Monday, April 28, 2008

What the…?

My partner, Ryan, is not completely on board with this whole foods, carb-controlled, exercise-like-a-madwoman sort of lifestyle, so you can imagine that things get a little rocky now and again. But I think I'm making some headway. Last night she was telling me that out of curiosity she looked at the label on the frozen dinner she was eating. I don't think she'll eat this particular dinner again.

The ingredient list started, innocently enough, with potatoes. (Okay. That's real food.) Second ingredient—“seasoned cooked beef product.” Huh? This does not sound like food. It contains “beef, water, dextrose, soybean oil, modified cornstarch, potassium chloride, salt, potassium and sodium phosphates, caramel color [and] natural flavors.” She told me that she got this picture in her head of meat being liquified, then having crap added to it, reshaped, frozen and then she was supposed to eat it after all that. She's told me she's only going to eat frozen dinners which contain distinctly identifiable meat from now on. Either that or stop looking at ingredient labels.

She apparently had a lot of food adventures this weekend while I was gone, because she also found this actual product at a local grocery store—apples that are injected with grape juice so that the apple tastes like a grape. I don't even know where to begin with this one.

What's wrong with just eating an apple that tastes like an apple? Or eating meat that doesn't have corn products and "natural [meat] flavors" added?


Friday, April 25, 2008

Homeward Bound

I'm on my way over to eastern Washington this weekend to see family for the first time in about 7 months. No one has seen me since I started the new eating plan. They're aware I've lost weight, but that's about it. This should be fun!

Eating Grain
Reader Gail left this comment the other day: "I thought complex carbs (whole grain bread etc.) broke down slowly and so don't cause the sudden upswing in blood sugar. I heart my brown rice and whole grain bread, and need some good reasons to say goodbye to them."

This refers to the Glycemic Index (GI) which measures the speed at which different foods containing carbohydrates break down to glucose. The faster the food converts to glucose the bigger the spike in your blood sugar. For a diabetic, the goal is to have a fairly level and optimal amount of glucose in the bloodstream during the course of a 24-hour period. One way of managing diabetes to eat foods that are low on the GI to meet this goal. And yes brown rice and whole grain breads are lower on the GI than white rice and wonderbread.

I stopped eating grains as part of managing my diabetes. It's not for everyone. Bread, cookies, pasta, etc. are all trigger foods for me so I had to remove them completely from my diet.

I loosely follow what's called the Paleolithic diet. "Diet" here means the food that comprises what we eat, not diet as in eating to lose weight so you can go back to eating the things that made you fat in the first place. This is pretty much the way I'm going to eat for the rest of my life.

My friend/trainer Kristn has a great post on her blog about this way of eating. I've stolen a little bit of it to share, with her permission. I recommend going over and reading the rest of what she has to say about the thinking behind eating this way.
  • Every meal or snack should include protein, fat and carbs.
  • Protein sources should be mostly meat, poultry and fish and whole eggs. The less processed the better.
  • Kristn's hierarchy of carb sources:
    • Non-starchy vegetables (most of your carbs should come from these)
    • Brightly colored starchy vegetables (yams, carrots, winter squash, beets)
    • Fruits
    • Whole grains & legumes (if your body can handle them). Be very careful with wheat, it is not tolerated well by many people.
  • Eat an ounce or two of nuts and seeds every day.
  • Dairy (if you can tolerate it):
    • Cheese 1-2 ounces/day
    • Yogurt (unsweetened)
    • Milk
Foods you should absolutely avoid whenever possible:
Sugar (in all forms like honey, maple syrup, etc.)
White flour, pasta, white rice
Processed Foods (anything pre-made or in a package)
Breakfast cereals

Note that she doesn't say not to eat whole grains, just try not to make them the primary source of your daily carb intake.

The bigger challenge for me than giving up bread (and that one was hard), was not eating processed foods any more. It's a hell of a lot easier to heat up a frozen dinner (or, let's be honest, eat cookies) than to prepare a comparable meal from whole foods. And since I'm sort of a workaholic, I tend to eat a lot of my meals while I'm working. It took some serious retraining as well as learning to cook extra portions and eat leftovers (which I've never liked) at subsequent meals.

The processed food industry is a topic unto itself, along with that most-favored-by-food-processors additive, high fructose corn syrup (HFCS). For now I'll just say HFCS is bad mojo. I plan on talking about that next week. If you're at the store this weekend, look at how many things contain HFCS. It's in everything. (Okay, okay—MOSTLY everything.)

And on that note…I hope everyone has a fabulous weekend. I've heard rumors that the sun might be out in Seattle tomorrow!

Tuesday, April 22, 2008

The Meat and Potatoes (or not)

The question I get asked the most lately is "What are you doing that's making such a difference?" (Last night I had someone I know quite well walk by me without saying hello, which was a little odd. She did a doubletake and then told me that she hadn't even recognized me.)

The short answer: I don't eat anything that comes in a box or is found in the middle of the grocery store.

Think about it for a second—all the stuff that's good for you is on the outside walls of the store—dairy, vegetables, fruit, meat, fish. The middle of the store is all the stuff that's been processed, is full of additives and high fructose corn syrup, or has had any nutritional value it might have contained processed out of it. It's just twisted that during processing, natural food can lose most of its nutritional value, so at the end of the processing they have to add back in nutrients. Eating through chemistry.

When I decided it was time to do something about my atrocious eating habits, I turned to my trainer. She'd already been where I was at the time. She lost nearly 100 pounds six or seven years ago and has successfully maintained the loss. She taught me how to eat a more whole food, carb-controlled diet. I stopped eating anything processed. I moved to eating grass-fed beef, pasture-fed chicken eggs (what I call happy cows and happy chickens—eating what they're supposed to eat, outside in the sun). I stopped eating most grains. Cut out bread, pasta, potatoes, etc. I still eat a little bit of brown rice and whole-grain oatmeal. I eat an average of 85 grams of carbs a day. I get the majority of it from vegetables and some fruit.

I eat meat. I eat eggs. I eat butter and cream. All that stuff that’s “bad” for you. I almost never feel hungry. For the most part, I don’t crave sugar or chocolate or junk food. (Although, last night I made dinner for a friend which included this signature chocolate thing I make for dessert. I almost fainted from the smell when I cut open the package of chocolate chips.) Last month I ate a piece of wedding cake at a friend’s wedding. It was the first sugar I’d eaten in six months—I didn’t enjoy it nearly as much as I thought I would. I just don’t seem to have that raging sweet tooth I’ve had most of my adult life.

And, yes, quitting all the carbs cold turkey was hard.* Especially the first 3 or 4 days. I basically sat in my living room at night having a battle with myself and trying to ignore the cravings and the late-night grazing habits. But once I started getting some good food in my body, the cravings went away and I started seeing results pretty fast. I dropped 40 pounds in the first four months. I’ve dropped 74 pounds to date from my heaviest weight. Just by cutting out anything that came in a box or had sugar or grains in it and working out 5 or 6 days a week.

My A1c dropped from 7.2% to 6.2% and three months later to 5.6%. My cholesterol dropped from 318 to 236. I have so much energy I don’t know what to do with myself sometimes. And the depression I’ve suffered from since I was a kid—gone. Completely.

*This does come with a word of warning, though. This is something you have to do cold turkey. It's really not something you can ease into. And it can really mess up a relationship if you don't warn your partner about what you're planning on doing before you do it, as well as leaving your friends scratching their heads when you retreat for a few weeks to battle your food demons. (Ask me how I know.)

Sunday, April 20, 2008

You Know How to Make A Girl Feel Welcome!

Wow! I had no idea so many of you would be interested in reading about my adventures in trying to smite the diabetes. Oh, the responsibility. Thank you for all the comments you guys left. And many thanks to Ryan for directing you over here!

Diabetes Sucks, Part 2
I really wanted to call my blog "Diabetes Sucks" but it turns out that someone had beat me to it and when you Google on that phrase it's really obvious I'm not the only one who feels this way about having diabetes—doesn't matter if it's type 1 or type 2.

Diabetes is one of those diseases that really can’t be managed for you by someone else—no matter how good their intentions. My partner Ryan tried for years to get me to eat better, to pay more attention to the diabetes, to gently remind me that I do, in fact, have diabetes—but it usually ended in arguments and pouting because I’ve never liked being told what to do. And I didn't want to be reminded about it while I was eating a piece of cake, or a big bowl of ice cream or seconds on mashed potatoes. I was happy living in my little bubble of denial.

It's a really personal disease because it affects so many parts of your life. It can affect how you socialize—whether friends invite you to food-related things or not, whether you participate in potlucks, how far from home you can get without a snack, whether you can have a glass of wine with dinner or not, staying away from the goodies that people bring to the workplace, food gifts from vendors, trying not to hurt your host's feelings when you don't eat something they've prepared, etc. Your fingers are always sore from the blood testing which makes it hard to do things you may enjoy like playing the guitar, crafts, or doing anything that requires fingertips. If you have squeamish friends, you have to go find someplace to test* and/or give yourself a shot of insulin. So you end up missing out on fun and conversation. You can see why it's a lot easier to just ignore the diabetes—it's just a heck of a lot more fun to pretend you don't have it.

Eating 101
Carbs are the enemy for diabetics. Most people know this. The more carbs you eat, the harder it is for your body to use the glucose, the higher your blood sugar goes, and the more exhausted your pancreas gets. So why the hell do doctors and nutritionists tell a type 2 diabetic to eat 200 grams of carbs a day without the benefit of injected insulin?

I did this for years. Guess what? My blood sugar averages were around 140 mg/dL which does NOT keep you out of the "bad things will happen to you later" level of the game.

My friend and fitness coach Kristn and I had been talking about eating for diabetes and the fact that what I'd been told to do wasn't working, so she sent me a link to Mark's Daily Apple where he pretty much laid out why type 2 happens and why eating all those carbs everyday is probably not a good idea. It’s written in laymen’s terms and talks about how the process works and how the excess carbs we eat contribute to type 2 diabetes. I learned more in this five or six minutes of reading than from my doctor, from the nutritionist, or from the 8 or 9 books I wasted money on about managing diabetes.

This got me thinking—I’d already been weightlifting hard for several months with measurable results (albeit no weight loss), but some definite rearrangement of fat. What if I tried to reduce my carb intake and packed on as much muscle as I could in order to increase my insulin sensitivity?

So that’s what started this sort of crazy journey. My initial goal really wasn’t to lose weight but to increase my insulin sensitivity so that my blood sugars would be more level—and lower—throughout the day and to eventually cut down on the amount of metformin I was taking. I figured if I snuck up on the diabetes from a different direction maybe I could beat it into submission.

And honestly, I'd given up on losing weight years ago.

*Personally, I test my blood sugar in the kitchen because that's where I am when I get ready to eat and I'm more likely to test if the meter's sitting there looking at me while I'm prepping a meal. Some people might think this is really gross but we're talking about a drop of blood slightly larger than the head of a pin.

Friday, April 18, 2008

What's an A1c?

In my last post I included a reference to my A1c test results. I realized that unless you have diabetes you probably have no idea what I'm talking about, so here goes.

A1c is short for glychohemoglobin A1c test. It’s a blood test that can tell you what percentage of red blood cells have glucose bound to them at any given time. The test gives a result for about 12 weeks worth of glucose levels and is a reasonable review of how well- or badly-controlled your diabetes is. Non-diabetics will range between 4% and 6%. You're considered to have good control if it's under 7%. The lower it is, the less likely you are to suffer from the many lovely complications diabetes has to offer.

Generally, it’s not used for diagnosing diabetes, but they take it after you’re diagnosed, as a baseline. Mine was 9.7% when I was diagnosed, which still wasn’t as awful as some people when they’re first diagnosed, but it wasn’t good. For a diagnosis of diabetes, I believe a fasting blood sugar above 126 mg/dL gets you into the club for life.

Thursday, April 17, 2008

A Little Family History

My father was diagnosed with juvenile diabetes (now referred to as type 1) at age 15, back in 1953. His care was as good as it could be during that era in rural Washington. His mother did her best to make sure he took his insulin, stayed away from sugar, etc. When he left home at age 18 or 19 and was on his own, things kind of went downhill. He drank. He smoked. He ate things that weren’t in his meal plan. At age 23 he met my mom and her parents, who took him in and got him back on track.

It took 15 years for the mismanagement of his diabetes to catch up with him. And then he paid. Fast forward to age 38 when he was told that his kidneys were failing. This was 1976 and it was rare for a diabetic to get a dialysis machine because it was still a relatively new treatment for kidney failure. I don’t know why he was given a machine, but he was. And with my mom’s great care, plus support from the Northwest Kidney Center, he lived for 11 more years—10 years longer than he’d been given without a transplant. During that time, he developed heart disease, severe neuropathy and diabetic retinopathy to go along with the kidney failure. Sadly, he did the majority of the damage to himself in his late teens and early 20s—those years when you feel the most immortal. He died after his third heart attack at age 49, in 1987.

What’s the Point of Talking About Dad?
I lived with a textbook example of what happens when you don’t take care of your diabetes. I was warned as early as age 22 or 23 that if I didn’t change my diet and lose the extra 30 pounds I was packing, I would probably develop diabetes at some point in my life. I didn’t listen. Who does at that age? (Dr. Lardy, if you’re out there, you were right.)

So here I am, at 45. I’ve had diabetes for seven years. For most of those years, I've had reasonable (but not great) control—A1c results ranging from 6.4% to 7.6%. Mostly, I'm sure, because I swam everyday for four years—because it sure hasn't been from eating right.

Lately, through reading and such, I've come to the conclusion that in order to avoid the complications I watched my dad suffer from, I need to keep my A1c under 6%—in other words, "normal" range—regardless of what my physician thinks is a good lab result.

Contrary to my denial over the years about having this damn disease, I really don't want to end up like dad.

Wednesday, April 16, 2008

Diabetes Sucks

I was diagnosed with type 2 diabetes on January 2, 2001. A heck of a way to start a new year! I weighed 260 pounds at 5’3”. I was just shy of 38 years old. My worst fear had come true—I had diabetes just like my dad.

This blog is about living (or not) with diabetes. For the first two years after I was diagnosed I did exactly what I was told by doctors and nutritionists. I thought I understood the disease because I’d grown up with a diabetic parent. Turns out I didn’t know shit about the disease I have, and neither did the medical personnel I was trusting to help me.

At the end of 2002, I suffered a back injury that left me unable to walk without assistance. I hobbled around for nine months and was at the mercy of anyone who was kind enough to bring me food or make me a meal. The only good thing that came out of it was daily swimming to keep moving. I gained back all the weight I'd managed to lose after my diabetes diagnosis. I pretty much gave up managing it and decided to ignore it for the next three years.

Then about 1.5 years ago I joined a gym, hired a trainer and worked out for a year. Six months ago I decided that I should look better for the amount of work I put in at the gym, so with help from my trainer, I radically changed the way I eat. I've lost 52 pounds since October 2007. It's made a huge difference in my blood sugar levels.

I thought some of the stuff I've been doing might be of interest to others. Maybe someone will read this and get something from it, maybe not. But here it is.

Thanks for reading.