FAQ's: the diet

Is this the Atkins diet or South Beach diet?

No. The Salad and Salmon diet is based on the clinical research of the Mediterranean diet. The Salad and Salmon diet focuses on emphasizing foods rich in omega 3 and omega 9 fatty acids, lean protein, legumes, and non starchy vegetables. Small amounts of whole grains are permitted. Keep in mind that The Hoffman Center believes in biochemical individuality, not "one size fits all" diets. So, carbohydrate content in the diet is adjusted on an individual basis.

What if I exercise? Can I have more complex carbohydrate?

Those who exercise intensively (long distance runners, cyclists) require more carbohydrate then their more sedentary counterparts. The Salad and Salmon diet is tailored to the individual. Additional complex carbohydrate would be added for very active individuals. Keep in mind that most people don't exercise at a level strenuous enough to warrant increased carbohydrate intake.

Why do you allow unlimited legumes on the Salad and Salmon diet? Aren't beans high in carbohydrate?

Beans are the perfect carbohydrate source. In the journal "Diabetes" a studied indicated that beans were found to offer second meal tolerance. Meaning, having beans for lunch will actually improve glucose response at dinner! This is very important for people with blood sugar abnormalities.

Beans have a very low glycemic load and glycemic index, thus resulting in a very slow rise in blood sugar. The natural combination of protein and carbohydrate with ample fiber is the reason for this blood sugar preserving effect.

Carbohydrate and weight gain depends on insulin, which transports glucose into the cell to be used as energy or stored as fat. The slow rise in blood sugar that occurs when eating beans, results in a slow rise in insulin response.

The combination of protein, carbohydrate and fiber also make beans "self limiting". It is very difficult to over do it with beans. Never have I heard in my nutritional career that a patient was bingeing on beans. They induce satiety pretty quickly.

Further, the fiber (soluble and insoluble) content in beans is wonderful for reducing cholesterol levels, and keeping one's gastrointestinal tract regular and healthy. Remember that good bacteria in the colon utilize fiber to form butyrate, which is transformed into the cancer preventing compound called butyric acid.

That's not all, the latest research says that the pigment in black beans makes them one of the most powerful antioxidants in the human diet!

To sum it up, beans control blood sugar, reduce appetite, are loaded with fiber, act as antioxidants and are low calorie. What a perfect addition to one's diet.

What do you mean by limited whole grains?

The Salad and Salmon diet restricts all carbohydrate from grain sources. This value is individualized based on the patient's health, diet, and activity history. However, a good starting point would be consuming no more than 1/2 cup of cooked whole grain twice daily. If you are overweight and struggled for years and feel that you are carbohydrate sensitive, omitting grains completely, or only consuming no more than 1/2 cup of cooked whole grain once per day would be a good place to start.

The impetus behind whole grain restriction returns our focus to insulin and the glycemic load and index. Regardless of the type, whole grains are high glycemic load foods that elicit a strong insulin response. The beneficial nutrients from grains can be found in greater quantities in the whole foods allowed on the Salad and Salmon diet (lean protein, legumes, non-starchy vegetables, nuts, and seeds). Grains are not essential for survival as a species. Paleolithic man consumed diets void of grains.

Shouldn't I be restricting my fat intake?

The fats recommended on the Salad and Salmon diet are healthy fats. Let's examine the two main fats in the Salad and Salmon diet.

Omega-3 fatty acids are unsaturated fats that can lower risk factors for heart disease, such as high blood pressure and cholesterol. Omega-3 fat can also help protect against stroke, diabetes and some cancers, as well as support the immune system. Good sources of omega-3 fats include wild salmon, walnuts and flaxseed.

Omega-9 fats contain large amounts of monounsaturated fatty acids (MUFAs). These fats can help balance blood sugar, and stimulate satiety. Olive oil is rich in MUFAs and antioxidant compounds which can help prevent heart disease. Studies show that diets rich in MUFAs promote health by preventing cancer, heart disease, diabetes, and high blood pressure. Good sources of omega-9 fats include avocado, extra virgin olive oil, macadamia nuts, macadamia nut oil, and grape seed oil.

Isn't a high protein diet controversial? I understand that osteoporosis can be a complication of a high protein diet.

Studies show that a high protein diet can help balance blood sugar, and actually support bone health, particularly when total vegetable intake is increased. Low protein intake can be a risk factor for osteoporosis.

An increase in protein intake has been clinically shown to improve blood glucose response in persons with type 2 diabetes.

Is this a good diet for cancer prevention or for cancer survivors who want to prevent recurrence?

The Salad and Salmon diet is rich in cancer preventing compounds such as indoles, lignans, and phytonutrients. Based on research from Tufts University, a diet rich in these compounds can reduce the risk of cancer. We believe that the Salad and Salmon diet is the best nutritional option for cancer patients. Being rich in the aforementioned cancer preventing compounds is only part of the point. According to clinical research, insulin resistance, and a high glycemic load diet is strongly associated with increased risk for certain cancers such as breast, prostate, and pancreas. This new research on glycemic load gives more insight as to the efficacy of the Salad and Salmon diet as part of nutritional therapy for the cancer patient and a wise decision for the person with prevention in mind.

Is this diet good for diabetics?

The Salad and Salmon diet is perfect for the diabetic patient. The insulin and blood sugar regulating effects of the diet help diabetics maintain control over blood sugar, preventing highs and lows, keeping them in balance for optimal health.

Does this diet help high blood pressure?

High carbohydrate diets can cause elevation in insulin which can make the kidney retain sodium ions, thus raising blood pressure. The Salad and Salmon diet controls insulin levels, and provides ample quantities of blood pressure lowering potassium and magnesium from unlimited quantities of nonstarchy vegetables and legumes. The antioxidant content of the diet helps reduce blood pressure.

How successful is the Salad and Salmon diet for lowering cholesterol?

The Salad and Salmon diet reduces cholesterol in as little as 6 weeks! The healthier fat content, along with high fiber, no sugar, and low starch equals considerable reductions in cholesterol, with preserved HDL (the good cholesterol) levels.

What effect does the diet have on energy, focus, concentration and mood?

The diet is rich in essential fatty acids (EPA/DHA) which have been shown to help balance mood, and focus. The essential fatty acids EPA and DHA support the health of the nerves and brain. Didn't you ever hear that fish is brain food? The blood sugar balancing effects of the Salad and Salmon diet enhance concentration. Overall, the diet increases energy due to the higher protein content, improved blood sugar control, and essential fatty acid content.

What about the Polychlorinated biphenyl (PCB) content in salmon?

The proven health benefits of eating salmon far outweigh the risk of cancer. The Food and Drug Administration says that "consumers need not alter consumption of farmed or wild salmon at this point in time." Britain's food watchdog agency also rose to salmon's defense, saying the levels of pollutants reported are within internationally recognized safety limits.

The Science study found trace amounts of polychlorinated biphenyls (PCBs) in farm-raised salmon. But PCBs aren't proven human carcinogens. Long-term studies of factory workers exposed to high levels of PCBs show that there is no increase in the incidence of cancer. Moreover, contaminant levels in salmon have gone down 90% in the past 30 years.

But even if PCBs were a danger, they wouldn't pose a threat in the quantities in which they are found in farm-raised salmon. The Science study found the concentration of PCBs to be 1.8% of the level the FDA finds tolerable -- an average of 36.6 parts per billion compared with 2,000 parts per billion in the FDA's guidelines. Put this in perspective: If a person eats eight ounces of farmed salmon every week for 70 years, the PCBs would increase his cancer risk by one in 100,000, the Environmental Protection Agency says.

Further, avoiding salmon can actually be bad for public health. Salmon is packed with omega-3 fatty acids, which are proven to reduce heart attacks. Studies indicate that the omega-3 fats in salmon may also be vital to brain development in young children and fetuses, help fight Alzheimer's, and help prevent breast cancer.

Fish labeled Atlantic Salmon denotes that it is farm raised (notice the absence of the term "wild").

Wild (usually fresh frozen) salmon is available at fish stores and some supermarkets seasonally. Certain online companies such as www.vitalchoice.com will ship both canned and fresh frozen wild salmon and other fish. They claim they can substantiate their claims of purity with documentation.

Canned salmon is usually wild. Check the labels.

What about the mercury content in fish?

Mercury content in fish is a serious problem. At the Dr. Hoffman's Practice, we regularly monitor levels of mercury in fish, and provide our patients with the most up to date information. Patients are given a list of fish to avoid, and fish that is considered safe to consume. Wild pacific salmon (also referred to as Wild Alaskan Salmon) is a safe fish to eat. The following list is from the environmental working group (www.ewg.org). This list may be updated, so access the link to keep abreast.

Avoid If Pregnant

Shark
Swordfish
King Mackerel
Tilefish
Tuna steaks
Canned tuna
Sea bass
Gulf Coast Oysters
Marlin
Halibut
Pike
Walleye
White croaker
Largemouth bass

Eat No More Than One Serving From This List per Month

Mahi mahi
Blue mussel
Eastern oyster
Cod
Pollock
Great Lakes salmon
Gulf Coast blue crab
Channel catfish (wild)
Lake whitefish

Lowest In Mercury

Blue crab (mid-Atlantic)
Croaker
Flounder (summer)
Haddock
Trout (farmed)
Salmon (Wild Pacific)
Shrimp

What if I am allergic to shellfish?

Shellfish is not a mandatory part of the diet. There are plenty of other fish, and lean protein to consume it its place.

Aren't shellfish, and especially shrimp, high in cholesterol?

While shellfish are high in cholesterol, they don't raise serum cholesterol levels. They are safe to consume for people with high cholesterol.

How long do I have to be on this diet?

Think of the Salad and Salmon diet as a lifestyle choice. One can easily remain on this diet for their lifetime, since it is very balanced, nutrient dense, and rich in the "right" type of fats.

I've been following the Salad and Salmon diet and have lost considerable weight but I'm still short of my weight goal. What can I do?

First we would need to examine the specifics of what you are eating in a 24 hour period and look for any clues as to why you have hit a set point. The first food group to consider would be carbohydrate. Specifically how much you are consuming per day. Sometimes reducing the amount of allowed whole grains on the Salad and Salmon diet, while focusing in lean protein, healthy fats, and non starchy vegetables can easily stimulates continued weight loss.

Why no mention of calories in the Salad and Salmon diet?

The Salad and Salmon diet is nutrient dense, but not calorically dense. Further, our focus is more on controlling total carbohydrate than total calories. Individuals for which the Salad and Salmon diet is warranted are usually carbohydrate sensitive. Very rarely are calories a factor. In those instances, overindulging in high calorie foods, such as nuts may inhibit weight loss. But those cases are quite rare. In the vast majority of cases patients begin the Salad and Salmon diet and lost weight without really "trying", and never count calories.

Why aren't artificial sweeteners allowed on the Salad and Salmon diet?

The Salad and Salmon diet focuses on whole foods. Man made artificial sweeteners are not recommended on the diet. Our position is that their safety is questionable. Many patients who try artificial sweeteners note an increase in cravings for carbohydrate. For more detailed information on artificial sweeteners please following this link to an article on our website http://www.drhoffman.com/page.cfm/132

What do I do about snacks?

Snacks are allowed on the Salad and Salmon diet. A hard boiled egg, a legume salad, a Granny Smith apple with cashew butter, 2 ounces of mixed nuts, organic yogurt with fresh blueberries are just a few examples of the virtually limitless snack options on the Salad and Salmon diet.

What do I do when I eat out?

When eating out, always focus on protein and nonstarchy vegetables. Grilled or baked fish or chicken with cooked vegetables or a salad with olive oil and balsamic vinegar would be a safe option. Avoid breads, breaded protein, fried foods, and sugar laden desserts.

Is caffeine considered OK on the Salad and Salmon diet?

Though coffee is not directly recommended on the Salad and Salmon diet, switching to decaf would be your best bet. Caffeine is a stimulant which can increase insulin, alter blood sugar, stimulate heart rate, induce insomnia, increase calcium loss, cause rebound headaches or rebound fatigue, and change mood. When giving up caffeinated coffee, always do it over the weekend so you have a few days to recover for the withdrawal effects of caffeine (which usually include headaches).

What about alcohol on the Salad and Salmon diet?

Alcohol is not directly recommended on the Salad and Salmon diet. However, if you drink, minimize consumption (2 to 3 drinks per week), and choose alcoholic beverages that offer health benefits, such as red wine. Red wine is rich in resveratrol, a phytochemical that acts as a strong antioxidant.

On the Salad and Salmon diet, I notice that some food is limited and others are not. Does this mean you can eat as much as you want of the unlimited categories?

Yes, you may consume as much as you desire of the foods that are unlimited (legumes and nonstarchy vegetables).

Where can I find recipes that support my use of the Salad and Salmon diet?

Please follow this link http://www.drhoffman.com/page.cfm/60 to our menu and recipe section which supports the Salad and Salmon diet.

I just started the Salad and Salmon diet and I'm feeling tired and irritable. Is this normal and will it go away?

Though rare, this response is common in people giving up diets rich in sugar and flour products, or after the cessation of consuming a food allergen. This withdrawal doesn't last long and usually passes in two to three days. Hang in there; an increase in energy and well being is on the way!

Am I only allowed to eat "Salad and Salmon"?

No. That is the name of the diet, not the only two choices of food you are permitted. The Salad and Salmon diet is rich in lean proteins (eggs, poultry, lean meat is optional), legumes, fruit, non-starchy vegetables, nuts and seeds, with limited whole grain content.

Is dairy allowed on the diet?

Dairy is a common allergen and should be consumed in minimal quantities. The Salad and Salmon diet allows organic yogurt at the quantity of one cup per day (sugar free), or organic soft cheese such as cottage cheese. Food allergy testing is recommended prior to making dairy a regular food in one's diet plan.

What if I'm an ethical or religious vegetarian?

Though some principles of the Salad and Salmon diet may be applied in a vegetarian diet, the optimal benefits will not be obtainable on a strict vegetarian diet. Options exist for patients to include high protein dairy and egg protein, but the absence of fish reduces total essential fatty acid intake. In some cases the genetic marker APOE4 will necessitate the implementation of a low saturated fat pesco-vegetarian diet.

I'm still confused about the diet; can you please summarize the key points?

The Salad and Salmon Diet

  • no flour products
  • limited whole grains
  • increase olive oil and foods rich in omega 3s
  • no sugar
  • one fruit a day
  • unlimited legumes
  • no hydrogenated fats
  • unlimited low starch vegetables
  • lean protein from fish, poultry, eggs (meat optional)
  • dairy is allowed in minimal quantities in the form of organic yogurt (1 cup per day), or organic soft cheese such as cottage cheese.