A Dietitian’s Journey – out of denial and approaching health

Today it’s 4 weeks since I began “practicing what I preach” when it comes to a low carb high fat diet and to be frank, the results have astounded me.  Over the last two years, I’ve been reading through the literature on this topic and while I knew that eating this way could produce significant results – I had no idea that it would be possible to see blood sugar and blood pressure come down this much in this short a time, especially given how well, and much I eat. Then there is the weight and inches lost. This is a summary of my progress to date.


Out of Denial

Part of this ‘journey’ of getting healthy myself, has been to come out of denial.

When we ‘deny’ something, we say it is untrue – but it was not as though I was deliberately deceiving myself or anyone else about my health, I was simply omitting to find out the magnitude of reality.

In psychological terms, I was in denial.

Out of Diabetes Denial

In the first entry in this journal, I mentioned how I didn’t know how high my blood sugar was because I hadn’t measured it in ages. I hadn’t had my HbA1C measured in a year and a half.  I didn’t want to know how bad it was. Despite being a Dietitian with a post graduate degree in Human Nutrition, I didn’t want to know how unhealthy I was.

In 6 months from the time that I began this journey, I want to know what my labs show. HbA1C measures the amount of glucose bound to hemoglobin (glycated hemoglobin) and since it takes 3 months for the red blood cells in our bodies to turn over, it takes that long for HbA1C to begin to reflect the dietary changes made. Having my HbA1C measured in 6 months will show my average plasma glucose level since I started eating a low carb, high healthy fat diet.

Using good scientific methodology, I should have measured my fasting blood glucose and HbA1C at baselinebefore I started to change what I am doing and then measure them again in 6 months.  That way, I could calculate the magnitude of change, but I didn’t so I can only go on what I have.

I know that my blood sugar has been ~12 mmol/L because that’s what it would be this past month when I would eat more ~ 50 gm of carbs. Before I started this journey, I was eating significantly more carbs than that.  Furthermore, the previous three years, my fasting blood glucose was 7.9 mmol/L (Feb 2013), 9.1 mmol/L (Sept 2014) and 9.7 (Aug 2015). Extrapolating that data to the present date brings it pretty close to 12 mmol/L.

out of Hypertension Denial

Without question, prior to a month ago, I would have been diagnosed with hypertension (high blood pressure) as the first week of this journey, my blood pressure was 1/3 of the time in Stage 2 Hypertension with one  hypertensive emergency (i.e. higher than Stage 3 hypertension) and 50% of the time I was in Stage 1 hypertension, with the remaining ~ 15% in pre-hypertension. The last time my GP measured my blood pressure was a year and a half ago (Aug 2015), I was straddling Stage 1 and Stage 2 hypertension.

It was a ridiculously high blood pressure of a month ago that was the impetus for me to change.  That day, I became my ‘first client’.  That day, I began practicing what I preach and as someone with insulin resistance, I began eating low carb, high healthy fat.

out of Dyslipemia (Cholesterol) Denial

I have no idea what my lipids were when I started changing how I eat, but I know what they were for the last 3 consecutive years. My LDL  cholesterol (so-called “bad cholesterol”) was hovering around 3.00 mmol/L, with the normal range for low risk individuals being 1.50-3.39 mmol/L. However due to having Type 2 Diabetes, as well as a family history of high cholesterol, I am high risk and my LDL levels need to be ≤ 2.00 mmol/L. 

My HDL cholesterol (so-called “good cholesterol”) was high; ranging between 1.76 mmol/L three years ago, to 1.91 mmol/L two years ago, to 2.25 mmol/L – significantly above the 1.10 mmol/L cutoff, however my GP did not consider that protective. His determination for putting someone on lipid lowering medication (statins) is based only on LDL levels. In discussion with him, I decided that I would take a dietary approach first and that this would be following a low carb high healthy fat diet. The agreement was that I would get my labs taken again in 3 months.

out of obesity and overweight Denial

I knew how much I weighed a month ago, but it had been a year and a half – since August 2015 since I calculated my BMI – and more significantly, since I measured my waist circumference. Today, after a month of significant diet changes, I came out of denial with respect to my weight, and calculate my “numbers” – just as I do for my clients. After all, I am now my ‘first client’.

It turns out, I am overweight now – which means I was just in the obese category at a BMI of 30.5 (obese is a BMI > 30) when I began this journey.

No matter how I calculate it, I still need to lose at least another 30-40 pounds.

By the Scale

Based on the scale, I need to lose 29 pounds for my BMI to reach the high end of the “normal weight” category (< 25). To put myself in the mid-range of the normal weight category, I should lose another 35 pounds. 

By Fat Percentage

Based on my fat percentage, I need to lose 17% of my body weight (29. 1/2 pounds) to be at a healthy 23% (non-athlete, female). That’s another 30 pounds.

By Waist to Height Ratio

For my waist circumference (in inches) to be half my height (in inches), I need to lose 30 pounds.

How do I know?

Because all these years, I kept my leather pant belt from when I was that size and I remember well how much I weighed, then.


MY RESULTS – ONE MONTH UPDATE

So how am I doing after one month eating low carb high healthy fat?

my Weight

It is now the end of the 4th week and I have lost 5 pounds.

That’s right, I didn’t lose a thing this week.  Am I upset?  Not at all, because I lost another half off my waist.

my Waist Circumference

In the first two weeks, I lost an inch off my waist, the third week, another 1/2 inch came off and today I measured my waist again – without sucking in my belly (what would that prove?!) and it is down another half inch. In total, in one month, I lost 2 inches off my waist.

Based on my Waist to Height Ratio (WHTR), I still have another 8 inches to lose off my waist – which would have seemed so discouraging a few weeks ago, except that 2 inches came off effortlessly, with me following the Meal Plan that I designed for myself.

It's great having the skills to take my health into my own hands, knowing I am getting all the micronutrients that I need - but for those that need help getting started, there are Dietitians such as myself who can help!

During the entire 4 weeks I was never hungry (if I was, I could eat!) and I’ve been meeting my daily requirement for protein as well as Calcium, Magnesium, Potassium, Vitamin K, Vitamin A, Vitamin C and Vitamin E.

Yes, my fat intake is high (~75% of calories) but most of the fat I choose to eat is monounsaturated fat, such as cold pressed olive- and avocado oil, fats in nuts and seeds, as well as omega-3 fats from fatty fish such as salmon, mackerel and other fish (such as cod). Based on the reading I have been doing in the literature, I do not believe that eating this way poses any adverse health risk to me. If it did, I wouldn’t eat this way and would certainly not encourage others to do so.

Based on the literature, there is nothing inherently "bad" about eating saturated fat. Our bodies actually make it in the form of palmitic acid. I eat eggs occasionall or cheese and put a splash of cream in my coffee but when it comes to my main sources of fat, I look to cold pressed olive oil which is 65-80% monounsaturated (oleic), 7-16% saturates (palmitic) or cold pressed avocado oil which are 76% monounsaturated (oleic and palmitoleic acids), 12% polyunsaturates (linoleic and linolenic acids) and 12% saturates (palmitic and stearic acids), as well as fat from nuts (almonds, pine nuts, macadamia nuts) and seeds (pumpkin, mostly).

The only thing that is “low” in my diet is carbs, but since I am being sure to meet my micro-nutrient and protein requirements, I can see no physiological purpose for having more carbs.

my Fat percentage

I’ve gone from ~ 41.5 % body fat to 40 % body fat in a month. Okay, I’ve a long way to go, but I am doing what I need to do, the results will come.

My Blood Sugar

I should mention that to track my blood glucose accurately, I am using two glucometers; (1) one that is a year old made by GE and using it with brand new blood glucose test strips and (2) a brand new glucometer, made by Abbott which also takes Ketone Strips, so I can track my ketone levels.

I am purposely keeping my ketones low and being sure that the "numbers" (weight, waist circumference,fat %, blood glucose and blood pressure) decrease slowly and steadily. 

As far as those who recommend a high fat diet, I take what most would consider a conservative approach.

Ketone meter – measuring B-hydroxybutyrate
Ketone sticks – for measuring ketones in urine

As long as I kept my net carbs (carbohydrate minus fiber) reasonably low, I did very well, but above that my body could not handle the carbohydrate load. Without a doubt, I was very insulin resistant –which is no surprise, considering I was diagnosed with Type 2 Diabetes ~ 10 years ago.

This past week, I tracked my carbs carefully (easy to do and requiring no apps) and my blood glucose continued to decrease this past week, in a linear fashion at all times of the day .

My body is doing exactly what it was designed to do; happily breaking down the fat I have stored up over the years and converting it into glucose for my blood.

This was my blood sugar last night, 2 hours after supper. 

I haven’t seen post-prandial (after-a-meal) blood glucose levels like this since I’ve been Diabetic, which is 10 years!

This was supper;

zucchini spaghetti – with meat sauce and Asiago cheese
mixed green salad with extra virgin olive oil, goat feta and pumpkin seeds

As you can see, I am hardly starving!

I used to love fruit on my salad, but have found that snap peas cut up have just the right amount of sweetness, lots of fiber and a whole lot less carbs!

Blood Pressure

I should mention that to track my blood pressure accurately, I purchased a brand new, top-of-the-line sphygmomanometer which measures my blood pressure automatically 3 times, one minute apart and takes the average. 

Week One

The first week my blood pressure was divided up between

50% Stage 1 hypertension

~30% Sage 2 Hypertension

hypertensive emergency (not good!)

<15% pre-hypertension

 


Week Two

The second week my blood pressure dropped to;

>80% Stage 1 Hypertension

<20% pre-hypertension 

This can largely be explained by naturesis (kidneys getting rid of the excess salt through the urine) in response to the insulin drop.


Week Three

The third week my blood pressure was;

~85% Stage 1 Hypertension

~15% pre-hypertension 

Yes, it was a tiny bit higher, but very stable, with my diastolic pressure (the second number in blood pressure) hitting normal levels several times.

Week Four

This week my blood pressure was;

~81% Stage 1 Hypertension

~19% pre-hypertension 

 

Its getting progressively lower each week.

The last few nights, I saw “normal” blood pressure readings;

March 25 2017
March 26 2017

 

 

 

 

No, my blood pressure readings are not (yet) always normal, it has only been FOUR WEEKS! On average, my blood pressure has come down 1 mmHg / day for 4 weeks in a row.

Final Thoughts

Data is data and while not scientifically ‘objective’ data, and with a sample set of only 1, the “numbers” are convincing.

I feel well, I am eating better than I have in years. My sleep has improved significantly. My clothes fit looser and when I look in the mirror, the face that looks back is more familiar.  An added benefit is that my fingers, which have been stiff for years, are much less so.

I can’t think of any drawback to eating this way, except for the space required to have lots and lots of fresh vegetables in the house and that I am going through them at an alarming rate!  Thankfully, I have an extra fridge in the garage, so I don’t need to shop more than once a week. 

Even food cost, which was a bit of a shock the first week (as I had to purchase ingredients I didn’t use before, and certainly not in that quantity) has leveled off. I spend a lot less money on milk and large amounts of cheese and a lot more on the best quality olive oil and avocado oil.  Protein quantities are about the same as before, except there is more animal protein now as I used to be mostly vegetarian. Protein sources are mainly fresh fish, chicken, and marinated flank steak. None of these are high in saturated fat, so even those of my peers that might worry about people who may be physiologically sensitive to higher saturated fat levels would not be concerned about the way I am eating.

Yes, I am eating “high fat” but 80% of it is what even the most conservative health care practitioner would admit are “healthy” fats; olive oil, avocado oil, fat in nuts and seeds and the fat naturally found in fatty fish. Studies seem to show that even those who eat a much higher saturated fat diet, suffer no adverse health issues. At the end of the day, I am meeting all my dietary needs and the only thing that is missing is the “carbs”.  So?

Unless someone can present me with a compelling reason why I need those carbs, I see no reason not to keep eating the way I am eating and teaching others who wish to do so, the same.

To our health!

Joy


Note: I am a "sample-set of 1" - meaning that my results may or may not be like any others who follow a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


follow me at:

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Spaghetti Zoodles with Bolognese Sauce

On a cool, rainy day, there is nothing quite as comforting as Spaghetti and Bolgnese Sauce, but who wants all those carbs? So I invented “Zoodles“; “noodles” made from zucchiniWell, I don’t think I exactly ‘invented them’ because I have since seen other people post articles about them, but they were innovative at the time.

Now that I’ve made these a few times, I actually prefer them to wheat-based noodles, because you can eat a large plateful and not feel overstuffed afterwards.  And when cooked just right, they actually can be wound up on a fork, just like pasta!

al dente Zoodles and Bolognese sauce

So how do I prepare Zoodles?

For two large servings, I take 2 or 3 slender, firm zucchini (less seeds this way) and shred them on a Japanese mandolin*, using the middle thickness of cross blade.

* I use the Benriner mandolin, but one of those "spiralizers" would work too, except it would be difficult to avoid shredding the pulpy middle.
shredded zucchini, ready to cook

I place the pile of raw “Zoodles” on a plate, sprinkle about 1 tsp. of water on top and cover with a microwave cover.  Then I microwave them at 80% power for 3 minutes, then let stand for 3 minutes. I drain the excess water by placing the cooked Zoodles in a colander and leave them covered until ready to serve.

cooked zucchini Zoodles, ready to top with sauce

Top with your favourite sauce and voila! Spaghetti Zoodles Bolognese – without the carbs!

Spaghetti Zoodles with Bolognese Sauce

Buon appetito!


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Two People, Two Options: living healthy or dying prematurely

This weekend has been a challenging one, as I received two pieces of news. The first was of one client’s incredible success following the low carb high healthy fat diet and the shocked reaction of his doctor, and the other was of the death of a friend who had Diabetes, high blood pressure and high cholesterol. In this blog, I will share how these two events embody the two options each of us have; (1) living a healthy life to the fullest or (2) living with diet-related disease and dying prematurely of ‘natural causes’.


“JP” – a Picture of Success

Last fall, I had a reasonably fit 35-year-old client contact me wanting to lose 15 pounds. He went to the gym twice a week for an hour, and ran 10 km per week, but had put on some pounds and wanted to lose them.

As I always do, I asked for a copy of recent blood test, assessing his fasting blood glucose, HbA1C (3 month average of blood glucose), cholesterol (lipid panel) and requesting his doctor-assessed blood pressure. (Sometimes people insist that I counsel them without seeing blood work, but I explain that they ran out of crystal balls when I was graduating, so I have no choice but to get labs.)  I gave my new client a Lab Test Request form to bring his doctor.  The GP scoffed at the Lab Test Request Form asking him to requisition a lipid panel for a young, fit 35 year old whose parents are both living. That changed when the tests came back, and this man’s triglyceride level was higher than I had ever seen anyone’s, ever. His non-HDL cholesterol was very high and his HDL was very low. LDL wasn’t even available because his triglycerides levels were through the roof. His ferritin was astronomically high – not a sign of excess iron, but likely inflammation.

His doctor called him into the office immediately and wanted to put him on statin medication right away and referred him to the Lipid Clinic at a major local hospital.

My client told his doctor he wanted to wait 3 months and first follow my dietary recommendations and see what would happen to his lipids, and was advised against it by his doctor. My client was insistent, so the doctor told him that his recommendations were for him to eat “decrease saturated fat and carbohydrates, increase fruit and vegetables, increase insoluble fiber and fish, make his plate 1/2 vegetables, 1/4 protein, 1/4 starch“.

After seeing me, he agreed to limit fruit to max 1 / day, preferably a few berries on top of 2 or 3 huge salads with plenty of good quality olive oil and to have most of his carbs as vegetables. He learned that “not all vegetables are created equal” and I taught him to differentiate between those he could eat as much as he wanted at each meal and those he should limit or avoid. We talked about milk consumption, and the health benefits of eating plenty of fatty fish, such as salmon, mackerel and fresh sardine. And we talked about carbs. We talked a lot about carbs. Carbs in fruit, carbs in milk, carbs in bread, pasta and rice, and carbs in vegetables. 

I designed an Individual Meal Plan for him, making sure he obtained sufficient macronutrients (protein, fat and carbs) as well as micronutrients (especially potassium, magnesium, sodium, vitamin C and calcium, vitamin D and vitamin K) – and factoring in his desired weight loss. I explained that if he followed his Meal Plan, it is perfectly reasonable for his triglyceride levels to be <2.00 mmol/L in 2 more months. 

Three weeks later, his doctor ran his labs again.  His triglyceride level was almost a third what it was! His non-HDL was down substantially and his HDL was rising nicely. When he was seen at the Lipid Clinic, they were willing to give him 2 more months to get his lipids in the normal range before starting him on medication.

Friday, he wrote me telling me that his triglycerides we down well below 2.00 mmol/L and added;

“this amazed the doctor!”

My client left his doctor’s office without a medication prescription and with only the recommendation to keep eating the way I taught him. My client added that he was already within 2 – 3kg of his goal weight.

It’s not magic.

The doctor should not have been amazed that diet alone can be this effective – even for someone for whom high cholesterol has a genetic component. The literature documents the role of a low carb high fat diet.

But it is easier to write a prescription than educate a patient. 


My High School Friend – preventable premature death

Last night I learned that my friend since high school, died from natural causes. She had Type 2 Diabetes, high blood pressure and high cholesterol. She and I were the same age.

Three years ago, when my friend was first diagnosed as having Diabetes, she asked my opinion about having received Diabetes counselling in her province to eat 45 gm of carbohydrates at each meal and at least 15 gm of carbohydrates at each of 3 snacks – that’s 180 gm of carbohydrates per day.  A mutual friend of ours from the same province, who had also been recently diagnosed with Diabetes confirmed that she too was advised to eat 45 gm of carbohydrates at each meal and at least 15 gm of carbohydrates at snacks. At that time, I had explained to my friend what I had been learning about the role of excess carbs in Diabetes, hypertension (high blood pressure) and high cholesterol. While I provide distance consultations in my practice (using a combination of phone, email and fax), as Dietitians we are advised specifically not to provide dietary counselling to family members or friends. With my ability to help directly being very limited, I recommended that she find a Dietitian near her who could teach her about managing this triad (called “metabolic syndrome“) using a low carb high fat diet. She followed the standard dietary recommendations to the letter and took her multiple medications as prescribed. Her blood sugar levels came down using medication (but that was effectively treating the symptom of high blood sugar, not the cause which is the underlying insulin resistance). Her blood pressure kept going higher and higher despite medication, so more medication was added.  She then developed high       cholesterol.      

Today, my friend is dead, in what may have been an entirely preventable, premature death.

So I am left asking myself ‘could following the standard recommendations of eating 180 gm of carbohydrate per day (or more) with Type 2 Diabetes, high blood pressure and high cholesterol — without treating the underlying cause (insulin resistance) have contributed to her death’?

The literature is certainly full of studies documenting the beneficial effects of a low carb high fat diet on metabolic syndrome – but she was never given that as an option.  She was prescribed medication for lowering blood sugar and blood pressure, but nothing was done to lower her insulin resistance.

A lifetime of work by the late Dr. Joseph Kraft with almost 300,000 people documents that it is the insulin resistance that underlies cardiovascular disease  not the high blood sugar. Furthermore, 65-75% of people with normal blood sugar levels still have insulin resistanceand the same elevated risk of having a heart attack. 

We keep treating the symptoms and people keep dying anyways – and those without any symptoms are walking around with elevated risk of dying from cardiovascular disease, and don’t even know it.

We are told;

“Diabetes is a chronic, progressive disease”

which means that once diagnosed with Diabetes, you’ll have it forever – and that eventually it will get worse, requiring medication, then more medication and finally insulin.

When people have bariatric surgery (“stomach stapling”), their blood sugars come back to normal within weeks and at the end of a year, they no longer have any of the clinical symptoms of Diabetes.  Their fasting blood glucose levels are normal and their HbA1C levels are normal. They are essentially as if they don’t have Diabetes. Their Diabetes is in remission.

So is Diabetes REALLY a “chronic, progressive disease”? No, it can be stopped.

If the reason people became Diabetic was because of how they were eating, why is it SO hard to grasp the concept that they could get well, but changing how they are eating?

At the end of the day, we have a choice.

We can do as my client above did and put everything we have into changing how we eat based on good, sound scientific studies and with medical supervision, or we can keep doing what we’ve been doing, expecting different results.

I made my choice a month ago tomorrow, and will write an update in the blog titled “A Dietitian’s Journey” tomorrow, for week four  (see Food for Thought tab, above).  Here’s a teaser; two days ago my blood sugar levels were several times at normal levels – and were overall much lower than a month ago. Last night (twice) and once this morning, my blood pressure was in the normal range.  One month!

I ask myself, what will my labs look like in 3 months or 6 months of addressing the underlying insulin resistance (instead of the symptom of high blood sugar?) What will be life be like, when I have normal blood sugar levels and normal blood pressure and normal cholesterol levels?

It will look better than the alternative.

Rest in peace, dear friend.


Note: Everyone's results following a LCHF lifestyle will differ as there is no one-size-fits-all approach and everybody's nutritional needs and health status is different. If you want to adopt this kind of lifestyle, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


follow me at:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/

 

 

Significance of Insulin Resistance

Insulin resistance is a condition where your body keeps producing more and more insulin in order to transport glucose out of the blood and store the excess by converting it to fat. When cells have become resistant to insulin, glucose builds up in the blood and results in “high blood sugar”. The problem is that high blood sugar is a symptom of the problem, it is not the problem itself.  Insulin resistance is the underlying cause and is highly significant to those with completely normal blood sugar levels.

Those with high fasting blood glucose may notice symptoms that are associated with Type 2 Diabetes; including excess urination and excess thirst. This is the body’s way of trying to dilute the high levels of glucose in the blood. A very sobering fact is that 75% of people with insulin resistance have normal fasting blood glucose levels and don’t know that they are insulin resistant.

They have NO symptoms whatsoever.

They don’t know that they are at increased risk for heart attack and stroke.

The Silent Risk of Insulin Resistance

Insulin resistance is a risk factor for atherosclerosis* – also called “hardening of the arteries”. Atherosclerosis is where plaque builds up inside the body’s arteries and if the plaque build-up occurs in the heart, brain or kidney, it can result in in coronary heart disease, angina (chest pain) or chronic kidney disease. These diseases are normally associated with Diabetes, but it is the underlying insulin resistance of Diabetes that creates the increased risk – not the high blood sugar itself.  Worthy of note, it is being insulin resistance that increases one’s risk – whether or not one also has high blood blood sugar.

The plaque that builds up in atherosclerosis may partially block or totally block blood flow to the heart or brain and if a piece of the plaque breaks off or if a blood clot (thrombus) appears on the plaque’s surface – this can block the artery  resulting in a heart attack or a stroke (in the brain).

Three quarters of people with normal fasting blood glucose are at increased risk of atherosclerosis and as a result, to heart attack and stroke due to insulin resistance and they don’t even know it, because their blood sugar is normal!

* a few recent references (there are many more):
Pansuria M, Xi H, Li L, Yang X-F, Wang H. Insulin resistance, metabolic stress, and atherosclerosis. Frontiers in Bioscience (Scholar Edition). 2012;4:916-931. 

Santos, Itamar S. et al., Insulin resistance is associated with carotid intima-media thickness in non-diabetic subjects. A cross-sectional analysis of the ELSA-Brasil cohort baseline, Atherosclerosis 2017 Mar 10;260:34-40

Insulin Resistance with Normal Blood Glucose

Dr. Joseph R. Kraft, MD was Chairman of the Department of Clinical Pathology and Nuclear Medicine at St. Joseph Hospital in Chicago, Illinois for 35 years. He spent a quarter century devoted to the study of glucose metabolism and blood insulin levels.

Between 1972 and 1998, Dr. Kraft measured the Insulin Response to a carbohydrate / glucose load in almost 15,000 people aged 3 to 90 years old using a 5-hour oral glucose tolerance test with insulin assays. Data from 10,829 of these subjects indicated that 75% of subjects were insulin resistanteven though their fasting blood sugar level was normal.

That is, having a normal fasting blood glucose level, and normal HbA1C level does not preclude someone from being insulin resistant and at increased risk for heart attack and stroke.

The American Heart Association states on its web page that;

“exactly how atherosclerosis begins or what causes it isn’t known, but some theories have been proposed. Many scientists believe plaque begins to form because the inner lining of the artery, called the endothelium, becomes damaged. Three possible causes of damage to the arterial wall are (1) elevated levels of cholesterol and triglycerides in the blood (2) high blood pressure and (3) cigarette smoking“.

It is known that high triglycerides in the blood are largely a result of diets high in carbohydrates where excess carbohydrate that isn’t converted to glycogen and stored in muscle and liver is stored as triglyceride (three fatty acids attached to a glycerol molecule).

Insulin resistance in our cells, results in our bodies releasing more and more insulin in order to try to clear the same amount of glucose from our blood to store it in our liver as triglyceride (fat!). As covered in the blog post on the hormonal effect of insulin, it is the insulin which drives increased hunger and specifically increased craving for carbohydrates.  A viscous circle is created.  Diets that are 45-65% carbohydrate result in more and more insulin to handle the same carb load (that is the very nature of insulin resistance) and this increased insulin leads to even more insulin resistance, increased hunger and craving for….you guessed it: more carbs.

Since insulin’s main role is to store the excess glucose not needed immediately to fat – our bodies produce more and more triglyceride (fat!) the more carbs we eat and the more insulin resistant we are. That is, a high carb diet results in high triglycerides – which the American Heart Association recognizes as playing a role in the development of atherosclerosis. That is because triglycerides are converted to VLDLs to transport fat around the body and when their triglycerides ‘passengers’ are depleted, what is left is LDL, the “bad cholesterol” we have all heard about.  The ONLY source of LDL is VLDL, and high triglyceride is largely the result of a diet that is too high in carbohydrate.

Insulin also plays a significant role in the regulation of blood pressure through its effect on sodium transport. As insulin rises, excess sodium is retained by the kidneys, increasing blood pressure.  Insulin resistance compounds this problem, causing blood pressure to rise even more.  It has long been known that people with Diabetes develop high blood pressure – but it is the underlying insulin resistance that is driving that, not the symptom of high blood sugar.

What is alarming is that based on Kraft’s research with ~11,000 people over 20 years, potentially 75% of people are insulin resistanteven though their fasting blood sugar level is normal. This insulin resistance drives the increased triglycerides and high blood pressure that characterize what the American Heart Associations states is believed what underlies the development for atherosclerosis – and the corresponding risk of heart attack and stroke.

Could insulin resistance be a silent killer?

Kraft’s Patterns of Insulin Response

Kraft plotted the data from ~11,000 subjects and five distinct Insulin Response Patterns emerged.

Insulin Response Curves – image adapted from Dr. Ted Naiman

‘Pattern I: is a normal, healthy insulin response to a standard glucose load. Dr. Kraft called this ‘Euinsulin’.

image by Joy Y. Kiddie MSc RD
Pattern I: Normal Insulin Response Curve

Pattern II – is a hyperinsulinemic insulin response to a standard glucose. Note that Pattern II is considerably greater than the normal insulin response curve (Pattern I) and this greater insulin response is sustained for 5 hours after the ingestion of the glucose. 

image by Joy Y. Kiddie MSc RD
Pattern II hyperinsulinemia compared to normal glucose response (Pattern I)

Superimposing the hyperinsulinemic insulin response of Pattern II over the normal Pattern I insulin response curve, it is easy to see how much higher the Pattern II (yellow curve) is over the normal Pattern I (green) curve.  This is the early stages of insulin resistance.


Pattern III – is a hyperinsulinemic insulin response to a standard glucose load. Compared to the normal insulin response curve (Pattern I), it much greater during for 5 hours after taking in the glucose.

image from Joy Y. Kiddie MSc RD
Pattern III hyperinsulinemia compared to normal glucose response (Pattern I)

Superimposing Pattern III (hyperinsulinemia) insulin response curve over the normal (Pattern I) insulin response curve, its easy to see how the insulin response is delayed (skewed to the right). This results in blood glucose remaining high, as insulin is not responding as it should. Keep in mind, this is occurring in people with normal fasting blood glucose levels.

The Pattern III curve also goes so much higher than the normal Pattern I insulin response curve – which means that more insulin is released and this higher insulin release is sustained for the 5 hours after taking in the glucose.

This is “silent” pre-diabetes  delayed insulin response and much higher levels of insulin for a much longer time – but with normal fasting blood glucose!


Pattern IV – Pattern IV is what Dr. Kraft calls “Diabetes in Situ” – literally “Diabetes in Place”. Looking at the Pattern IV insulin response curve compared to Pattern I (the normal insulin response), it is apparent that it is much greater for the entire 5 hours after taking in a standard amount of glucose.

image created by Joy Y. Kiddie
DIABETES IN-SITU: Pattern IV insulin response points compared to the normal Pattern I insulin response curve (in green)
image created by Joy Y. Kiddie MSc RD
DIABETES IN-SITU: Pattern IV insulin response curve compared to the normal Pattern I insulin response curve (in green)

Surprisingly, 40% of people with a Pattern IV Insulin Resistance still had normal fasting blood glucose

75% of people displaying Pattern II, II or IV insulin responses do not know that they are at greater risk for atherosclerosis and as a result to heart attack and stroke because they have no symptoms.  Their blood sugar levels are normal.

Finally, insulin resistance is the most common cause of Type 2 Diabetes.

Normal fasting blood glucose and normal HbA1C results do not reveal whether or not a person is insulin resistant – only a 2 hr glucose tolerance test can do that. Unfortunately, a 2 hour glucose tolerance test is usually only requisitioned when fasting blood glucose and HbA1C results come back abnormal.

Potentially, up to 75% of people are insulin resistance and have NO IDEA!

They are at increased risk for heart attack and stroke and have NO SYMPTOMS.

They don’t have increased thirst or increased urination like Type 2 Diabetics, but are at the same risk.

The Good News

The good news is, we can lower insulin resistance – and as a byproduct of that, shed excess weight in the process. This is accomplished through (1) a low carbohydrate diet with or without the use of (2) stretching the amount of time between meals (sometimes called “intermittent fasting”).

When designed properly, a low carbohydrate diet can provide all of the recommended intake of vitamin and minerals – while lowering insulin resistance.

That is where I come in.

I can assess your physiological needs for energy and nutrients and design an Individual Meal Plan that will enable you to lose weight, without being hungry all the time – and that will help lower your insulin resistance and the associated risk of cardiovascular disease related to insulin resistance.

Want to know more?

Click on the “Contact Us” tab above, and send me a note.

To good health!

Joy

Copyright ©2017 BetterByDesign Nutrition Ltd.  LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without regular monitoring by a Registered Dietitian and with the knowledge of your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing something you have read in our content. 


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A LCHF Diet

low carb high fat (LCHF) diet is a way of eating that maximizes the body’s natural ability to access one’s own fat-stores for energy. Fat takes the place of carbohydrate as the preferred source of energy, so most of the body’s energy needs comes from a wide variety of healthy fats. A low carb high healthy fat diet  minimizes carbohydrate-based foods, has a moderate amount of protein and has a high amount of healthy fats.

We use the dietary fat that we eat and our own stored fat for energy and by keeping carb intake low, insulin levels are allowed to fall, which in time makes our cells more sensitive to it. As insulin levels fall, so does hunger – so we eat meals when hungry, until we are no longer hungry – but are no longer hungry every few hours.

The low carb high healthy fat diet

These are the categories and types of food that are available to enjoy on a low carb high healthy fat diet

Low Carb High Healthy Fat – food categories (acknowledgements: adapted from an illustration by Dr. Ted Naiman)

Macronutrients

The exact ratio of macronutrients in your diet (i.e. grams of carbs, fat and protein) will differ depending on your age, gender, activity level, current body composition as well as any health conditions or medication you may be taking.

Here are some general guidelines to give you an idea;

Protein

A low carb high healthy fat diet does not have unlimited amounts of animal protein, although some variations of this style of eating do. There is a reason for this. When carbs are reduced, the body can synthesize glucose from protein (through a process known as gluconeogenesis), so if you eat too much protein, it can slow down your body’s transition to burning fat stores, for energy. The type of low carb high healthy fat diet that I encourage, provides sufficient protein for our body’s needs based, but not excess.

Fat

One thing all low carb high fat diets have in common, is that they are lower in carbs than the conventional low fat calorie-restricted diet and high in fat.

People often ask me “isn’t saturated fat ‘bad’ for us?’, without realizing that ~80% of the saturated fat in our bodies is actually made by our body, and only 20% comes from diet. If it was that ‘bad’ for us, why would our bodies naturally manufacture it?

The questions often follow as to how much saturated fat should we eat? What about polyunsaturated fat? Monounsaturated fat?

Eating a diet that is high in carbs while eating lots of fat, including saturated fat is a concern, but eating a diet rich in saturated fat while eating low carbs is not inherently detrimental.

According to Phinney and Volek (The Art and Science of Low Carbohydrate Living), when someone is adapted to eating a low carb high healthy fat (i.e. are in “fat-burning mode”), saturated fats do not raise LDL cholesterol. That said, why eat only saturated fat? Eating a wide range of healthy fats from a variety of natural sources provides our bodies with all the essential fatty acids we can’t make, as well as provides us with foods that can reduce inflammation.

I recommend that people look mainly to plant-based fats such as those found in avocado, olive, avocado oil and coconut oil (which is largely made up of medium chain triglycerides that is processed through the lymphatic system rather than the liver), nuts and seeds as well as omega 3 fats found in fatty fish for the bulk of their fat sources, beyond the saturated fat that is found in their protein sources.

Nuts and seeds, including almonds, walnuts, pumpkin and sunflower seeds, pistachios etc. contain carbs – ranging from ~1.5–4 grams net carbs per ounce (30g). Cashews which are actually fruit not nuts, are the highest in carbs, ~ 7 net grams per ounce (30g) but more importantly, since nuts are high in omega-6 fats (which are pro-inflammatory and compete for binding-sites with the omega-3 fats from fish) I recommend that these be eaten in portioned quantities – such as added on top of a salad or a handful with a meal.

Chia and flax seed are approximately 1–2 grams net carbs per 2 Tbsp (50 ml) and are excellent sources of both soluble and insoluble fiber.

All fats on the meal plan are healthy – which is why I call this approach “low carb high healthy fat”, but for a small percentage of people for whom high LDL cholesterol continues to be a concern, eating less saturated fat may be beneficial. Each person’s needs and familial risks are different, so no one low carb high healthy fat Meal Plan is the same.

Carbohydrate

Carbs are a healthy part of the low carb high healthy fat diet, but excess carb is minimized.

There are naturally-occurring carbs in non-starchy vegetables and low-sugar fruit (such as lemon, lime, eggplant, cucumber and tomatoes) and berries, as well as those found in nuts and seeds – and these are not restricted.

When starting a Low Carb High Healthy Fat Diet

Although not everyone does, some people experience some of the following symptoms, which usually subside within a couple of weeks. For each, I have offered some suggestions to minimize them:

  • headaches: often a result of eating too little salt. As insulin levels fall, so sodium is excreted by the kidney in urine. The drop in sodium results in the headache.  Taking 1-3 gms of salt per day (I prefer sea salt) will alleviate this. If you are taking medication for high blood pressure, be sure to check with your doctor before making any changes to your diet.  “Bone broth” is another way to restore electrolytes that are lost as insulin levels fall. Be sure you’re drinking plenty of water and also consuming enough salt/sodium.
  • sleep disruption: often a result of needing to urinate more, but sometimes experienced when people of switching from being in “carb-burning mode” to being in “fat burning mode”. Some people find taking some magnesium (with calcium) before bed helpful.
  • digestive changes: some people find they get slightly looser stools or get slightly more constipated when starting.  I can help troubleshoot this with you to get things back on track.
  • aches and pains: some people feel a little achy and almost flu-like for a few days when they are switching fuel sources.  Some people call this the “keto-flu”.  Making sure to have a balanced amount of sodium/potassium and calcium/magnesium as well as taking extra omega 3 fatty acids is helpful.

My role as a Dietitian

As a Dietitian, I make sure that you understand the effect that following a low carb high healthy fat diet can have on your body.  If you are taking medication for high blood pressure  (hypertension) or to lower blood sugar, I’ll ask you check with your doctor before starting, as blood sugar and blood pressure medications may need to be adjusted lower, as insulin levels fall.

If you aren’t taking any medication, I’ll help you transition into understanding that fat in and by itself is not ‘bad’ and that eating good quality healthy fats, nutrient-dense carbohydrate-containing foods and high quality animal protein is part of a healthy diet that will enable you to feel better, lose weight and lower insulin resistance.

I’ll design your Meal Plan so that it is adequate in macronutrients (protein, carbohydrate and fat) as well as micronutrients (vitamins and minerals – especially Calcium, Magnesium, Potassium, B-Vitamins, Vitamin A, Vitamin D, Vitamin K and Vitamin C) and sufficient in soluble and insoluble fiber  – suitable for your age, gender and activity level, and that factor in any diagnosed medical conditions you may have.

I’ll make sure that you are eating sufficient food in each of the food categories to meet your dietary needs, while adjusting for weight loss, if that is also a goal – so that you can just focus on eating healthy, ‘real food’.

Have questions ?

Feel free to send me a note using the form on the Contact Us tab, above.

To your health!

Joy


Note: Everyone's results following a LCHF lifestyle will differ as there is no one-size-fits-all approach and everybody's nutritional needs and health status is different. If you want to adopt this kind of lifestyle, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


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A Dietitian’s Journey – three weeks in

INTRO: Three weeks ago, the pain of changing was less than the pain of remaining the same and so I changed. At that time, my blood pressure had hit dangerously high levels and I didn’t even know what my blood sugar levels were, as I hadn’t checked them in ages. I didn’t want to know. Despite being a Dietitian, I was in classic denial. March 1st, I began eating low carb high fat (LCHF) and delaying the time until the next meal (called “intermittent fasting”). Keep in mind, three weeks is an incredibly short period of time, but I did not expect to see these kinds of results. There was not only significant weight loss (water?) but loss of inches around the waist (also water?), but lower blood sugar and blood pressure, as well.

Today is three weeks since my journey began and here is an update on my progress – three weeks in.

Blood Sugar

In the first two weeks, my blood sugar decreased substantially even on the days I was not intermittent fasting – provided I ate very few carbs. When I was eating what most would consider “low carb”, my blood sugar would spike.

arrows indicated 2 periods of eating 10-15% carbs

It became clear that as long as I kept my net carbs (carbohydrate minus fiber) fairly low, I did very well but above a certain level my body could not handle the sugar load. You can see this from the graph above.

On Saturdays I was eating more than that level of carbs, which can be seen indicated by the grey arrows, below the graph. My blood glucose would spike if I had any more than the carbs found naturally in low carb meals.

I could see clearly that I was very insulin resistant –which is no surprise, considering I was diagnosed with Diabetes ~ 10 years ago. Despite my pancreas producing more and more insulin in response to eating carbs, the insulin was unable to take the glucose (sugar) from my blood in a reasonable amount of time, to store it in my liver.

[Note: According to the research of Dr. Joseph R. Kraft between 65-75% of people with normal blood sugar are actually insulin resistant - that is, they have the same risk of hardening of the arteries and heart attack as those with Diabetes, they just don't know it because they don't have high blood sugar to indicate that. That's is very sobering.

Since realizing how sensitive I was to more than the carbs naturally found in non-starchy vegetables and nuts and seeds, I cut out all other sources – including my beloved Hawaiian purple yam and homemade (baked) yam fries…for now, until my blood sugar levels are consistently in the non-diabetic range and my insulin levels, normalized. Even then, I know I will only be able to eat such things once in a while and in small servings, but that’s okay. As one of my sons would say “dying is bad“.

A week ago, I began tracking my carbs (easy to do and requiring no apps – not even a pencil). I aimed to keep them at the same lower levels and as you can see from the graph below, there has been linear decrease in my blood glucose levels at all times of the day – including first thing in the morning, after lunch, after dinner and before bed. It’s only been three weeks!

Week three – March 15 – Mar 21

Interestingly, the little ‘spike’ yesterday was in the early morning after – I hadn’t eaten for 12 hours! The effects of cortisol, perhaps?

My body was breaking down the fat I have stored and was converting it into glucose for my blood – a process known as lipolysis. This is a ‘good’ thing. My body was doing exactly what it was designed to do;

(1) store excess glucose as fat, in times of plenty,

(2) break down stored fat for glucose, in lean times.

The issue is, there have been no “lean times”.

Blood Pressure

Week One

The first week my blood pressure was divided up between

50% Stage 1 hypertension

~30% Sage 2 Hypertension

hypertensive emergency (not good!)

<15% pre-hypertension

It was all over the place (very hard on the heart) and the systolic pressure (the first number in a blood pressure) was very high.

After the issue with my eyes (which was non-diet or lifestyle-related) having hypertension (high blood pressure) put me at risk for blindness. I took this very seriously!


Week Two

The second week my blood pressure dropped to;

>80% Stage 1 Hypertension

<20% pre-hypertension 

This can largely be explained by the fact that the first thing that happens when we reduce insulin levels (a response to eating low carb) is something called naturesis. That is simply a medical term meaning our kidneys get rid of the excess salt by making us pee a lot. This period usually lasts ~4-10 days following going low carb.


Week Three

This week my blood pressure was;

~85% Stage 1 Hypertension

~15% pre-hypertension 

Yes, it was a tiny bit higher, but very stable.

The first two weeks I ate very low sodium as I usually did, but this week I actually had to start adding salt into my diet as my kidneys had expelled all the excess sodium it was retaining and my sodium levels were too low.  I felt a bit lethargic and light-headed.  The reading I’ve been doing in the literature and the Conference Proceedings I’ve been watching from some of the world’s leading physicians that treat diseases (such as Diabetes, hypertension / high blood pressure, dyslipidemia / high cholesterol as well as Alzheimer’s and some cancers) using a low carb high fat diet, mentioned this need for increasing sodium after the first 10 days.

A pleasant surprise was seeing my diastolic pressure (the second number in blood pressure) hit normal levels several times.

One of the roles of insulin (besides taking the glucose in our blood and storing it in our livers as glycogen or fat) is to signal the kidney to retain salt.  That makes us bloated and causes our blood pressure to go up.

Being Diabetic or insulin resistant (65-75% of people aged 3- 90 years, according to Dr. Joseph Kraft’s robust studies) causes people to retain sodium and raises their blood pressure. Hypertension (high blood pressure) is called “the silent killer” – but much of this is entirely diet related.  For the most part, is not too much salt, but too many carbs and too little green leafy veggies (rich in potassium) that underlies high blood pressure.

Anthropometrics

Weight

The first week and a half, my weight dropped ~4 pounds – much of it was water, from my kidneys expelling the excess sodium.  My weight didn’t budge for most of the last week and a half, but I didn’t let that discourage me.  My body was now burning fat and not carbs and the weight loss necessarily had to follow.

It is now the end of the 3rd week, and I have lost 5 pounds all together.

Waist Circumference

In the first two weeks, I lost 1 inch off my waist and this week, another 1/2 inch came off.  That is a very good thing – but for a different reason than I thought.

As Dietitians, we were taught that BMI (weight-to-height ratio) and waist-to-hip ratio allows us to factor in the greatest risk of cardiovascular events (heart attacks, strokes) but current research is showing that there is a much better predictor years of life lost (YLL) due to overweight, and that is the waist-to-height ratio.

Years of Life Lost (YLL) compared to Waist to Height Ration (WHtR)

Most of us have heard that where we carry our fat is even more important than how much of it we actually have. This is true.

Carrying it around the abdomen (belly fat, what Dietitians and Doctors call “central adiposity“) is a greater predictor of cardiovascular risk than BMI (weight to height ratio). Simply put, being an “apple” as opposed to a “pear” is not good.

But what should our waist circumference be?

A meta-analysis from 2012 pooled data from multiple studies which in total looked at more than 300, 000 adults in several ethnic groups, found that Waist to Height Ratio (WHTR) was a far better predictor than BMI or Waist Circumference of cardiovasular of metabolic risk factors in both sexes.

Ashwell M, Gunn P, Gibson S (2012) Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 13: 275–286

The least amount of years of life lost is associated with a Waist to Height Ratio of 0.5 (mine was not anywhere near that!).

That is, take your height and divide it by 2.

NOTE: Measure your waist at the location that is the mid-point between your last rib and the top of your hip bone, with the front and back of a flexible seamstress-type tape measure at the same height, and your belly fully relaxed. This is not the time to suck it in! If you measure your height in inches, measure your waist in inches and if you measure your height in cm then measure your waist in cm.

If the result of your Waist to Height ratio is greater than 0.5, then welcome to the club.  The question is, what to do about it?

That’s where I can help.

Practicing what I preach,

Joy

Note: I am a "sample-set of 1" - meaning that my results may or may not be like any others who follow a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


follow me at:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/

A Dietitian’s Journey – the road to better health

A Dietitian’s Journey – the road to better health

In the previous article titled “A Dietitian’s Journey – the beginning“, I shared about why I am (1) following a low carb high healthy fat diet and (2) extending the time between meals in my pursuit of improved health. In this post, I talk about the smaller third of the picture, (3) exercise. Why I am doing this is because quite literally, my life and quality of my life depends on it.

This “journey” is my road to better health – to optimal health.

As a Registered Dietitian in private practice, I’ve spent the last decade helping people in the Lower Mainland of Vancouver learn how to eat healthier, lose weight, lower their blood sugar and blood pressure and have cholesterol that is in the healthy range.  While I had lost 50 pounds myself a few years ago, little by little over the last 2 years, I’d put 1/2 of it back and along with the higher weight, came higher blood sugar levels, followed by high blood pressure.

My “fat picture” – prior to losing 50 lbs.

I had two choices; (1) go on medication or (2) change my lifestyle. I chose the latter. March 1 2017 was the beginning of the journey, on the road to better health.

But what was the “road”?

Over the last 2 years, I’ve done a lot of reading with regards to the physiology of why and how diets high in carbs underlie the “obesity epidemic”.  I understood how excess carbs that were not needed for energy were converted to fat and stored in the liver. I also understood how this excess fat in the liver negatively impacted cholesterol levels – that it wasn’t eating fat that gave people high cholesterol (except for a very small minority with genetic conditions) but eating too many carbs.

Day in, day out in my private practice I’d explain to people how eating “plenty of fruit and vegetables” was making things worse for them because of the carb content in these foods – foods that were eaten with- and between meals. I knew that following the standard recommendations of the last 40 years – to eat low fat and high carbohydrate and restricting portions was not going to accomplish my goal.

I decided to “practice what I preach” by eating a low carb, high fat diet (LCHF), and by extending the time between meals.  In time, I also hope to incorporate short periods of high intensity interval training (HIIT), but for now I just need to get moving!

Since I am not yet “fat adapted” – that is, my body hasn’t yet switched over to using my own fat stores as a fuel source, I knew that I needed to start with walking. Baby steps!

Yesterday, I set an appointment with myself to do just that, and while I was 3 hours later than I planned to be today, my ipod wasn’t charged and it was 5° C and pouring rain, I went to the track and did what I said I would do.

Here’s a clip from my first workout:

Note: I am a "sample-set of 1" - meaning that my results may or may not be like any others who follow a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

Copyright ©2017 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.) 

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


follow me at:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/

A Dietitian’s Journey – the beginning

A Dietitian’s Journey – the road to better health

I remember back at McGill, when I was doing my undergrad training as a Dietitian, one of my professors saying that most people chose Dietetics because they came from a background of disordered eating or diet-related health issues.  True to form, most of my extended family were obese and most had Diabetes, high blood pressure and high cholesterol and were on a whole host of medications for each.

Fast-forward 20 years (and several children later) and despite losing 35 of the 60 pounds I had to lose, I became Diabetic. More recently, I’ve had high blood pressure.

Unable to answer my questions regarding addressing both of these through a low-carb-high-healthy-fat eating plan, my GP referred me to an Endocrinologist. After a thorough physical examination and a whole host of blood work, she asked me about how I planned to address this, given that I am a Dietitian.  Hesitantly, I told her that I planned to eat a high healthy-fat diet and low carb diet with a medium amount of protein and use intermittent fasting to lower insulin resistance. She asked me what percent of “net-carbs” (total carbs minus fiber) I was aiming for and what percentage of protein and what my fat sources would be, and I told her.  I was waiting for an extremely negative reaction, but instead was completely taken aback by her reply. She said that from she’s been reading in the literature, my plan was not only evidenced-based, but that if I didn’t don’t lose the rest of the weight and eat this way, that I will end up on both medication for my blood sugar, and cholesterol and likely for my blood pressure, too.

I began to implement the dietary and lifestyle changes and was seeing my “numbers” coming down, but like many people, life happened and I didn’t follow through. The weight crept up and presumably so did my blood sugar and pressure, but I had stopped monitoring those ages ago. But it was a problem with my eyes — one whose cause was unrelated to being Diabetic or having high blood pressure that was a game-changer for me. Having these conditions put me at higher risk of losing my vision and this was simply not something I was willing to risk.

Two weeks ago, I arrived at a fork-in-the-road. One direction was the same as most of my family took; with medication for blood sugar, blood pressure and cholesterol. The other was the road that I am taking; the one less traveled, but very well-researched, and with the encouragement of my Endocrinologist – a low-carb-high-healthy-fat way of eating, with extended periods of time between meals, and periods of days of eating and then not eating. Not “starving”, but “intermittent fasting”.

The difference?

Starving results in the body lowering its metabolism to spare calories and intermittent fasting and alternate-day fasting results in the body raising its metabolism and burning stored fat.

The expected outcome?

The first goal begins with lowering insulin resistance; which is the underlying cause of Type 2 Diabetes, and with lower insulin resistance follows lower blood sugar levels – both fasting blood sugar and A1C (3 month average).

A change in diet and strategic use of fasting, lowers insulin and cortisol levels which in turn, lower triglycerides (TG). TG are largely a byproduct of a high-carb diet (especially affected by fructose), so lowering these results in lower TG and in turn, lower levels of LDL (bad cholesterol) and higher levels of HDL (good cholesterol).  Lower insulin and cortisol as well as less abdominal fat, results in lower, more normalized blood pressure.

Will it work?  The research seems to indicate it will and over the weeks to come, I will posting the results of some of that research so that the context of what I’m doing can be understood.  After all, I am a Dietitian and a scientist — it has to be evidenced-based.

The First Two Weeks – off to a good start

Blood Sugar

Of course this is an incredibly small period of time to look at, but in the first two weeks since I started my low-carb-high-healthy-fat eating with intermittent- and alternate-day fasting , my blood sugar has decreased substantially even on the days I was eating, provided I was eating very few carbs.

arrows indicated 2 periods of eating 10-15% carbs

Blood Pressure

My blood pressure went from 50% Stage 1 hypertension with 1 hypertensive emergency (scary!) and ~30% Stage 2 Hypertension the first week:

…to approximately 80% Stage 1 Hypertension and almost 20% Prehypertension the second week.

That is a significant change!

My weight is only down ~ 4 pounds, but I’ve lost 1 inch off my waist.

I am not hungry on my intermittent-fast days …and keep in mind, I talk about food all day long with my clients. If I am not talking about food, I am working on meal plans and writing about food!  If I was hungry, this would be torture, but it’s not. In fact, the last time I ate was last night at supper and I feel fine. I should have had a coffee though (as I get caffeine headaches if I don’t).  I’ll make one soon.

I’ve only taken one alternative-day fast so far and it went fine.  I drank “bone-broth” (I’ll explain in coming blogs!) and had my morning coffee with a little cream, no milk because of the carbs. I don’t really like cream, but it was okay.  Bone broth is interesting — a bit like chicken broth, but different.

One side-bonus that I never expected, is that I am sleeping better than I have in years.  Crazy good sleep and waking up rested.  What a great added bonus.

I have a long way to go to get to my goals (plural) because I’ve set the bar very high…and why not? If the literature indicates that this works, then I want;

(1) blood sugar in the non-diabetic range

(2) normal blood pressure

(3) normal / ideal cholesterol levels

(4) a waist circumference in the “at or below” recommended values of the Heart and Stroke Foundation

Will I meet all these goals?  Who knows?! But I won’t know if I don’t try and the alternative of a life of medication for blood sugar, blood pressure and eventually cholesterol too does not appeal to me!

So join me in my journey – a journey of change, of good health and on a road less traveled.

Joy

Note: I am a "sample-set of 1" - meaning that my results may or may not be like any others who follow a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

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LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.


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