Liver and Onions

Some people hate liver. My wife does not care for organ meat. She would rather die than eat a filtering organ. Me, I like offal of all kinds: liver, kidneys, sweetbreads, heart, tongue, gizzards. Bring it on. It's a shame you can't hardly find it any more at the grocery. We do see kidneys once in a while. Liver--beef liver--seems to be the one consistent exception to the new rule. Occasionally calve's liver. But usually it's hidden in the freezer section.

This particular liver is special. It comes from our dairy, Smith Mountain Creamery, which sells a wide variety of meats. The beef is from their own dairy cows. Lamb and pork they obtain from other farmers in the area. Especially if you are trying to save a penny, it's hard to resist liver.

My favorite way to prepare liver is still the classic diner version. First caramelize a skillet-full of onions. Then drop a dollop of butter in the pan, raise the heat and cook the liver fairly quickly on each side. Unless it is a very thick slice, it will be done in just a couple of minutes. I prefer mine with just a hint of pinkness in the center, not always an easy thing to achieve. Serve immediately.

Exhibit A

Regard, the belly.

Belly fat is now considered a harbinger of heart disease, along with high blood pressure and high cholesterol. Since I have all three, and since I am of an age when these things become a real concern, and since my father recently experienced quadruple bypass surgery, I have decided to restrict carbohydrates from my diet and lose 35 pounds. Or even a little more.

This picture was taken yesterday, eight days after I started my new food regimen. I've lost eight pounds (about one pound per day) while attempting to get "ketotic," that state when the body, deprived of carbohydrates, thinks it is starving and begins digesting its own fat. I now weigh 210 pounds. My goal is 180.

I wish I had had blood work performed immediately before I took the low-carb plunge. My previous results, from December 2007, showed a total cholesterol level of 201, with HDL (good cholesterol) at 43 and LDL (bad cholesterol) at 122. My total triglycerides were 178. My most recent blood exam was a week ago, or more than a year after I started taking Liptor to reduce my cholesterol and four days after I started the low-carb diet. It showed that my total cholesterol had actually risen to 211. My HDL had slumped slightly to 41, while LDL had gone up to 149. But I was very glad to see that my triglyceride level, a very real measure of cardiac risk, had plummeted to 103, a drop of 42 percent.

Naturally, my doctor was less interested in my triglycerides than increasing my dosage of Lipitor and getting me to eat less fat. You can hardly blame him. The current dogma of the medical establishment is that fat raises cholesterol and needs to be treated with a statin drug such as Lipitor. But in fact this is merely a hypothesis. Doctors still doesn't know exactly what causes heart disease or what role cholesterol--especially dietary cholesterol--might play. I am convinced that carbohydrates, because of their singular relationship with insulin and the way the body stores fat, is the greater culprit.

In fact, 80 percent of cholesterol is produced by our own bodies, in the liver. The extent to which we produce our own cholesterol and what our bodies do with it is largely a matter of genetics. We can't change genetics. But that leaves only 20 percent of cholesterol related to what we eat. I am more inclined to believe that the huge effect that carbohydrates have on insulin production, and the direct relationship between insulin and body fat, outweighs the 20 percent of cholesterol that we control with our diet.

The American diet has become a runaway buffet of carbohydrates based on a government-subsidized glut of corn and other grains. Walk into any supermarket and you can see it: aisle after aisle--floor to ceiling--of carbohydrates in a thousand different manifestations. Kids go to school on a breakfast of potato chips and high-fructose corn syrup. Our most popular vegetable by far is the potato, usually in the form of French fries. We are a nation of irrepressible snackers. Call it the Great Carb Addiction.

The problem is that all those carbs force the pancreas to work overtime making insulin. Insulin turns the carbs into glucose for energy, but if we already have enough glucose, the sugar gets stored as fat. Accumulated fat presses on the organs, causing high blood pressure. Pretty soon you're looking at cholesterol out of balance followed by insulin resistance and diabetes.

Sharply reducing carbohydrates brings insulin back to a sane level. Although it sounds counterintuitive, a body deprived of carbohydrates and in a state of ketosis will actually process fats out faster than they come in. A metabolic transformation occurs. You can consume more calories and continue to lose weight. But it is common for people who eat a high-protein, low-carbohydrate diet to consume fewer calories than before, even when they are told they can eat all the steak and pork chops they want. The reason is, you don't feel as hungry when you stop eating carbohydrates. I know that in my own case I am rarely hungry any more since cutting back sharply on my carb consumption.

"You ought to add up the calories in all the food you eat all day. I think you'd be astounded," my wife was fond of scolding me. That's because I was always snacking on something, usually some form of carbohydrate. And since I work at home, food is never far away. Well, I never did add it all up. But I know I am eating much less now and the cravings have disappeared. Carbohydrates are a bad habit.

Nine years ago I stopped smoking. It wasn't easy, and the final cigarette was lit only after years of trying to quit. I'm hoping that as a result of this new approach to food, and a better appreciation for the sinister effects of a carb-rich diet, I will soon break the carbohydrate addiction as well.

Note: A healthy level of total cholesterol is considered to anywhere from 100 to 199; HDL 40 to 59; LDL anything under 100. Triglycerides, according to current thinking, should be less than 150. All measurements are milligrams per deciliter. Also, the suggested healthy ratio of triglycerides to HDL cholesterol is anything less that 5:1.

Breakfast

Poached eggs with fresh sausage patty and braised greens.

Preparation time: 10 minutes

Shopping: None

A high-protein, low-carb breakfast for me means two eggs. I prefer them poached to avoid the greasy cleanup from fried eggs. As you can see, I also like my yolks runny.

In the past, I used toast to sop up the yolks and I was mighty frustrated for a time chasing the yolk around the plate without that handy piece of browned bread. Then it occurred to me to add some greens from our own garden to the plate. They do an excellent job of mopping up all that delicious yellowness, so full of beneficial omega-3 fatty acids as they come from eggs laid by hens that forage outdoors on a local farm.

My method of poaching eggs is to heat water in an iron skillet, season with white vinegar and bring to a strong simmer. I crack the eggs and release them gently into the water. Fresh eggs will hold together very well. (Old eggs tend to break apart--not good for poaching, better for hard-boiling.) After a few minutes, I remove the eggs with a slotted spoon. You can pat them dry with a paper towel--or not.

The greens were harvested last year and blanched before being frozen. After defrosting, I simply cook them in salted water until tender, then dress them with a bit of vinegar. Two years ago we helped slaughter pigs on our friend Brett's farm and came away with many pounds of sausage and sausage meat. The meat had been at the bottom of the freezer. We made several different kinds of sausage that year and I'm not sure which this is. I neglected to label it. A sandwich-size package made six patties that I baked off in the oven and have been eating over the last week.

This is the kind of breakfast that gets me out of bed in the morning.

Embracing Ketosis

Deny the body carbohydrates and it goes into starvation mode. It starts digesting fat already stored. This can be a problem for dairy farmers. If cows don't get enough feed when they start lactating, they can develop "fatty liver" disease from all the fat their body metabolizes. It can be a very serious problem for Type I diabetics as well. The blood becomes dangerously acid, to the point of being life threatening. My diabetic wife, once sick with flu and unable to keep food down, had to be hospitalized and sustained intravenously.

Actual starvation will bring on this condition as well, called ketosis. It's a natural self-preservation mechanism: faced with a lack of food, the body begins to feed on itself, starting with its stores of fat. More than 100 years ago, the medical profession discovered the carbohydrate trigger. Denying carbohydrates to induce ketosis became an extreme form of dieting.

Carbohydrate abstinence remained more or less in the background until a certain medical doctor specializing in alternative healing, Robert C. Atkins, made a fortune advocating a way to lose weight fast and remain slim on a reduced carbohydrate regimen.

We here at The Slow Cook disdain fad diets and generally reject "dieting" in favor of consuming a wide range of healthful foods. We grow plenty of our own and enjoy playing with our food in the kitchen. We're not purists, and we sometimes eat more than we should, but we try to stick with foods you might call "natural" or "real" over those that have been manufactured or processed in a factory. But as I settle into middle age, and after taking the tender remonstrations of my spouse into account, I have decided that a fat belly, high cholesterol and elevated blood pressure require a closer look at my diet. To give myself a better chance at seeing grandchildren, I've decided to give up carbohydrates and go ketotic.

At least temporarily.

For all his trouble, Robert Atkins was tarred for not being able to produce scientific proof supporting the safety and efficacy of his diet. The "Atkins Diet" was ridiculed by people who thought it was all about gorging on bacon and eggs. In fact, that's not what the Atkins Diet is about. It is about ketosis as a first step toward mitigating the effects of too much insulin coursing through the body, storing fat everywhere, as a result of too many carbohydrates in the diet. Many others have written about the carbohydrate effect. Michael R. Eades and Mary Dan Eades, for instance, have authored some of the most compelling works on health and nutrition I have seen, all centered on the dangers of carbohydrate-induced insulin in the body.

I won't bore you with a lecture or a scientific treatise here. I'll save some of that for later. Feel free to read more about it yourself. Meanwhile, I'll leave you with a few bullet points that I hope explain in general terms what my detour into the world of ketosis and carbohydrate abstinence is about:

* This is not just a vanity issue for me, but a matter of facing up to certain glaring indicators of potential heart disease and premature death. Over the coming weeks and months, I hope to get back to my college trim, which means dropping between 30 and 35 pounds and learning to keep it off.

* I am satisfied that ketosis brought about by abstinence from carbohydrates does not pose a danger to my health. I am monitoring my weight and blood pressure daily. My hope is that losing weight will reduce my blood pressure enough that I can discontinue the blood pressure medication I am currently taking. I will be consulting with my physician about this, as well as about certain potassium issues that arise with blood pressure medication and carbohydrate withdrawal.

* For the time being, my diet will consist almost entirely of proteins. I will not be eating breads or pasta or potatoes or cake or fruits or juices at all. My daily carbohydrate intake for at least the next two weeks will be about 20 grams, approximately the amount in one oatmeal raisin cookie.

* It's true that this style of eating incorporates lots of animal fats along with "good" fats such as extra-virgin olive oil. The human body historically has an amazing ability to put these lipids to good use when carbohydrates are out of the picture. I will be losing weight--not gaining it--and my cholesterol levels should go down, not up. That's the wonder of eliminating much of the insulin the pancreas produces when we are consuming too many carbohydrates.

* Over hundreds of thousands of years of evolution, humans ate meat and fats whenever they could get their hands on it, along with a wide variety of low-carb berries, nuts and seeds. And they were healthier. It wasn't until grain cultivation came onto the scene 10,000 years ago--practically yesterday in evolutionary terms--that humans developed a hankering for a carbohydrate diet. Now we are surrounded by carbohydrates and we can't get enough them. We are practically addicted to carbohydrates, whether in the form of french fries or potato chips or sodas or fruit drinks or cakes or candies. Nearly everything in the supermarket is loaded with carbohydrates, resulting in an epidemic of modern diseases: obesity, diabetes, hypertension, cardio-vascular disease. For this we can thank an agriculture and food matrix-- subsidized by our tax dollars--that thrives on a glut of cheap corn and other grains.

* Protein and fats are essential for survival. Our bodies cannot function without them. Carbohydrates, on the other hand, are--nutritionally speaking--absolutely unnecessary. We would do fine without carbohydrates. Think of the Eskimos, who survive on seals and whale blubber and fish.

* I'm beginning to think that what this country needs it not so much tweaking around the edges of its agriculture policy as an all out war on insulin levels nationwide. Let's get carbohydrates out of the nation's schools, and stop encouraging kids to follow a food pyramid based on grain products. Let's stop training children to be our future diabetics and cardiac patients.

Today I begin Day 3 of the new regime. Yesterday I had fried eggs and sausage for breakfast, salmon salad and avocado for lunch, a snack of oily sardines and a few almonds. Dinner was soy-glazed chicken breast with mustard greens. So far I feel fine and I'm looking forward to devising more high-protein, low-carbohydrate meals. I promise I will update you with important details as developments warrant.