This phase offers the opportunity to reintroduce the whole foods that were off limits in the first two phases of the Atkins Diet. While this is good news for those who miss apples, oatmeal and yams, for example, it’s also an opportunity for people to lose the control they have maintained until now. These guidelines, used in concert with a carb counter, should help your patients navigate these tricky waters. Remind them that not everyone can reintroduce these foods; others can handle only small amounts or have them only occasionally. The operative phrase is to proceed with caution.
Higher Glycemic Fruit
A broader array of fruit is the first group of foods typically reintroduced in Pre-Maintenance. Assuming a patient didn’t have trouble with moderate portions of berries, cherries and melon in OWL, she can now experiment with other fruits. Net Carb gram counts vary significantly from one type of fruit to another. If eating any of these fruits arouses carb cravings or triggers unreasonable hunger, advise backing off them for a while before trying again. All fruit is high in sugar and should be treated as a garnish. A good rule of thumb is to aim for just two portions a day. To add “new” fruits to the berries already being consumed, start with small portions (no more than a half-cup) of such relatively low-carb fresh fruits as plums, peaches, apples, tangerines and kiwis. Additionally:
- Avoid the higher carb fruits, at least initially. One small ripe banana packs about 21 grams of Net Carbs and its close relative, the plantain, even more.
- Pass on canned fruit. Even fruit packed in juice concentrate or “lite” syrup is swimming in added sugar.
- Drying fruit, including apricots, raisins (grapes), prunes (plums) and apple slices concentrates the sugars, elevating their carb count. Steer clear of them.
Also continue to avoid fruit juice, which might as well be liquid sugar, with the exception of lemon and lime juice. A cup of unsweetened apple juice, for example, racks up 29 grams of Net Carbs, and orange juice (even freshly squeezed) is a close runner-up. Without the fiber to slow its absorption, fruit juice has the impact of a sledgehammer on one’s metabolism. To consume less sugar and more fiber, advise your patients to have an orange instead of OJ, or an apple instead of apple juice or applesauce.
The second food group typically reintroduced in Pre-Maintenance is comprised of vegetables like winter squash, sweet potatoes and root vegetables such as carrots, beets and parsnips. All root vegetables are rich in minerals, and brightly colored ones are full of antioxidants, but these same vegetables are significantly higher in Net Carbs than foundation vegetables are. Advise your patients to keep portions small, at least initially. Even within this grouping, carb counts vary greatly. Carrots and beets, for example, come in well below corn on the cob and potatoes. And a single serving of cassava exceeds the total carb intake for a day in Induction, with taro a close runner-up.
As the last rung on the Carb Ladder, whole grains are usually the last food group to reintroduce (if at all) in Pre-Maintenance. Ounce for ounce, grains are generally the highest in carb content of any whole food. You’ll note that we refer to this category as whole grains, not simply grains. Oats, buckwheat, brown rice and other whole grains are good sources of fiber, B vitamins, vitamin E and minerals such as zinc and magnesium. But they and products made with them—whole grain bread, for one—come with a high-carb price tag. These foods can be problematic for individuals with a low carb tolerance. They should be introduced with care and, if tolerated, consumed in moderation.
Refined grains, including white rice, have been stripped of their valuable bran and germ. The germ is the seed embryo, which is rich in antioxidants, fatty acids and other micronutrients. Whole grains include pearled barley, bulgur, buckwheat (kasha), rolled or steel-cut oatmeal, quinoa and wheat berries. Wild rice (actually a grass) is also acceptable in this phase. Refined grains are not on the list of Acceptable Foods for Phase 3. Nor are processed foods such as bread, pasta, pita breads, tortillas, crackers and breakfast cereals. Some people can consume some of these foods. It’s essential that your patients carefully inspect the Nutritional Facts panel on all processed products; foods that incorporate grains qualify as minefields. Baked goods made with whole wheat or other whole grains—look for 100 percent whole grain—tend to be higher in fiber and thus lower in carbs, as well as higher in micronutrients. If white flour is the first item on the ingredients list, followed by whole-grain flour, it is not compatible with a low-carbohydrate dietary approach, even in the last two phases of Atkins.