Kitchen Couture: Customizing Your Healthy Home

Welcome ! Since there are hundreds of delicious recipes that are just a click away on the main Atkins.com site, in this article we're going to concentrate on food shopping, selecting appliances and utensils, and cooking techniques. Whether you've just learned to boil water or you're a whiz in the kitchen, you'll find the information in this article easy to apply. The emphasis on whole foods and quality ingredients means that you can expand your health-conscious culinary horizons.

Before we start discussing ingredients and techniques, let's talk about some of the appliances and cooking tools you need--and those you don't need--in your health-conscious kitchen.

 
Small Electric Appliances
Let's start in the kitchen with some hard-working smaller appliances that deserve space on your counters:

Immersion blender: Keep it handy for making your own mayonnaise, hollandaise sauce and other egg-based dressings and sauces, as well as frozen drinks and smoothies. Immersion blenders are wonderful when you want to thicken a soup without adding flour or starchy vegetables like corn or potatoes. Just purée some of the cooked vegetables in your soup to thicken it without the starch.
Slow cooker: Great for stews, goulashes and other dishes that use less-tender cuts of meats, which are full of flavor but take time to cook to the right tenderness. If you're busy all day and like the thought of coming home to find dinner waiting, you can trust the slow cooker to safely cook your dinner unattended.
Food processor: Useful for chopping, slicing and shredding everything from cheese to cabbage, making bread crumbs out of high-fiber whole grain bread or finely chopping nuts for a crispy coating for meat, poultry or seafood.
Microwave oven: If you've only used it in the past for popcorn and carb-laden convenience foods, you'll find it incredibly handy for thawing individual portions of frozen dishes, melting butter or sugar-free chocolate for desserts and a myriad other uses.
Toaster: Your toaster will be more useful than ever. High-fiber, whole-grain breads are at their best when they are toasted. Toasting also mellows the soy in high protein, soy-based breads.
Toaster oven: In addition to making high-fiber, whole grain toast, this appliance is handy for broiling fish, poultry and chops. It's also good for putting a bubbly topping of cheese sauce on cooked broccoli, cauliflower and other veggies. You can prepare all of those things in your full-size oven, too, but a toaster oven is often faster and uses less electricity.
Pots and Pans
Chances are if you have good-quality pots and pans, you'll be in fine shape. Make sure you have an ovenproof skillet; those made of plain cast iron or coated in enamel are a good choice. This flexible piece of cookware allows you to transfer a dish directly from the stovetop to the oven, a must-have for creating a flawless frittata. Cast iron boasts excellent heat retention, even heat distribution and nonstick properties (when well seasoned, as explained below), but it does require more care at first than do other pans. It's incomparable for all kinds of searing and frying. Dutch ovens also come in handy for slow-cooked meals and casseroles. If you're a garage-sale shopper, keep an eye out for a used one in good condition, but don't buy one with any rust on it.

Don't forget muffin tins and ramekins. Both can be a tremendous help when it comes to controlling the size of the portions you serve. Muffin tins in both the 12-muffin size and the mini-muffin size are useful when you begin to explore some of the great-tasting alternatives like flax seed meal (high in both protein and fiber) or soy flour. Ramekins are wonderful for baked custards, mini-casseroles and other similar dishes. Be sure to get ramekins that can go straight from the freezer to the oven, so you can prepare ahead and freeze for later use.

Seasoning and Caring for Cast Iron
When you get a new cast iron pot or pan, scrub it thoroughly with warm soapy water to remove the factory-applied anti-rust coating. Dry it completely. Then season it by coating the inside liberally with a fat or oil that has a high smoke point. Cast iron purists season their skillets with melted lard or beef suet, but peanut or grapeseed oil will do. Put the empty skillet in the oven and bake it for an hour at 350º F. Turn off the heat and let it cool in the oven to room temperature, wipe it out well, recoat it lightly, bake it for another 15 minutes and let it cool again. Wipe it out thoroughly, and give it a quick scrub under hot tap water using a plastic-bristle vegetable brush that you'll use exclusively to clean it in the future.

Once you've seasoned the pan, the secret to making your cast iron last forever is never allowing soap to make contact with the skillet again; always dry it thoroughly, too. After each use, pour off whatever's left in the pan, scrub it under hot running water with the brush until it's clean and dry it promptly. With proper care, the skillet will last a lifetime (or two!), and the surface will only improve with age.

If you've read up on other articles on this site, you already know how to ready your pantry, refrigerator and freezer. If you haven't yet researched this, the first step is clearing out all the junk foods and any convenience items that rely on high sugar content and other refined carbs like white flour for their flavor and bulk.

 
Much of the food you will be eating will be fresh--primarily meat, poultry, fish, eggs, cheese and vegetables--so it will be stored in the refrigerator. If you live with others, everything you will be eating is perfectly suitable for them to enjoy as well. If you're like most people and are somewhat pressed for time, doubling recipes and freezing half for another meal can be a huge time saver. It not only makes cooking more complicated dishes worthwhile; it also gives you speedy options for evenings when you're rushed. Plus, it increases your choices when you're faced with that age-old question: "What's for dinner?"

So it's a smart idea to clean out your freezer. If you've been an inveterate saver of leftovers, you'll probably find plastic- or foil-wrapped packages of mystery foods that you once decided to save, but which are now irredeemably freezer-burned or so old that they've lost all their nutrition value and flavor. After you toss those, organize your freezer so you'll always have room for seven or eight packages of frozen main dishes, and guard that space like it's Fort Knox. It'll pay off in the long run. If you have a device to heat-seal freezer bags, be sure to use it; if you don't, zip-close freezer bags also work well.

Weekly Planning
To simplify shopping and cooking, it's always a good idea to plan out a week's worth of meals and snacks. Take some time on Sunday, for example, and write them down, so you don't even have to give your meals a second thought in the coming week. Do it after you've had a meal, too, so you aren't hungry when you plan. Consider at least three or four main dishes that you can double, and then you can freeze the other half for another meal. If you want ideas or inspiration, check out the Recipes section here on the Atkins site. You'll find literally hundreds of recipes, all with nutritional information. When you're done with your plan, make a shopping list. Organize it by aisles or departments in your supermarket to speed and ease your visit to the store.

All of this preparation may seem like a lot of trouble, but in addition to solving the what's-for-dinner question, weekly planning also can have the following benefits:

It helps you organize your shopping trips, allowing you to get in and out in the least amount of time with minimum distractions. Every supermarket chain knows that the more time you spend in their stores, the more money you'll spend and the more high-profit impulse items you're likely to buy. A well-organized list is your armor against unnecessary purchases.
You'll educate yourself about what goes into the foods you may have been taking for granted. Along with the knowledge of your own body's tolerance for, and ability to handle, different amounts and kinds of foods, following the common-sense nutritional principles of high protein, high fiber and low sugar will help you arm yourself with the facts to make informed decisions about the foods you'll eat for the rest of your life. Since knowledge is one of the keys to success, that alone makes advance planning worthwhile.
Two precautions to keep in mind:

Never go grocery exploring when you're even the least bit hungry. Shop after you've eaten a full, satisfying meal with adequate protein and fiber.
Don't trust the big print on the front of the package. Read the Nutrition Facts label and the list of ingredients, and pay special attention to the serving size.
Between-Meal Snacks
 
Be sure to plan and shop for snacks, too. Great between-meal nibbles include olives, cheese, avocado and protein snacks, such as roast turkey or cheese; but be careful to choose protein snacks without added fillers or nitrites. For your crunchy cravings, try nuts and seeds. Premeasure snacks and keep them in a handy place in the refrigerator (one ounce of cheese cut into cubes or a half-dozen olives, for example) so you can grab them quickly and you won't be tempted to eat the whole package or jar. And always keep some hard-boiled eggs handy, either to eat as-is, make an egg salad or deviled eggs or garnish with cooked spinach.

For those times when you're stuck in your car or traveling, non-perishable, portable snacks are a life-saver, since healthy fare is hard to find at fast-food places, convenience stores and airports. When you need a great-tasting, convenient snack that's high in protein and fiber and low in sugar, you can depend on Atkins Advantage® nutrition bars and shakes to meet your on-the-go nutrition needs.

Cooking with Fats
Finally, before we leave the supermarket, a few words about fats and oils.

Don't hesitate to experiment with various kinds of oils. Taste them to see what their native flavor is like, then consider how they might complement your favorite salads or other dishes. When you're buying oils, look for those that are minimally processed and cold-pressed, since even the heat generated in processing oil can destroy some nutrients and cut down on flavor. Store oils in airtight containers in a cool dark place, and store the more exotic oils, which you might use only rarely, in the refrigerator, since many of them will turn rancid if you don't.

The fats you want to avoid at all costs are manufactured trans fats, also known as hydrogenated or partially hydrogenated oils. You'll find these fats in the list of ingredients in many processed foods, including packaged baked goods. Food companies are allowed to claim zero trans fat on the package if there is less than 0.5 grams in one serving. When you consider that two servings will give you one gram of trans fat, it is best to read the list of ingredients and look for hydrogenated or partially hydrogenated oils. Zero should mean zero. You won't find trans fats in Atkins Advantage products.

Some Great-Tasting Oils
Of all oils, olive oil has the greatest health benefits. Choose cold-pressed, extra virgin olive oil when possible. Olive oil contains monounsaturated fat, a very beneficial fat for the body (avocados and nuts also contain monounsaturated fat). Monounsaturated fats generally:

Elevate levels of HDL ("good") cholesterol, which tends to mitigate risk for heart disease
Lower levels of LDL ("bad") cholesterol, which tends to raise heart disease risks
Monounsaturated fats are typically liquid at room temperature, but solidify when refrigerated.

Besides olive oil, here are some other great, healthful choices.

Avocado and macadamia oils are cold pressed and are rich sources of monounsaturated fats. They are a terrific source of omega-3 fatty acids, and most important, as with all cold-pressed oils, the taste is great. Avocado oil is a good source of vitamin E.
Grapeseed oil has a neutral flavor. It is an excellent source of vitamin E, valuable antioxidants and essential fatty acids such as linoleic acid (also known as omega-6).
All three oils have a high smoke point that lets you fry foods without smoking or burning. They are also excellent for sautéing and baking.

What's Next?
In the next section we'll look at some techniques that are useful in cooking, and suggest some places to find lots of recipes. Be sure to take the quiz and complete the assignment for this lesson, then stop by the Message Board to ask questions, share experiences and perhaps swap some cooking tips or recipes that have worked well for you.

Now let's tackle specific areas by exploring techniques and ingredients you can use. We'll start with sauces and gravies.

 
Sauces and Gravies
This section shows you how to create delicious, healthy sauces and gravies.

White Sauce
Many traditional sauces rely on a combination of equal parts butter and flour (called a roux) for thickening. The roux is cooked either just long enough to remove the raw flour taste, or even longer--sometimes to a dark brown color for dishes like gumbo--and then combined with milk, cream, wine, stock or water to make a sauce or soup.

Béchamel is the most basic white sauce. It's sometimes called a "mother sauce" because it's the foundation for so many other sauces and it's nothing more than flour, butter and milk.

Since white flour is not an optimal choice, the traditional recipe won't work. Non-starchy thickeners such as guar, carob and xanthan rely on vegetable gums, for their thickening properties, but they're best suited for gravies and sauces where you might traditionally use cornstarch. These types of sauces already have a dominant flavor and body provided by another ingredient.

The gum thickeners also work well in gumbos, although the nutty taste of a dark roux won't be there, so you'll need to heavy up on other flavor elements like filé and pepper or hot sauce. Some people even add a touch of one of the liquid smoke sauces as a replacement for the taste of a dark roux, although you should be careful to select one without nitrites.

You might try a roux with whole-wheat flour. Whole-wheat flour makes an excellent substitute for refined flour. It will deliver satisfactory body to a béchamel sauce along with a couple of egg yolks if you need additional thickening--especially if you're using it as a base for something else like a cheese sauce. Just be very careful not to let the sauce come to a boil after you've added the yolks, or the sauce will curdle.

Egg-Based Sauces
 
The most basic egg sauce is hollandaise. It used to be considered difficult to make, but now recipes for blender hollandaise are everywhere. Because it's practically foolproof, you can whip up a batch to top steaks, broccoli or asparagus in no time.

Easy Blender Hollandaise Sauce (from Atkins for Life Low-Carb Cookbook)

2 sticks unsalted butter
3 large egg yolks
1-1/2 tablespoons fresh lemon juice
1/4 teaspoon salt
1/8 teaspoon white pepper
Melt butter in a small saucepan until it is bubbling but not brown.
Combine yolks and lemon juice in a blender. With the motor running, slowly drizzle in melted butter. Season with salt and pepper.
Cook time: 3 minutes
Yield: 1 cup
Serving size: 2 tablespoons
Net carbs/serving: 0.5 gram
You can store this sauce in the refrigerator and reheat it in a double boiler. However, it's so easy to make that you can whip up a fresh batch in less time than it will take to get out the double boiler and then stand there stirring until it's reheated. So rather than saving and reheating, try cutting the recipe to suit your needs. Each egg yolk will require 2/3 stick of butter, 1/2 tablespoon of lemon juice, and salt and pepper to taste.

You can add garlic, basil, chives or dill to hollandaise for variety, depending on what you're going to serve it with. Toss additions into the blender before you blend the yolks and other seasonings, and then add the butter.

Whenever you make a sauce based on egg yolks, you end up with leftover egg whites. For an easy low-sugar dessert treat and no waste, whip the whites until they're stiff, add some sucralose (marketed as Splenda®) to taste, even a teaspoon of unsweetened cocoa if you wish, then spoon them onto an ungreased cookie sheet and bake at 225ºF for an hour, or until they begin to brown on top. You can keep egg whites in a sealed container in the refrigerator for up to four days, or in the freezer for up to six months. Just be sure they're completely thawed before you use them.

Other Cooked Sauces
Some other commonly used thickeners for sauces include butter, heavy cream and sour cream, but be careful not to allow a sauce to boil after you've added sour cream or it will curdle. For maximum thickening with butter, remove the sauce from the burner and stir it in at the last minute.

Of course, some gravy will thicken when boiled down, but that often makes the flavor too strong, so consider one of the vegetable gum thickeners instead.

Barbecue Sauces
Depending on which part of the country you live in, barbecue sauces are either sweet, tart or spicy, and some of the best are all three. The problems you encounter when making a barbecue sauce are that many of them are tomato or ketchup-based, others contain molasses for sweetness and color and many call for brown sugar.

Instead of sugar or molasses, sucralose (Splenda) can be used to add sweetness. Sugar-free pancake syrup contributes both sweetness and body.

Some grill masters add more Worcestershire sauce for its color and tang. With a spicy sauce, add a dash or three of chipotle sauce, but be careful if you're not used to it. In addition to a wonderful smoked pepper flavor, it will give your taste buds something of a delayed burn that can sneak up on you.

Marinades
Meat marinades are used to flavor and tenderize meat, usually in the refrigerator, for anywhere from a few hours to couple of days. Marinades are different from sauces because they aren't intended to become part of the finished preparation, so no matter what's in them, very little of the actual contents become part of the dish; it's primarily the aromatic elements that permeate the food.

Some of the best marinades, especially for pork loins and lamb, start with beer. The bitter bite of hops is especially complementary to pork, and plays well against the smoky flavor gained from cooking over charcoal. Don't confuse ingredients in a marinade with those in a cooking liquid, especially if the liquid is to be turned into a gravy.

The same holds true with marinades based on wine. Even with chicken, so little is actually absorbed by the meat that the calories and carbs added are inconsequential. Of course, the base liquid is only the start. You can enrich marinades with garlic (either chopped or roasted), onions, and herbs like rosemary, cilantro or thyme. Yogurt works particularly well as a marinade for chicken.

Warning: Marinades, by their very nature, have been in contact with raw meat for a significant time. If you use them for basting, keep them at the temperature of the finished meat. For example, keep poultry marinade at 165ºF or above. Otherwise, discard them.

Sweeteners
Sugar substitutes have come a long way in recent years. The preferred sweetener for cooking applications is sucralose. It's available in both packets and granular form under the brand name Splenda. Because it stands up to heat without breaking down or losing its sweetening power, it's suitable for all kinds of cooking.

If you can't find Splenda or it's unsuitable for you for some reason, saccharin is another option.

The FDA recently removed saccharin from its list of carcinogens, basing its decision upon a thorough review of the medical literature and the National Institute of Environmental Health Sciences' statement that "there is no clear association between saccharin and human cancer." It can be safely consumed in moderate amounts--no more than three packets a day. Saccharin is marketed as Sweet 'n Low®.

Acesulfame potassium, also known as ace-K, is another non-caloric sweetener option. It's about 200 times sweeter than sugar. Because it cannot be metabolized, it passes through the body without elevating blood sugar. The FDA has authorized the use of ace-K after evaluating numerous studies and determining its safety. It is sold under the brand name Sunett™.

Veggies, both cooked and raw, are an important source of fiber. Remember that nutrient-rich carbohydrates are an essential element of any healthy diet.

 
Salads
Eating a lot of salads is part of common-sense nutrition and the Atkins Advantage nutritional principles, so it's important to have a large number of recipes in your repertoire to keep things interesting.

There are plenty of greens in the garden besides iceberg and romaine. In fact, most well-stocked produce departments now carry either prebagged or bulk "field greens," which offer an enormous variety of flavor and texture. Just be sure to have your salad spinner handy and wash the greens thoroughly, even those that claim they have been prewashed.

Grape tomatoes, so-called because of their size and shape, add an extraordinary amount of color and flavor to a salad. Better yet, they are available year-round, and hothouse cultivation ensures reliable flavor. If you haven't tried them yet, don't miss out any longer.

Add color, variety and flavor with slices of bell pepper (they come in yellow, green, red, orange and even purple), cucumbers, scallions, sliced radishes, avocado, broccoli florets and sliced raw mushrooms...and that's just for starters. Don't forget that you can top salads with grated cheese, real crumbled bacon, chopped olives or sliced hard-boiled eggs.

Salad Dressings
There's a dizzying array of bottled low-sugar salad dressings on supermarket shelves, and real Ranch dressing is low in sugar already.

But why not make your own? Try these for starters:

Mash half an avocado and blend it with some mayonnaise and a bit of olive oil, salt and lemon juice for a rich and creamy dressing.
To make a delicious blue cheese dressing, take a cup of sour cream and crumble in a few ounces of blue cheese, add a grated or crushed clove of garlic, a bit of salt, some olive oil and a tablespoon or two of water. It will get better if it sits in the refrigerator overnight.
Make a tasty Thousand Island dressing by starting with 4 ounces of mayo. Chop up a hard-boiled egg into small pieces, or mash it with a fork. Stir the egg in with a few tablespoons of ketchup.
For that matter, you can easily make your own mayonnaise in the blender. Mayo is nothing but egg yolks, oil, a bit of lemon juice and a touch of salt. As with hollandaise, be careful to add the oil in a slow, steady stream and give the yolks time to incorporate. If you like the taste of olive oil, substitute it for half of the vegetable oil. Add a clove of garlic or some fresh dill or basil for variety.

With all that at your command, there's no reason salads should ever get boring. If you're going to eat salads, you might as well do it right and enjoy the results!

Homemade mayonnaise contains raw eggs. Although the risk of salmonella is slight, it's a good idea to thoroughly rinse the eggs and then wash your hands before you break them. If anyone in your household has a compromised immune system stick to commercial mayonnaise, which contains eggs that have been pasteurized.

Cooked Vegetables
 
If you are not already a vegetable lover, you could be in for a surprise. Veggies are not only good for you but, prepared properly, they are downright delicious...even Brussels sprouts and other members of the cabbage family!

Most green vegetables need only a short time to cook, whether you steam, sauté, stir-fry or grill them. Go to the Recipes section of this site for tasty recipes ranging from Spiced Bok Choy to Sautéed Winter Greens. (This list of vegetable recipes will give you an idea of the offerings.)

Do yourself a favor and approach vegetables with an open mind. You, and your body, will be glad you did.

The question, especially if you've been relying on convenience and fast foods when you're in a hurry in the morning or during the noon break, isn't "What's for dinner?" It's "What's for breakfast, lunch and dinner?" So let's consider some ideas, meal by meal, and even the occasional dessert.

Breakfast Ideas
 
Your mother was right when she told you breakfast was the most important meal of the day. Eating three square meals daily is still important, but breakfast gives you the boost of energy you need to start the day after fasting overnight. Also, research studies show that people who regularly eat breakfast are better able to control their weight. When you're following common-sense nutrition principles, skipping breakfast is not an option.

Eggs to the Rescue
Eggs can be a lifesaver. You can scramble a couple of eggs while you're reheating a few slices of precooked bacon or preparing lox. Add a slice of high-fiber whole-grain toast or a high-fiber tortilla for a great-tasting breakfast that's high in protein. If you roll your breakfast in a tortilla, you can eat it on the way out the door. A little grated cheese boosts the flavor, too. For variety, scramble the eggs with chopped up Canadian bacon or ham and use Swiss or Monterey Jack cheese instead of cheddar.

Another approach is to flip traditional meal ideas around. Heat up the pork chop or sliced chicken left over from last night's dinner and serve with some sliced tomatoes and avocado. That way, you only have to get up five minutes earlier.

And remember that great-tasting Advantage nutrition bars and shakes offer on-the-go nutrition when you don't have time for a meal. With high protein, high fiber, low sugar and no trans fats as well as healthy levels of fat, calories, vitamins and minerals, Atkins Advantage® products provide good nutrition and hunger satisfaction.

In other words, when it comes to breakfast, think beyond traditional breakfast menus. Scroll through these breakfast and lunch recipes to get some fresh ideas. On weekends, you can cut loose and fix those shirred eggs if you want!

Lunch Ideas
 
If you're dining out during your lunch break, you probably have a host of choices. Most restaurant servers have become accustomed to diners' requests to hold the bread basket and substitute a healthy vegetable for the fries or mashed potatoes. Ask questions about the content of salad dressings and sauces. It's hard to go wrong if you order grilled chicken or a hamburger (minus the bun, of course) or a chef's salad.

If you want to take your lunch and have access to a refrigerator at work, make roll-ups the night before with deli turkey or ham slices, a bit of your favorite mustard and cheddar or Swiss cheese. Add a hard-boiled egg and a small salad and maybe some olives, and top it the next day with the dressing you keep stashed in the refrigerator at work. Or tote along the leftovers from last night's dinner and reheat them in the microwave.

Dinner Ideas
 
The Atkins recipes section has dozens of dinner ideas to start with, and you probably have cookbooks full of great recipes. But don't stop there--these recipes should just be the starting point for you. As you go through the recipes, pay attention to how to get around foods laden with white bread, white rice and white potatoes, and you'll quickly develop a feel for how to adapt your own favorite dishes to healthy cooking.

Don't be afraid to experiment:

Very few Americans eat lamb, for example, but truly good spring lamb is tender and delicious, with a rich, buttery flavor. Try it medium-rare for best results. Grill a rack of lamb or individual lamb chops that you've marinated overnight in a paste of oregano, garlic and olive oil. Don't be put off by the chops' small size. Lamb is so rich that three or four small chops are a satisfying meal.
If truly fresh seafood is available where you live, start with salmon fillets and expand your horizons from there. Most people who say they don't like fish probably have only had it when it was overcooked, so pay close attention to what you're doing whether you grill, pan-fry or bake fish.
Try chicken with new sauces. Buy split chicken breasts, bone them yourself, and then use the skin and bones to make a quick stock by boiling them for 20 to 30 minutes. Then sauté the breasts and use the light stock as a base for a sour cream and dill sauce; chicken, like veal, is almost a blank culinary canvas to which you can apply a great many flavor combinations.
Desserts
 
You have a lot more dessert options than you might think. You can enjoy sugar-free fruit-flavored gelatin with a dollop of whipped cream. Or make pudding with vegetable gums instead of cornstarch. Experiment with meringues of different flavors or different fillings (and use up all the egg whites you'll have left from making all that mayonnaise and hollandaise sauce). There are a number of wonderful sugar-free ice creams on the market now. Top the ice cream with sugar-free chocolate sauce and whipped cream, or with fresh blueberries, or with a blueberry sauce you make yourself by cooking down a package of frozen blueberries.

And Finally...
You've learned that there are plenty of cooking options and methods that you can use as alternatives or replacements for your old style of cooking and eating. Hopefully you've awakened your spirit of exploration, and you'll try some new foods and ways of cooking them. We hope you'll not only look at recipes just to find out how to make something, but also to analyze them to discover why certain ingredients and techniques are used.

And most of all, we hope you'll eat well, enjoy cooking, love what you cook and live a long, happy and healthy life as a result.

Disclaimer: Nothing contained on this Site is intended to provide health care advice. Should you have any health care-related questions, please call or see your physician or other health care provider. Consult your physician or health care provider before beginning the Atkins Diet as you would any other weight loss or weight maintenance program. The weight loss phases of the Atkins Diet should not be used by persons on dialysis or by pregnant or nursing women.