than scheduled so that we could get a good 10 days of 2.5:1 under our belt before traveling.

Traveling, especially air travel, feels like a big hurdle. We’ve been analyzing our list of regular foods to figure out what we need to pack, what we can shop for on arrival, and how to keep it simple yet appealing for Nora. Interestingly, we have noticed that bringing up her carbs has made us rely on heavy cream even more even though she is getting slightly less total fat. There are very few whole foods that have both carbs and significant fat (pretty much just kalamata olives). So for every extra serving of carbs, she still needs 2.5 g of fat on the side. We didn’t realize it at the time, but changing the ratio was easier when we were adding protein because protein foods (think cheese) usually have fat in them. Even small adjustments have changed the meal planning landscape.

Now, on to granola:

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In these years of keto cooking I’ve come across a few paleo-granola recipes and always thought I should make some for Nora. However, I always hesitated because I couldn’t imagine putting in any honey or dried fruits when she was more carb-restricted, so any recipe that worked for her would have amounted to a pile of crunchy nuts. Maybe not worth the effort when she eats plenty of raw nuts already.

IMG_4894Now that she gets 25 grams of carbs per day (remember when it was 10 g of carbs per day…for almost 2 years?), I threw one of the paleo-granola recipes into my recipe analyzer website and saw my opportunity. Nora is now eating dried currants and honey! It’s just a bit, but they are in there. And this granola is so very delicious, with just a hint of sweetness, that it is much more than a pile of crunchy nuts. It is at 2.1:1 ratio, so just a bit of extra fat brings her to 2.5:1. It will be highly packable and a very “normal” breakfast on our trip. Nora also loves it! She asked for granola instead of popcorn when she watched a movie with friends recently and keeps suggesting it as a snack option. As she says, it’s like cereal, only better!

I would recommend this recipe for anyone doing MAD, low-carb, gluten-free, paleo (is this recipe paleo? I can’t keep track, decide or modify for yourself). I’ve been eating it for breakfast with my kefir too. I went back to the commercial granola this morning for comparison and preferred the homemade granola because it was more flavorful and crunchy, and not as sweet. Nora has had it for breakfast daily with full-fat plain Greek yogurt, heavy cream, and a few fresh blueberries, formulated for a 2.5:1 ratio.

If you or your child are on a high-ratio strict ketogenic diet, this batch-process might not be appropriate for you. You may still be able to make granola, but you will want to divide the ingredients down into individual servings so that you know exactly how much carb, protein and fat is served at one time. When I take 20 g of granola out of the batch, I don’t know if Nora is getting 3 or 7 currants in her breakfast. I only eyeball it to make sure I’m getting a spoonful of granola with a reasonable mix of nuts and currants. At this point I’m confident that the difference won’t matter for her, but back when we were striving for seizure control and counting the days and months of seizure-freedom I would not have taken chances with it. Alternatively, I think you could leave out the currants and be more confident that any serving taken from the batch is approximately equivalent in carbs because the honey is equally distributed.

Actually, you can completely revamp this recipe any way you like, as long as you keep the general proportions the same. This is my 2nd version of granola. The first time I used dried cranberries instead of currants and slivered almonds instead of pecans. I also included sunflower seeds in that batch, and less coconut. The first time, I basically pulled all of the nuts and dried fruits out of my cupboard and used what I had on hand. In this version, I bought the ingredients that I needed to make it lower carb and higher fat.

I know that most people won’t have brown rice protein powder in the cupboard, and it is not essential to the recipe. It’s been hanging out in our cupboard since Nora’s MAD days, when I was trying to cram more protein into everything I made for her. Now I want to use it up! Go ahead and experiment with what you like, but remember that if you are keeping close track of nutritional information you will have to analyze your recipe accordingly. The nutritional facts given here are specific to these ingredients and to be used as a reference only. Nutritional facts for the whole batch are given, and please see the note on nutritional information at the end of the post for more details.

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Nutritional information in one whole batch of MAD About Granola. See below for individual serving nutritional information. Analysis by http://caloriecount.about.com

MAD About Granola
200 g (1-2/3 cup) walnuts
200 g (1-2/3 cup) pecans
100 g (3/4 cup) macadamia nuts
50 g (2/3 cup) zante currants
50 g (1/2 cup) Bob’s Red Mill golden flaxseed
30 g (1/3 cup) unsweetened shredded coconut
10 g (1 Tbsp) brown rice protein powder
30 g (1 large) egg white, lightly beaten
30 g (2 Tbsp) water
40 g (3 Tbsp) coconut oil
40 g (2 Tbsp) honey
5 g (1 tsp) vanilla extract
1 g (1/2 tsp) ground cinnamon
1 g (1/4 tsp) salt

Preheat the oven to 200 degrees F and line a baking sheet or roasting pan with parchment paper or a silicone baking mat.

f1829440Measure the whole nuts and currants and pulse in a blender or food processor to chop the nuts, but don’t grind them into a fine meal. Pour into a large mixing bowl. You will get some nut dust, which is ok. If there are any nuts that are nearly whole, pull them out and chop down to smaller pieces. Everything should be coarsely chopped. Next, measure the flaxseed, coconut and protein powder (if using) and add to the chopped nuts. Combine well.

In another mixing bowl, whisk together the egg white with the water until bubbly and slightly foamy.

In a microwave-safe bowl, melt the coconut oil. Measure and whisk in the honey, vanilla extract, cinnamon and salt. The cinnamon makes it look dark, as in the photo. Add this to the egg/water mixture and whisk well. Use a rubber spatula to be scrape all of the mixture out of the bowl.

Combine the wet and dry ingredients, stirring everything well to make sure it is all coated. The mixture should be evenly moist but not pooling liquid on the bottom of the bowl. The liquid will pick up all of the small loose bits and bind them together, which is just what we are looking for.

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Spread the granola mixture evenly on the parchment or silicone mat-lined baking sheet or roasting pan and bake for at least 60 minutes, stirring after 20 minutes, and again after 40 minutes. After the last stir I pressed the mixture firmly into the pan so that chunks could bake together. Turn off the heat and let the granola sit inside the oven until cool. I waited several hours. I made it in the morning and did the hour of low baking, then took it out of the oven in the evening after dinner. The granola will continue to dry and form clusters in that time.

Use a spatula to gently break the granola into clusters. Some loose bits will also break off. It’s all good. Transfer everything to a 2-quart sealable glass jar, or any airtight container to keep it fresh.

Nutritional information note: Notice from the nutritional information that the raw measured ingredients add up to 787 grams before cooking. After cooking, the whole batch weighed 710 grams. Typically baked goods lose about 10% of their weight by volume when the moisture cooks out of the food, which is true here as well. That means that you get more carbs, protein and fat per gram of cooked food because only the water weight disappears. When you calculate the nutrition per cooked serving in a batch like this, you have to divide by the cooked weight to get accurate nutritional data.

For every 1 g of cooked granola in this recipe, there are:
Carbs: 0.13 g
Protein: 0.15 g
Fat: 0.58 g
Fiber: 0.09 g

Add that up, and you get 0.97 g of macronutrients in 1 g of granola. We can infer that there is 0.03 g of water left too. Math and science at work!

In a 20 g serving typical for Nora, a scant 1/4 cup, this recipe has:
Carbs: 2.64 g
Protein: 2.91 g
Fat: 11.66 g
Fiber: 1.86 g
127 calories
2.1:1 ratio

Enjoy! Inspiration for this recipe from: http://www.theroastedroot.net/paleo-granola/ and http://againstallgrain.com/2012/01/29/grain-free-scd-paleo-vanilla-granola/. But just google paleo granola and you will find many more! Try it and you will never go back to commercial granola or cereal!

Continuing to wean and a berry tart for spring

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Nora’s birthday pool party, with keto cheesecake and strawberries, post-sunscreen and goggles!

We moved Nora’s ratio down to 2.75:1 about 10 days ago and she continues to thrive. So much has been going on that we have not had time to write a thing–dance recital, kindergarten graduation, Father’s Day, summer vacation, and Nora’s birthday! She turned 6 last Sunday and enjoyed a pool party with her friends. She requested Keto-Perfect Cheesecake as her birthday treat, with lots of strawberries on top! Half of the cake was lunch, the other half was afternoon snack and part of dinner. What a great day!

This feels like a significant step down in ratio because Nora’s myoclonic seizures didn’t stop until we were using a 3:1 ratio in a consistent way throughout her day. We are now below what felt like our “safe” point. Ted has checked ketone levels with the urine dip sticks and found that she isn’t in the highest ketosis level all of the time anymore, although still quite strong. From here on out we increase her carbs and decrease her fat because she is now getting the daily protein requirements for a kid her age. When we stepped it down to 2.75:1, she went from 17 g of carbs per day to 21 g of carbs per day. That’s a pretty big jump, 4 extra grams of carbs is a treat (see 1 gram of carb of various foods here). Hooray for fresh berry season! We are getting at least 1/2 pint of raspberries from our own bushes every day and getting to the farmers’ market weekly to make the most of her new carb allotment. I’m starting to think about trying the higher-carb fruits and veggies that have been off-limits.

Look at all of those berries!

Look at all of those berries!

With all of the milestones, particularly moving down the ratio and her birthday, both Ted and I have been feeling more anxious. We don’t take for granted that Nora is so big, healthy and smart today, which sometimes makes the wean seem all the more perilous. The better things are with Nora, the more we have to lose if epilepsy lashes out at her again. Of course, we still have every reason to believe that she will wean off the diet and do fine, but some of these moments have us holding our breath, hoping that it is all behind us. We went camping last weekend. Nora could not remember going camping before, it has been so long since we went as a whole family. She loved every minute of it and we had watermelon with our dinner, including some for Nora. We are going back to visit family and friends in the Midwest this summer, which we have not done since starting the diet. We hope that this is the new normal.

I’ve done some extra baking to let her enjoy the new ratio, mostly using almond meal more than I have before. I tried this berry tart crust recipe, slightly modified from the Almond-Pecan Piecrust recipe in The Joy of Gluten Free, Sugar Free Baking and it turned out great. Sturdy enough to remove the tart mold and look like something from the French bakery while being simple and delicious. It’s a keeper.

Nutritional information for one Tart/Pie Crust, with berries. Nutritional analysis by http://caloriecount.about.com/

Nutritional information for one Tart/Pie Crust, with berries. Nutritional analysis by http://caloriecount.about.com/

Tart or Pie Crust
(1 serving, 2.5:1 ratio)
13 g almond meal/flour
3 g ground pecans, or hazelnut meal/flour
3 g coconut flour, Bob’s Red Mill
6 g butter, melted
0.3 g baking powder
1 g vanilla extract
dash of salt
4 to 5 g water as needed (see below)

Preheat oven to 325°F. Weigh and mix together nut flours, baking powder and salt. You can use a sprinkle of no-carb sweetener such as stevia if desired.

Melt butter and mix in vanilla extract. Stir into dry ingredients and add water just until the mixture is stiff, like the consistency of playdough.

Put the dough into a single-serving tart or pie pan, spread it with your fingertips until it is evenly distributed. You could also shape it into a flat circle on parchment paper or a silicone baking sheet. Prick the bottom and sides a few times with a fork to prevent air pockets. Cover the edges with aluminum foil (or not) and bake for 10 minutes if using a cream-like or custard filling. I haven’t tried it, but I bet the blueberry panna cotta recipe would be wonderful if added to a baked tart crust. I’ve got a mind to try the vanilla cream pie filling recipe from the cookbook as well, with appropriate modifications.

IMG_4779To make it a berry tart, calculate the amount of berries and coconut oil or butter you want to use as a topping. For example, for a 3:1 ratio, you could add 10 g blueberries, 20 g raspberries, and dot with 5 g coconut oil (pictured). Bake for about 20 minutes or until berries are bubbly and crust is browned. Then serve 14 g cream on the side, as whipped cream, with tea, or as “keto milk” thinned with water and with a drop of vanilla flavoring.

I’ve used this basic recipe for berry tart and cheesecake for family and friends after trying it for Nora. Using a full-sized recipe and pie pan, I made the chocolate crust version adding cocoa powder and sugar (of course, for Nora I would use stevia instead of sugar–the chocolate requires some sweetener or it would be too bitter). The crust got rave reviews from a group of grad students! I personally like the flavor better if I skip the coconut flour, but it holds together better if it is included. This recipe is versatile enough to be modified for your needs. If you want to make a firm-sided tart, make sure to use the coconut flour version and a little more water. If you don’t mind it a little more crumbly, use all pecan or hazelnut and slightly less water. It’s all good.

Two Takes on the Pizza Crust

Kids love pizza, and keto kids deserve pizza too. Pizza is also a common quick meal, frozen or delivered, for many families on busy days. But with a keto kid you can’t feed the whole family, so it’s nice to have a fairly simple pizza crust that you can pull together or pull out of the freezer to include your keto kid while you wait for the delivery guy to show up. We’ve spent two years refining our pizza crust techniques, and I think we have 2 winners to share.

The first is a re-purposed version of cheddar crackers, from the Keto Cookbook. It is simply a mix of about equal parts ground macadamia nuts and shredded cheddar cheese. I left out the egg white and it worked fine for a quick crust, but it isn’t very sturdy. It is made of just 2 common ingredients and I don’t have a recipe because you can make it as large or small and vary the proportions as needed to fit in a meal (see examples below).

Mound of cheddar and macadamia nuts on a small pizza plate (left), and after pressed and baked (right).

Mound of cheddar and macadamia nuts on a small pizza plate (left), and after pressed and baked (right).

Simple instructions: Set the oven to 375°F. Measure the shredded cheddar and ground macadamia nuts together, mix well, and press into a small circle on parchment paper placed on a baking sheet. Bake until melted together and barely browned and bubbly. Take out and add toppings, bake again until cheese is melted.

Quick snow-day lunch. Nora pizza (left), frozen pizza (right).

Quick snow-day lunch. Nora pizza (left), frozen pizza for Anders (right).

You can build a meal around it. For an example of proportions, we made a little pizza of 10 g shredded cheddar, 16 g ground macadamia nuts (baked to crust), 10 g tomato sauce, and 14 g whole milk mozzarella (with enough fat on the side to make the ratio correct).

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Tostada-crust with hamburger, cheddar, and olives.

We also used this tostada-style with hamburger, cheddar and olives. I used 12 g ground macadamia nuts, 10 g shredded cheddar, mixed and baked the crust as described. Then added 14 g hamburger, 10 g sliced kalamata olives, and 6 more grams of cheddar. With avocado and extra fat (fish oil and cream) on the side. Sour cream would be a great addition, although not loved by our keto kid.

I thought it was easy to make 2 crusts at a time, knowing that I would use one again the next day also. Using the second one the next day helped me keep track of the proportions of cheddar and macadamia nuts.

 

The second pizza crust winner is from our Toasting Bread recipe. It has been a smash hit recipe for sandwiches and toast, and now as a pizza crust. I experimented with a few other pizza and focaccia recipes also from The Joy of Gluten-Free, Sugar-Free Baking and decided that the toasting bread can’t be beat. It is not a spur-of-the-moment-throw-together crust, but you can make a big batch and put them in the freezer to pull out and use anytime. Weigh, calculate your toppings, and put it in the oven until the cheese is bubbly and the crust is warm. Easy as pizza pie.

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Toasting bread and pizza crusts from the same batter.

We are on spring break right and it’s been pouring rain all day, so I spent several hours baking. It is nice to get ahead by having a few items in the freezer for quick meals. Nora asked for toasting bread again and I have found that I like to make it in a small loaf pan instead of the full-sized pan. This time I made a full recipe, put 1/2 of the batter into the small loaf pan, and made the rest into 12 pizza crusts. Because I’ve figured out the nutritional information per baked gram of bread (see original post) I didn’t pre-weigh the crusts. I can just weigh them before using them and build the meal around it.

I like making this bread recipe because it doesn’t require whipping the egg whites until stiff and carefully folding in the other ingredients. It all just goes into the mixer and it is soft and sticky enough to work with. It puffed up surprising nicely in the oven. Each baked crust is solid enough to hold up, not at all crumbly, but with a nice bready texture and nutty flavor.

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When I experimented with the other crust recipes we had some fun by pressing the dough into gingerbread cookie cutters. Instead of rolling out the dough and cutting out pieces, I pressed the dough into the shapes and then carefully removed the cookie cutters, using a small rubber spatula to keep the edges in shape. That was fun and Nora liked topping them herself. They are very small, so bigger kids might get 2!

IMG_2967When I figure out the full pizza meal, I weigh out all of Nora’s pizza toppings onto a small plate and let her build her own pizza. She loves the chance to work with her food and make it her way. She also nibbles on the toppings and licks her fingers, a rare pleasure for a keto kid! Because it is all allotted to her meal, it doesn’t matter whether she puts it all on the pizza. I just try to remind her to put enough on her pizza to enjoy it when it comes out of the oven!

It is especially nice to have a pizza crust that can be sliced and eaten in pieces, and will stand up to being carried around. We took an outing to our favorite local pizza place and brought Nora’s pizza along with us. It was a treat to eat out together, which is pretty rare for us. A pizza crust that transports well while still being delicious (not just edible) is a special thing.

Keto Valentine’s Day Love

Nora woke up yelling “Valentine’s Day!” She loves love. She made her own Valentines for all of her classmates after being inspired by the card she received from Grandma Sheryl. She started with making a heart, and wrote “Happy Heart Day” and just kept rolling until she made one for each member of her class! I only helped with the heart shape, otherwise it was all-Nora.

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For a little extra special keto treat to bring to school, I melted her daily B^3 and poured it into a heart-shaped silicone cup to re-harden with the apples on top. I also made a “cookie” of ground macadamia-coconut oil-blueberry to solidify in another heart mold. Easy!

Her teacher sent home a note asking the kids to bring cards to exchange, but she didn’t really specify that candy was not welcome. I’m sure Nora will see some candy today, and we’ve had a talk about it. As an alternative, I made some Lego-guy chocolates from the Charlie Foundation’s Chocolate Candy recipe (with video!). I added a drop of peppermint extract to one batch for a twist. Unfortunately the heads fall off when they pop out of the mold. Good thing they are not long for this world anyway.

Happy Valentine’s Day! Spread the keto-love!

Blueberry Almond Muffins

Snow days! Two days off school leading up to a weekend, playing in the snow and lots of together time means baking time to keep everyone happy and satisfied.

IMG_4517Nora requested toasting bread for PBJ sandwiches. Anders requested blueberry muffins. But I knew that once Anders had blueberry muffins Nora would want blueberry muffins, so I pulled out The Joy of Gluten-Free, Sugar-Free Baking and tweaked their recipe for Blueberry Hazelnut Muffins to make everyone happy.

And oh. my. good. ness. They are so good!

I made one batch (below) and took out enough batter for 3 muffins for Nora, in pink and purple silicone muffin cups. Then I put a bit of sugar into the leftover batter for the rest of us and re-mixed, added in the blueberries, and put ours in yellow and green silicone cups. They are nutty delicious, either warm and cold.

I’m also sure that the original recipe using milk of any kind instead of heavy cream would also be very good. If you’re into that kind of thing.

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Nutrition information for one Blueberry Almond Muffin, by www.caloriecount.com

Blueberry Almond Muffins
(makes 10 muffins)
90 g raw egg (2 eggs)
115 g (1/2 C) Organic Valley Heavy Whipping Cream
7 g (1.5 tsp) vanilla extract
5 g (1 tsp) lemon juice
85 g (3/4 C) Bob’s Red Mill hazelnut flour
85 g (3/4 C) Bob’s Red Mill almond meal/flour
30 g (1/4 C) slivered or sliced almonds
6 g (1 Tbsp) baking powder
3 g (1/4 tsp) salt
40 g frozen blueberries (1/4 cup, or more if diet allows)

Measure egg, cream, vanilla and lemon juice into mixer. If you want to add some liquid stevia or other carb-free sweetener, add it now as well. Mix thoroughly on low in electric mixer, or by hand.

In a separate bowl, combine nut flours, almonds, baking powder, and salt. If you want to add a powdered no-carb sweetener, add it here. Mix well. Add the dry ingredient mixture to the wet ingredients and mix on medium very well, one to two minutes. You want to beat a little air into it to fluff up your muffins. These ingredients are a lot of heavy lifting for the baking powder.

Measure 43 g of batter into each muffin cup. Then add 4 g of frozen blueberries to each cup, pushing them into the batter and smoothing over the top.

Bake at 350° for about 35 minutes or until golden brown on top and springy to the touch.

IMG_1401These are 2.17:1 ratio. Served with 25 g Organic Valley Heavy Cream plus 1 drop of vanilla flavoring and a thinned with a bit of water to make “milk” for a 3.5:1 ratio.

Now we are snowed in and need more baking supplies to make more of these! They will go too fast!

 

Almond & Orange Florentines

I like to cook, therefore I like to listen to the Splendid Table. When I saw this Almond Florentine recipe on their website, I knew it would be keto-possible. Worked like a charm!

IMG_4313It is so easy, delicious and look at that fancy little cookie. Who could resist? It was a simple way to make an elegant holiday treat for Nora, and a batch with a little sugar for the rest of us!

A tip of you are making them for the whole family: reduce the sugar by at least half. I reduced the sugar a bit, and found them very very sweet. The orange still comes out, but I would like to taste the almond flavor too. The sugar is only for flavor, because Nora’s came out fine with no sugar at all.

One more tip: Kids like to zest oranges with a cheese grater or zester. Anders did the whole orange for me. Just make sure that they get the colored peel and avoid the white pith. Get them busy in the kitchen!

Nutrition information for 1 almond florentine cookie (recipe makes 10). Nutrition information provided by www.caloriecount.com

Nutrition information for 1 almond florentine cookie (recipe makes 10). Nutrition information provided by www.caloriecount.com

Almond & Orange Florentines
(makes 10 servings, 1.43:1 ratio)
30 g Egg whites
100 g Sliced almonds
2 g Orange zest

Preheat the oven to 300°F. Line a heavy baking sheet with a silicone mat or parchment paper brushed lightly with vegetable oil.

Measure and briefly beat the egg whites. Then gently mix them with the sliced almonds and orange zest. Measure 13 g portions of the mix to make little mounds on the lined pan, spaced a bit apart. Dip a fork in a small bowl of water and flatten each mound. Make them as thin as possible without big gaps between the almond slices.

Bake for about 12 minutes, until the cookies are golden brown. Cool completely before serving.

Nora's cookies on left, rest of family's on the right.

Nora’s cookies on left, rest of family’s on the right.

You can add a drizzle of high-quality dark chocolate for extra flavor. I use Green & Black’s 85% dark chocolate. Melt a square in a small silicone pinch bowl by putting it in the microwave for 30 seconds. Check and microwave again briefly if necessary to melt it.

Put one cookie on the gram scale and tare it. Drizzle the melted chocolate on to the cookie until you reach the desired amount. I used 1.5 grams of chocolate on Nora’s, which added 0.41 g carbs, 0.15 g protein, 0.75 g carbs (9 calories, 1.33:1 ratio).

The ratio is very low for her, so we make “hot chocolate” out of heavy cream and a pinch of cocoa powder, steamed with the espresso machine’s attachment. Lovely holiday treat.

Popcorn!

Nora gets popcorn! What a revelation! I read on another keto-mom blog that popcorn was her son’s favorite snack, and I was kinda like “shyeah, right. Not gonna work for Nora. Too many carbs.” Sorry I doubted you Sara. Now I’m with it.

I did look up the nutrition facts on popcorn after I saw that blog post and still thought that it wouldn’t work easily. It didn’t have as much fiber as I expected, and Nora could probably only have a few grams. I thought that her few grams would just look pathetic next to a serving that the rest of us would get. And I didn’t have any popcorn in the house, so that was also a big barrier to trying it.

I was motivated to try it again because her class is having a popcorn party tomorrow for their accumulated good behavior. I bought some popcorn to test it out. Super easy way to make plain popcorn for everyone: put some plain kernels in a small paper bag and microwave it for a few minutes, take it out when the popping slows down, or it will burn. That’s it! You will never eat that chemical-laden microwave popcorn again!

For tomorrow’s popcorn snack, Nora will get:
4.5 g popcorn
5.5 g butter (melted on and drizzled on popcorn)
5 g melted coconut oil mixed with 8 g ground macadamia nuts and a drop of banana flavoring, chilled to make a “cookie”

IMG_4310

162 calories
3.3 g carb
1.2 g protein
16 g fat
1.3 fiber
3.5:1 ratio

And look at all that popcorn! A near proper bowl! It is super carby per gram, but it’s so light that you get a lot of popcorn per gram. That’s the key to success.

This will be her morning snack at school when everyone has popcorn, so we will load her breakfast with protein and very little carbs so that she is evened out by lunch. She is excited! And it sure helps that she is up to 14 g carbs per day, on her way to 16-17 g. We can easily squeeze in a few extra carbs with snack.

I am sure that popcorn will also become a favorite snack for Nora too.

The simplest keto meals

Ted here. This post is about the very simplest keto meals. Especially from the perspective of the secondary cook.

Christy is a food wizard. She gets food. She can create new things from basic components. She can produce batches of treats for Nora that we can use over the week. That is not an area of significant competence for me, but I can certainly make simple keto meals for Nora. So what do we do when energy and time are low, more complex treats are not available, and Nora needs to eat? Here is our most basic template for an easy lunch (or dinner).

Base:
Start with a base of avocado. Avocados are stellar. They are at about a 3.5:1 ratio on their own, plus they are fibrous. They can be simply diced, or spread as butter. We’ll generally start with 20 to 30 grams of avocado for a meal. Macadamia nuts (see more on them below) can also serve the role of a meal base. Both avocados and macadamia nuts work well to start the meal calculation because they are both high ratio, and give you a solid start on all four of the major constraints: carbs, protein, fat, and fiber.

Carbs:
The major sweet parts of the lunch come from apple, red pepper, carrots or berries (e.g., blueberries, strawberries, and raspberries). Peppers and raspberries get priority because of their high fiber and low carb content (relatively). Apples, blueberries, strawberries, and carrots pack much more of a carb punch, so those are added if the other major constraints are met and there is still a bit of carb to give. Generally there will be 5 to 30 grams of total fruit, depending on the mix.

Protein:
Cheddar cheese is the primary protein base. Nora likes it, it is easy to cut and weigh, and it has a good amount of fat too.  It is versatile too in that it can be served sliced, cubed, shredded, melted, or melted and reformed.  Something like 10 grams to 20 grams is typical. Sliced turkey and ham are also popular. Ham is nice because it has some fat. Sometimes we’ll put cream cheese and butter on the sliced meat and roll it up to get more fat in there.

Fat:
Cream is our primary fat, either mixed with water and a few drops of vanilla flavoring to make “milk,” or steamed in our espresso machine with a pinch of cocoa powder. The amount of cream will be between 10 and 40 grams, depending on what else is in the meal. We’ll might also look for opportunities to put butter on or in things. The other two big fat delivery mechanisms are macadamia nuts and kalamata olives. Those are especially nice if I want to avoid liquids (i.e., cream) in the meal, for example, with a packed lunch. Macadamia nuts do have some carbs, so it will use up some of that allotment, but their high fat and high fiber content provide a significant tradeoff for that. Kalamata olives are one of very few foods that have both fat and carbs, but no protein, so they make a natural keto complement to meat and cheddar. However, they have no fiber.

Fiber:
The fourth constraint. Generally I check for fiber when I am satisfied with the amount of carbs and the ratio of the meal. If the fiber content is too low — we shoot for about 11 grams of fiber for Nora over the day — then I’ll circle back and see if I can trade something out for more raspberries, macadamia nuts, or Flackers. Flaxmeal is another option, and can be mixed in with any butter in the meal.

Variety:
Lastly, we’ll check to see if there is a reasonable variety of textures and tastes. Meaning, is there something creamy and something crunchy? Is there something sweet and something salty?

A typical, very simple lunch:
8 g apple
15 g avocado
15 g cheddar cheese
8 g Flacker with 8 g butter
15 g macadamia nuts
13 g cream with water and vanilla flavoring to make “milk”
—————————
3.52:1 ratio
2.5 g carbs
6.9 g protein
33.1 g fat
4.4 g fiber
336 calories

At the bare minimum, if I have avocado, cheddar cheese, raspberries, and cream, I can cobble together the most basic tasty meal that satisfies all the constraints. Add some sliced meat, other berries, apples, peppers, carrots, cream cheese, macadamia nuts, kalamata olives, and Flackers, and we can switch things up enough to keep the simple meals interesting from day to day.

Blueberry Panna Cotta

Oh panna cotta! Where have you been hiding for the last 2 years? Why has it taken so long to discover you?

I’ve been a little obsessed with a cookbook put out by a fabulous restaurant in Portland, Toro Bravo. I haven’t even eaten there personally, but I’ve heard a lot about it. One of my life goals is to eat there. It’s 2 hours away, and often a 2 hour wait. It’s an attainable life goal; I like to have a few like that.

I’m reading this amazing, honest, detailed and hilarious cookbook, which has all of 7 dessert recipes, and start reading about panna cotta. John Gorham, owner, chef and author (who is free with cussing), tells about tasting the best ever panna cotta made by a pastry chef he worked with. The pastry chef replied:

This is the simplest recipe known to man. You can’t fuck it up. You can’t make it not amazing. It has four ingredients and takes five minutes and is foolproof so long as you pay attention.

Nora's Thanksgiving panna cotta, extra fancy.

Nora’s Thanksgiving panna cotta, extra fancy.

I’ve made custard. I’ve made ice cream. I’ve heated and stirred and cooled cream-based desserts. Panna cotta means “cooked cream.” I just assumed that something so Italian and so revered had to be difficult. The secret is out, and I’m making panna cotta. It was our Thanksgiving dessert.

The beautiful thing about panna cotta is that it doesn’t require sugar to make food-science magic. For ice cream, you need sugar to lower the freezing point. In baked goods, sugar plays a role in texture. In jams it makes the pectin gel. But all panna cotta really needs is cream and gelatin, and it gives back a soft luscious creamy dessert that can be flavored any way you want it.

The Toro Bravo recipe calls for gelatin sheets, which he claims are the key to success but require attention to detail. Contrary to the pastry chef’s opinion, it is “fuckupable” (his word, I’m just quoting here). I couldn’t find gelatin sheets at our fancy grocery store and I’m an old hand at powdered gelatin, so I found a recipe from another of my favorite chef-bloggers, David Lebovitz (and his recipe). He uses powered gelatin, and that’s good enough for me.

I’m up to 6 ingredients here. You have to use water with the powered gelatin, so that adds 1. I also included a bit of that whey protein I’m trying to use up. This recipe has so much fat that adding enough berries to get it to a 3.5:1 ratio was a heck of a lot of carbs at a time for Nora. The whey protein is undetectable in the panna cotta, but provides some needed protein to lower the ratio.

I used blueberries because Nora loves them and they are beautiful, but you can use any berries you like. Just adjust the amount of berries to get the correct nutritional breakdown. Blueberries are the highest-carb berry that we use, so if I substituted strawberry or raspberry it would be even more berrylicious!

Nutrition information for 1 serving of Blueberry Panna Cotta (recipe makes 8 servings). Nutrition information by www.caloriecount.com

Nutrition information for 1 serving of Blueberry Panna Cotta (recipe makes 8 servings). Nutrition information by www.caloriecount.com

Blueberry Panna Cotta
(makes 8 servings)
250 g Organic Valley heavy whipping cream
180 g Frozen blueberries
3 g Vanilla extract
2 g Gelatine powder
40 g Cold water
4 g Ultimate Nutrition whey protein powder

Warm and cream, vanilla and blueberries together in a small saucepan until the blueberries start to give up their juice and all is warm. Blend and mash them together so that they are well distributed.

When making a batch recipe, I’m concerned that one of the servings will be carb-heavy and often add the carb component separately to each serving. You can certainly warm the blueberries separately and divide them evenly on top of the cooled panna cotta, which I would recommend if your kid is very sensitive or just starting the diet. You need to be sure that every serving is what it says it is. I’m now comfortable doing this for Nora, but I was not always and I’m still careful.

Measure the cold water into a medium sized bowl, so that the water is broad but not very deep. Evenly sprinkle the gelatin powder over the surface of the water and let it sit, undisturbed, for 5 to 10 minutes.

If you want to be able to turn your panna cotta out on to a plate to serve, lightly grease 8 small cups with coconut oil. I just served ours in the cups. We used wine glasses for our fancy Thankgiving dessert, but I did the rest in ramekins and small tea cups.

Pour the warm cream mixture into the water and gelatin and stir well, so that the gelatin can dissolve completely and evenly. You won’t be able to tell, so stir a little longer than you normally would just to be sure.

Divide evenly into the 8 prepared cups, about 60 g each. Depending on how long you warmed the cream, you might have lost a bit of water. You could measure them at 59 g each to be safe and not come up short. If you incorporated the blueberries into the cream, make sure you get about the same number of chunks in each cup (this will depend on how big your blueberries are. If you are really uptight, count them and divide by 8!)

Chill for at least 2 hours to set until firm. If you make David Lebovitz’s recipe for the rest of the family, I think he skimps a bit on the gelatin, or ours just had to sit much longer to get a firm gel. Add a bit more gelatin than he suggests if you want to be able to eat it sooner rather than later.

One last tip: If your cream is clumpy and separated, you will probably get a thin layer of grainy butter at the top of your panna cotta. It’s doesn’t ruin it, but you should know. Keep the lumps out if you can.