(Not to be confused with either Dietary Ketosis or The Ketogenic Diet; refer Diet page)

The following information has been supplied to me by a team of Dietitians who have visited Professor Ezrin's Clinic in the United States. It is designed as a general guideline only. For more information, ask your doctor, or you should book in to see the dietitians. Many with IR respond to the Insulin Aware diet, but others, need to follow Ezrin's diet which achieves Dietary Ketosis The following are some notes to be read in conjunction with the A&C Insulin Aware Diet reproduced below.

i) The first paragraph is aimed at removing simple and refined carbohydrates from the diet. I would suggest that you completely avoid those foods listed in the lefthand column. Instead you choose foods from the righthand column in paragraph 1 but note that you must include protein foods whenever possible. If you must have a snack you must include protein foods whenever possible. If you must have a snack between meals then I would urge you to have a small piece of cheese and lettuce or a stick of celery with sugar free peanut paste or cream cheese wiped into the groove. Do not have a biscuit or bread or cake between meals.

 ii) The protein foods are listed in paragraph 3. You will notice that the diet includes both cheese and eggs. Many are concerned about cholesterol. The cholesterol in your blood comes not only from the cholesterol in the eggs, butter, fat and cheese that you eat but is also made from the simple carbohydrates in your diet!! A muesli bar, white rice and noodles are all rapidly turned into fat and cholesterol in your body under the influence of the metabolic changes associated with insulin resistance. Eggs have received a bad press but if you buy nothing else that is "organic", buy & eat only organic eggs; not free range eggs - that makes the hens happy & healthier but if the hens then go into the hen house & eat laying mash which contains blood & bone, then those eggs contain the fat, virtually unchanged from the animal fat in the blood & bone from the abatoirs!! An excellent breakfast or you is 1 egg either boiled or scrambled with 1 slice of rye or multi-grain bread.

iii) In the second paragraph you will notice that you should choose unprocessed slowly digested carbohydrate. Where it says "limit quickly digested carbohydrates" I would suggest that you avoid these until your symptoms are under control. Do not eat any potato, white rice, white bread, ordinary pasta or noodles. Only eat the wholemeal pasta, brown rice, rye and multi-grain bread.

iv) Moderate your intake of saturated fat but you can use olive oil or other vegetable oils in cooking but remember that they are high in calories and are in themselves fattening.

v) Eat lots of vegetables and salads but only have one piece of fruit daily after a main meal; not as a snack.

vi) Also obtain "The Sugar Free Book" available from Dymocks Standard Book in South Australia telephone 08 82235380. FAX 08 8223 5539. An alternative for breakfast is homemade muesli. The recipe for this is in The Sugar Free Book. The muesli should contain rolled oats which are uncooked. Do not buy ready prepared muesli as this has been roasted and is too easily digested. The muesli should contain nuts, almonds and seeds as set out in the recipe for "no sugar muesli".


1.1 Enjoy a diet low in simple/refined carbohydrates. For example limit or avoid these simple/refined carbohydrate foods:- 

Sugar, white, brown, raw, icing, honey

Spreads: jam, marmalade, nutella, syrups

Confectionary: lollies, cough drops, chocolate (even carob or

'diabetic'), muesli/health bars

Sweet biscuits and cakes: cream, chocolate, shortbread, doughnuts, sweet pastries

Sweet desserts: cheesecake, puddings, flavoured yoghurt, fruche, ice-cream, ice-cream toppings, jelly, fruit in sugar syrup, fruit pies

Sweet cereals: cocopops, honeysmacks, nutrigrain, some mueslis, sultana bran etc

Sugary drinks: cordial, soft drink, flavoured mineral water, fruit juice drinks (even "no added sugar" varieties), flavoured milk, milkshakes, sweet wine/sherry/ports, liqueurs, ordinary beer.


1.2 Some good alternatives (eat with protein foods whenever possible)

Tablet, liquid or powdered artificial sweetener

Low joule jam/marmalade, vegemite, promite, meat/fish paste, peanut paste

Low joule pastilles, artificially sweetened chocolate, no sugar boiled lollies

Scones (including whole) wheatmeal or coffee biscuits 'no added sugar' fruit loaf, crispbreads, cruskits, crackers

Low joule jelly, fresh/tinned/stewed fruit (without sugar), plain or artificially flavoured yoghurt, custard or junket made with rtificial sweetener, Dairy Bell Lite Ice-cream, 'no added sugar' instant desserts, low joule ice-cream topping Low sugar, high fibre cereals et porridge, Guardian, all bran, sugar free muesli

Low joule cordial/soft drink, plain mineral or soda water, coffee, tea, herb teas, artificially sweetened flavoured milk, dry wine or spirits, light beer (small amounts).


2. Choose unprocessed, slowly digested carbohydrates

These foods include oats, barley, buckwheat, bulgur, rye/multigrain bread, brown rice and wholemeal pasta. Limit quickly digested carbohydrates like potato, white rice, white bread, wheat based products and ordinary pasta and noodles.

3. Include protein at every meal.

Protein foods include seafood, lean beef, pork or lamb, chicken, ham, cheese, yoghurt, cottage/ricotta cheese, eggs, beans, lentils/legumes, nuts and seeds, tofu and tempeh.


4. Moderate your intake of saturated fat.

Some good ideas include choosing low fat dairy foods, trimming the fat off your meat, using low fat cooking methods (grilling, steaming, stir-frying, microwaving) and reducing the amount of butter or cream that you use.


Also: Eat lots of vegetables or salad, and moderate amounts of fruit.

Try to choose a variety of dark green leafy/cruciferous vegetables (eg. spinach, silverbeet, broccoli, cauliflower), orange/yellow vegetables (eg carrot, swede) and other vegetables/salad (eg green beans, lettuce, tomato, onion, mushrooms, capsiciums, cucumber, sprouts, celery). Fruit does contain simple carbohydrate (fructose) - have only a couple of pieces per day.


The performance of a 2 hour glucose and insulin tolerance test, whilst not generally recommended, does help the doctor and patient to understand the mechanisms of insulin resistance and help to persuade the patient to make the necessary changes to diet and lifestyle to achieve control of this ubiquitous and difficult syndrome (see disclaimers below). AG March 22 1999



 Version 1. January 28, 1997.

 "I have been asked to examine the payment of Medicare (Australia) benefits for glucose and insulin assays in relation to allergy; I am of the opinion that currently the matter is sufficiently experimental that benefits should not be claimed; the place of these assays in allergy practice has yet to be defined in accepted medical practice".

Version 2. 1998

"It should be noted that the performance of a 2 hour glucose tolerance test with concurrent insulin levels is acting out of mainstream medical opinion; in generating pathology tests where many peer endocrinologists do not support the need or the appropriateness of such testing, the medical practitioner authorising the test must assume full responsibility for requesting that test. Therefore it is probably wise not to commit Medicare (Australia) to pay for the test until peer support arrives".

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