From avid carnivore to vegan (or somewhere in between)?

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  • janejellyroll
    janejellyroll Posts: 25,763 Member
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    Emheia wrote: »
    You can absolutely eat some meat - and anything else you love.

    There is no rule that says you have to 100% commit to a specific diet (unless advised by your doctor).
    I personally LOVE having vegan or vegetarian days/weeks, just because it exposes me to a different type of food than I might normally make otherwise. But you bet I'm still going to enjoy a steak here and there.
    Meat isn't "bad" for you, it just shouldn't be the primary source of your diet.

    You can explore vegan type diets by choosing not to eat meat for certain days, or even just meals. That alone will make an impact on your health and the environment. It doesn't need to be 100%.

    Just a reminder that veganism is an ethical position, so having "vegan days" isn't actually a thing.

    One can absolutely have plant-based days and I know many people enjoy incorporating those into their lifestyle to either explore new foods, change the focus of their diet, or reduce their impact on the environment.
  • kshama2001
    kshama2001 Posts: 27,913 Member
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    CeeBeeSlim wrote: »
    @AnnPT77 - thanks for the tip. I would have never of that.

    @kshama2001 - I add zucchini, green onions, peppers and spinach to one jumbo egg. I could certainly add more fruit and veggies throughout the day. I read something where I could treat more as a garnish - that could help.

    For those or you who gave up all or some meat - how long did it take before you felt different - if at all - and in what ways?

    If I can make it past midnight without snacking on a slim Jim - it’ll be a meat-free day! 👏

    I started reducing saturated fat and increasing fiber two months ago. I essentially gave up red meat and cheese, and increased fish and beans, berries, and other higher fiber foods.

    I immediately felt fuller on less calories, so am finally able to maintain a calorie deficit again.

    (I had changed my eating pattern when I moved in with my OH 4 years ago.) I mostly replaced butter with EVOO, which gives a slight increase in calories. I'm basically eating more Mediterranean style now.

    I made this change due to a medical condition, and am cautiously optimistic about that.
  • kshama2001
    kshama2001 Posts: 27,913 Member
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    CeeBeeSlim wrote: »
    @AnnPT77 - thanks for the tip. I would have never of that.

    @kshama2001 - I add zucchini, green onions, peppers and spinach to one jumbo egg. I could certainly add more fruit and veggies throughout the day. I read something where I could treat [meat] more as a garnish - that could help.

    For those or you who gave up all or some meat - how long did it take before you felt different - if at all - and in what ways?

    If I can make it past midnight without snacking on a slim Jim - it’ll be a meat-free day! 👏

    That's a good array of veggies but I am still wondering about the quantity. What's the total, in grams or ounces?

    Regarding using meat as a garnish, yes, my Thai cookbook seems to do this. In the past, I have doubled the meat and sauce when I make a recipe from it.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
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    lemurcat2 wrote: »
    mariomicro wrote: »
    As a diabetic, I can say that being vegan can be tricky for diabetics because of all the carbs. Vegan protein sources are typically about half carbs. I do have vegan diabetic friends who manage their blood glucose well, but it’s a way of eating that takes some thought, and not automatically healthier for diabetics.

    n=1 experience here. I have a British Asian friend of mine who is t2 diabetic and has become a vegan, not for religious reasons but because his GP convinced him it would be better for him. He has been eating at a caloric deficit for years. His diet is basically porridge, fruit and rice, which, according to mainstream medical science, is supposed to be super healthy, because it's high carb and low fat and protein. Well, he is still T2 diabetic and his insulin resistance has increased, so are all his markers deteriorating and will have eye surgery because he is losing his eyesight.

    Following up what jane said, there have been WFPB interventions with T2D that have shown rapid success. However, obviously that doesn't mean eating only oatmeal, fruit, and rice, which absolutely NO ONE would say is a healthy diet on their own. Instead, people eat a ton of vegetables, some fruit, beans and lentils, whole grains, and usually nuts and seeds. Meals are typically some combination of vegetables, beans/lentils, and whole grains, added fat is often avoided, especially if people are in weight loss mode, and fat is instead sourced from avocados and nuts and seeds and perhaps coconut.

    When I eat 100% plant based (I don't do WFPB at those times, but use some of the principles--however, I don't avoid olive oil at all, and also will use avocado and coconut oil, soy milk, tofu, and probably include more nuts and seeds, and I do still include white pasta, although the various bean-based pastas would be included too, and help to hit protein numbers if that's a concern). One big difference from how your friend eats is that it tends to be very high in fiber, to include far more protein (seems he isn't really getting more than the tiniest bit), and of course high in vegetables. For example:

    Breakfast might be oats flavored with some nuts and seeds and maybe soy milk plus some berries or else a smoothie with strawberries, winter squash, spinach, avocado, nuts or nutbutter, and silken tofu or white beans for protein. I also like savory oats with vegetables mixed in, although I tend to prefer that with an egg too so do it less then eating plant-based.

    Lunch might be a lentil stew with a salad on the side.

    Dinner would be something more elaborate, like a vegan version of an African peanut stew or else a stir fry with tofu and lots of veg with brown rice or some dish involving black beans, rice, and lots of greens, or perhaps a giant salad with some chickpeas and seeds on it and a mix of cooked veg along with the raw ones. The options are endless (and many cookbooks from areas of the world where meat is less common can be helpful). I'd likely have a piece of fruit as dessert.

    Speaking for myself as a diabetic, what I would find difficult about the plant-based way of eating you describe is that there are no options for times when your blood glucose is already high and you’re hungry. As a carnivore, or even an ovo-lacto vegetarian, I can reach for a Parmesan cheese crisp, or fry a couple of eggs, and know I’m not consuming even more carbs and making the problem worse. In fact, since protein stimulates an insulin response without raising blood glucose, my numbers tend to go down if I eat a bit of protein. Nuts and legumes, on the other hand, will raise my blood sugar. Particularly legumes. And it doesn’t take much - I learned pretty early that the “half cup” serving of most canned beans isn’t much of a serving, and it’s about the upper limit of what I can tolerate without a spike. Tofu in particular is disappointing because it is often substituted for meat in dishes, but it’s not safe for me to eat in large quantities as meat would be.

    One of the things about being diabetic is that it really helps to have at least some foods you can safely eat until you feel satisfied, so you don’t feel trapped by your disease.

    On the other hand, I could get along pretty well as an ovo-lacto. My usual breakfast is already that - steel cut oats with Greek yogurt, stewed apples, berries, nut butter, and a side of cottage cheese - and it keeps my glucose at normal levels for hours. In fact cottage cheese is like a magic food for me, filling and no rise whatsoever.
  • CeeBeeSlim
    CeeBeeSlim Posts: 1,267 Member
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    @kshama2001 I usually have this usual range - 30-35 grams of zucchini, and 20-25 grams of green pepper, 15 -20 grams of spinach and 10-15 grams of green onions. I’d top it with some Caribbean spicy sauce.

    My salads are usually about 60 grams of spinach topped with some Newman’s balsamic dressing.
  • CeeBeeSlim
    CeeBeeSlim Posts: 1,267 Member
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    @MikePfirrman - Lordy. That recipe sounds delicious. It’s funny how psychological this can be. If you presented this to me and told me it was meatless, i think I would find the dish tasty but feel not completely satisfied. If you told me there was indeed meat in the dish but crumbled up - I’d feel completely opposite! Go figure.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
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    lemurcat2 wrote: »
    mariomicro wrote: »
    As a diabetic, I can say that being vegan can be tricky for diabetics because of all the carbs. Vegan protein sources are typically about half carbs. I do have vegan diabetic friends who manage their blood glucose well, but it’s a way of eating that takes some thought, and not automatically healthier for diabetics.

    n=1 experience here. I have a British Asian friend of mine who is t2 diabetic and has become a vegan, not for religious reasons but because his GP convinced him it would be better for him. He has been eating at a caloric deficit for years. His diet is basically porridge, fruit and rice, which, according to mainstream medical science, is supposed to be super healthy, because it's high carb and low fat and protein. Well, he is still T2 diabetic and his insulin resistance has increased, so are all his markers deteriorating and will have eye surgery because he is losing his eyesight.

    Following up what jane said, there have been WFPB interventions with T2D that have shown rapid success. However, obviously that doesn't mean eating only oatmeal, fruit, and rice, which absolutely NO ONE would say is a healthy diet on their own. Instead, people eat a ton of vegetables, some fruit, beans and lentils, whole grains, and usually nuts and seeds. Meals are typically some combination of vegetables, beans/lentils, and whole grains, added fat is often avoided, especially if people are in weight loss mode, and fat is instead sourced from avocados and nuts and seeds and perhaps coconut.

    When I eat 100% plant based (I don't do WFPB at those times, but use some of the principles--however, I don't avoid olive oil at all, and also will use avocado and coconut oil, soy milk, tofu, and probably include more nuts and seeds, and I do still include white pasta, although the various bean-based pastas would be included too, and help to hit protein numbers if that's a concern). One big difference from how your friend eats is that it tends to be very high in fiber, to include far more protein (seems he isn't really getting more than the tiniest bit), and of course high in vegetables. For example:

    Breakfast might be oats flavored with some nuts and seeds and maybe soy milk plus some berries or else a smoothie with strawberries, winter squash, spinach, avocado, nuts or nutbutter, and silken tofu or white beans for protein. I also like savory oats with vegetables mixed in, although I tend to prefer that with an egg too so do it less then eating plant-based.

    Lunch might be a lentil stew with a salad on the side.

    Dinner would be something more elaborate, like a vegan version of an African peanut stew or else a stir fry with tofu and lots of veg with brown rice or some dish involving black beans, rice, and lots of greens, or perhaps a giant salad with some chickpeas and seeds on it and a mix of cooked veg along with the raw ones. The options are endless (and many cookbooks from areas of the world where meat is less common can be helpful). I'd likely have a piece of fruit as dessert.

    Speaking for myself as a diabetic, what I would find difficult about the plant-based way of eating you describe is that there are no options for times when your blood glucose is already high and you’re hungry. As a carnivore, or even an ovo-lacto vegetarian, I can reach for a Parmesan cheese crisp, or fry a couple of eggs, and know I’m not consuming even more carbs and making the problem worse. In fact, since protein stimulates an insulin response without raising blood glucose, my numbers tend to go down if I eat a bit of protein. Nuts and legumes, on the other hand, will raise my blood sugar. Particularly legumes. And it doesn’t take much - I learned pretty early that the “half cup” serving of most canned beans isn’t much of a serving, and it’s about the upper limit of what I can tolerate without a spike. Tofu in particular is disappointing because it is often substituted for meat in dishes, but it’s not safe for me to eat in large quantities as meat would be.

    One of the things about being diabetic is that it really helps to have at least some foods you can safely eat until you feel satisfied, so you don’t feel trapped by your disease.

    On the other hand, I could get along pretty well as an ovo-lacto. My usual breakfast is already that - steel cut oats with Greek yogurt, stewed apples, berries, nut butter, and a side of cottage cheese - and it keeps my glucose at normal levels for hours. In fact cottage cheese is like a magic food for me, filling and no rise whatsoever.

    That's interesting. What I've read about WFPB and T2D is generally quite positive (just as positive as low carbing, and I'm pro low carbing), but it's not really a concern of mine since I've never been IR. Interesting that nuts and seeds (which are mostly fat and have fiber and are common on even a keto diet) and legumes (which are generally high fiber -- when I do plant based my fiber # are over 50 because I have 2 servings of beans/lentils in addition to my usual veg) spike insulin, as I recall you saying oats and fruit generally don't. I couldn't really do WFPB because I like having a somewhat higher fat and higher protein diet and don't really love grains (they are okay, I eat them more when doing plant based, but could easily live without them and usually have a small serving when I have them).

    Super interesting that tofu is an issue as it's pretty low carb (extra firm, according to the USDA, is 1.2 g carbs and 1 g fiber, so 0.2 g net carbs for 100 g total and 10 g protein). I do think given that it must be super individual. I'm not at all anti low carbing and am often low carb myself (and as I recall you don't low carb), but one can balance carbs in a way that works for you without eating animal products if one is motivated to do so. The claim that plant based is inherently going to cause or exacerbate T2D or IR, as the other poster claimed, is just not supported.Re having foods one can just eat in abandon, normally it's non starchy veg, and most I've seen claim non starchy veg caused some insulin reaction were those who were basically super low carb versions of keto or "carnivores" which in itself causes IR, and not people who regularly ate lots of veg.

    Ideally, one would find a diet that put IR in remission such that eating carbs did not cause a spike, as anecdotally does seem to be the case with many on WFPB, as well as for many by simply losing weight (although in general I think having a good amount of fiber and sufficient protein is good anyway). I do find my personal protein preferences an issues with eating even in the modified from WFPB way I described, especially if trying to have a calorie deficit (lean meat and dairy is super helpful for satiety on a calorie deficit IME).
  • rheddmobile
    rheddmobile Posts: 6,840 Member
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    lemurcat2 wrote: »
    lemurcat2 wrote: »
    mariomicro wrote: »
    As a diabetic, I can say that being vegan can be tricky for diabetics because of all the carbs. Vegan protein sources are typically about half carbs. I do have vegan diabetic friends who manage their blood glucose well, but it’s a way of eating that takes some thought, and not automatically healthier for diabetics.

    n=1 experience here. I have a British Asian friend of mine who is t2 diabetic and has become a vegan, not for religious reasons but because his GP convinced him it would be better for him. He has been eating at a caloric deficit for years. His diet is basically porridge, fruit and rice, which, according to mainstream medical science, is supposed to be super healthy, because it's high carb and low fat and protein. Well, he is still T2 diabetic and his insulin resistance has increased, so are all his markers deteriorating and will have eye surgery because he is losing his eyesight.

    Following up what jane said, there have been WFPB interventions with T2D that have shown rapid success. However, obviously that doesn't mean eating only oatmeal, fruit, and rice, which absolutely NO ONE would say is a healthy diet on their own. Instead, people eat a ton of vegetables, some fruit, beans and lentils, whole grains, and usually nuts and seeds. Meals are typically some combination of vegetables, beans/lentils, and whole grains, added fat is often avoided, especially if people are in weight loss mode, and fat is instead sourced from avocados and nuts and seeds and perhaps coconut.

    When I eat 100% plant based (I don't do WFPB at those times, but use some of the principles--however, I don't avoid olive oil at all, and also will use avocado and coconut oil, soy milk, tofu, and probably include more nuts and seeds, and I do still include white pasta, although the various bean-based pastas would be included too, and help to hit protein numbers if that's a concern). One big difference from how your friend eats is that it tends to be very high in fiber, to include far more protein (seems he isn't really getting more than the tiniest bit), and of course high in vegetables. For example:

    Breakfast might be oats flavored with some nuts and seeds and maybe soy milk plus some berries or else a smoothie with strawberries, winter squash, spinach, avocado, nuts or nutbutter, and silken tofu or white beans for protein. I also like savory oats with vegetables mixed in, although I tend to prefer that with an egg too so do it less then eating plant-based.

    Lunch might be a lentil stew with a salad on the side.

    Dinner would be something more elaborate, like a vegan version of an African peanut stew or else a stir fry with tofu and lots of veg with brown rice or some dish involving black beans, rice, and lots of greens, or perhaps a giant salad with some chickpeas and seeds on it and a mix of cooked veg along with the raw ones. The options are endless (and many cookbooks from areas of the world where meat is less common can be helpful). I'd likely have a piece of fruit as dessert.

    Speaking for myself as a diabetic, what I would find difficult about the plant-based way of eating you describe is that there are no options for times when your blood glucose is already high and you’re hungry. As a carnivore, or even an ovo-lacto vegetarian, I can reach for a Parmesan cheese crisp, or fry a couple of eggs, and know I’m not consuming even more carbs and making the problem worse. In fact, since protein stimulates an insulin response without raising blood glucose, my numbers tend to go down if I eat a bit of protein. Nuts and legumes, on the other hand, will raise my blood sugar. Particularly legumes. And it doesn’t take much - I learned pretty early that the “half cup” serving of most canned beans isn’t much of a serving, and it’s about the upper limit of what I can tolerate without a spike. Tofu in particular is disappointing because it is often substituted for meat in dishes, but it’s not safe for me to eat in large quantities as meat would be.

    One of the things about being diabetic is that it really helps to have at least some foods you can safely eat until you feel satisfied, so you don’t feel trapped by your disease.

    On the other hand, I could get along pretty well as an ovo-lacto. My usual breakfast is already that - steel cut oats with Greek yogurt, stewed apples, berries, nut butter, and a side of cottage cheese - and it keeps my glucose at normal levels for hours. In fact cottage cheese is like a magic food for me, filling and no rise whatsoever.

    That's interesting. What I've read about WFPB and T2D is generally quite positive (just as positive as low carbing, and I'm pro low carbing), but it's not really a concern of mine since I've never been IR. Interesting that nuts and seeds (which are mostly fat and have fiber and are common on even a keto diet) and legumes (which are generally high fiber -- when I do plant based my fiber # are over 50 because I have 2 servings of beans/lentils in addition to my usual veg) spike insulin, as I recall you saying oats and fruit generally don't. I couldn't really do WFPB because I like having a somewhat higher fat and higher protein diet and don't really love grains (they are okay, I eat them more when doing plant based, but could easily live without them and usually have a small serving when I have them).

    Super interesting that tofu is an issue as it's pretty low carb (extra firm, according to the USDA, is 1.2 g carbs and 1 g fiber, so 0.2 g net carbs for 100 g total and 10 g protein). I do think given that it must be super individual. I'm not at all anti low carbing and am often low carb myself (and as I recall you don't low carb), but one can balance carbs in a way that works for you without eating animal products if one is motivated to do so. The claim that plant based is inherently going to cause or exacerbate T2D or IR, as the other poster claimed, is just not supported.Re having foods one can just eat in abandon, normally it's non starchy veg, and most I've seen claim non starchy veg caused some insulin reaction were those who were basically super low carb versions of keto or "carnivores" which in itself causes IR, and not people who regularly ate lots of veg.

    Ideally, one would find a diet that put IR in remission such that eating carbs did not cause a spike, as anecdotally does seem to be the case with many on WFPB, as well as for many by simply losing weight (although in general I think having a good amount of fiber and sufficient protein is good anyway). I do find my personal protein preferences an issues with eating even in the modified from WFPB way I described, especially if trying to have a calorie deficit (lean meat and dairy is super helpful for satiety on a calorie deficit IME).

    You’re right in that tolerances for different foods absolutely is individual, for example I don’t spike in response to tomatoes whereas I have a friend who does. My guess is we will someday find out this has something to do with gut flora, or even something we don’t have a clue exists right now. I mean, they discovered a whole new organ last year!

    Yeah, theoretically I could eat a bunch of non-starchy veg, although even that can have hidden pitfalls. Red cabbage for some reason will spike me if I eat too much of it. I used to get spikes after eating hot dogs and assumed it was the bun, even though it was one little whole grain bun that was 15g net carbs or something. Nope! It was the giant mound of coleslaw I was having on the side! Too weird. But the main problem with eating a ton of green stuff in a failed attempt to feel satisfied is that it makes me want to cry. While two slices of bacon makes me very happy. Even though I have known some charming pigs.

    Re: Remission. It doesn’t really work that way. On paper I have normal glucose numbers (a1c has been under 5 for years now) but that doesn’t mean I am no longer diabetic and can drink a big gulp like a normal person.
  • 33gail33
    33gail33 Posts: 1,155 Member
    edited February 2021
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    I ate vegetarian/vegan for 15+ years, then went pescatarian (eggs and fish only) for a couple. For the last few weeks I have been on an elimination type diet (for a health condition) where I pretty much have to eat meat to get enough calories and protein in. It is hell. I can't wait until I can go back to my bean and lentil and tofu based meals. I don't know how people eat like this every day, not sure I can stomach another piece of chicken. This anecdote is basically to say that sometimes when you stop eating meat you lose your taste for it.
  • MikePfirrman
    MikePfirrman Posts: 3,307 Member
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    33gail33 wrote: »
    I ate vegetarian/vegan for 15+ years, then went pescatarian (eggs and fish only) for a couple. For the last few weeks I have been on an elimination type diet (for a health condition) where I pretty much have to eat meat to get enough calories and protein in. It is hell. I can't wait until I can go back to my bean and lentil and tofu based meals. I don't know how people eat like this every day, not sure I can stomach another piece of chicken. This anecdote is basically to say that sometimes when you stop eating meat you lose your taste for it.

    We still eat chicken like twice a week, and seafood once a week. We eat red meat like once or maybe twice a month. We have both lost our taste for ribs. We don't like them any more at all. Mostly the fat just tastes gross. I also think my wife has really began to feel, just a bit, more compassionate in her reactions to meat. She and I are both huge animal lovers.
  • 33gail33
    33gail33 Posts: 1,155 Member
    edited February 2021
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    33gail33 wrote: »
    I ate vegetarian/vegan for 15+ years, then went pescatarian (eggs and fish only) for a couple. For the last few weeks I have been on an elimination type diet (for a health condition) where I pretty much have to eat meat to get enough calories and protein in. It is hell. I can't wait until I can go back to my bean and lentil and tofu based meals. I don't know how people eat like this every day, not sure I can stomach another piece of chicken. This anecdote is basically to say that sometimes when you stop eating meat you lose your taste for it.

    We still eat chicken like twice a week, and seafood once a week. We eat red meat like once or maybe twice a month. We have both lost our taste for ribs. We don't like them any more at all. Mostly the fat just tastes gross. I also think my wife has really began to feel, just a bit, more compassionate in her reactions to meat. She and I are both huge animal lovers.

    I have discovered that even chicken twice a week is too much for me. I made chicken thighs last night, ate one of them and the roasted veggies and put aside the other one because I just couldn't stomach it. I am beginning to dread making dinner because I just don't know what to make that will appeal to me. My stomach is turning right now just at the thought of having to choke down another piece of meat. Maybe I will get some ground meat and try to hide it in chili or something.
    Also funny that my post got a "disagree" - someone disagrees that I don't like eating meat I guess? It has definitely been an interesting experiment going back to eating meat after all these years, at least I know I'm not missing anything.
  • MercuryForce
    MercuryForce Posts: 104 Member
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    I like to claim that I'm an "accidental vegetarian". It's not a deliberate lifestyle choice (in fact the times I've done it intentionally, I failed). And because I'm doing it accidentally, I don't do it full time.

    But, I was trying to reduce the amount of fat in my diet and so started with things like replacing my morning sausage with a veggie sausage, or using baked tofu instead of fried chicken in Asian dishes, or replacing meat in my tacos with beans. Now I have times where I realize I've gone 3 weeks without eating any meat. For me it's not an all the time thing, this week I made a bean soup with a ham hock in it, and if I want a pepperoni pizza that's what I'm ordering. But, I've found even in those times I'm eating less meat.

    And, I've found those little switches have made it easier for me to stay within my calorie counts and I'm getting more fruits and vegetables into my diet. When I made the switch, a several month weight loss stall I'd been in suddenly turned into a weight drop, but that could be coincidence.
  • AlexandraFindsHerself1971
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    One thing you might try is to start eating from cuisines where meat is less prominent in the meal. Stirfries are a good way to enjoy more vegetables with your meat. Curries are also something where you can add vegetables and lessen the meat while not losing any flavor, or even go meatless. Soups and stews are often adaptable to this as well. A perfectly good bean soup can be made in meat stock for flavor with a very small amount of meat added, and the beans serving as the primary protein.

    I cannot follow my own advice, as I have a case of IBS that has decided I may not eat beans or most green vegetables without Dire Consequences, but it can be done, I've helped other people do it. I eat meat for two of my three meals a day, but usually not in quantity; at at least one meal a day it will be somewhat secondary and the protein will come from dairy. (Thank the gods I can still do dairy.)
  • Safari_Gal_
    Safari_Gal_ Posts: 1,461 Member
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    Hey @ceebeeslim - in original post you mentioned a concern about family history of heart disease.

    I also share this concern.. I can tell you our family vascular surgeon promotes a diet with limited saturated fat/salt/added sugar. Though I don’t have these issues.. I cook for a parent and drop off meals (Covid) .. so I’ve incorporated much of this in my own diet.

    For my parent - it’s a very strict diet - for me, I’m a bit more relaxed as I don’t have vascular issues🙏but am mindful it’s present in my family. Hopefully I can help control their issue and help mitigate any future issue for myself.

    Whatever meats I choose - i try to keep the saturated fat low .. OR make it an infrequent guest on the menu. (Duck is my fav ooooh)

    Saturated fat is one of the items I count in my diary on a daily basis besides sugars and sodium.

    Most deli meat is disappointing as it has added salt/sodium nitrate .... so I do all natural turkey, no salt added or keep the deli meat a rare presence in the house. Mortadella RIP

    I try to look at it as “health insurance” rather than what I can’t have. There are a ton of great menu options out there if you want to focus on vascular health.