A Dietitian’s Journey – practicing what I preach (9 week video update)

This coming Monday will be 9 weeks since I started this journey. The weight loss has been slow yet steady. I’ve lost 7 pounds and 2 1/2 inches off my waist. I can’t tell you how amazing it is to take jeans out of the dryer and put them on easily!

When I look in the mirror, I am starting to recognize the image that looks back. “She” had a neck and a chin – and “her” face is oval, not round. I know that person!

My blood pressure remains very stable (stage 1 hypertension) – down from the wildly erratic fluctuations between stage 2 hypertension, right up to a hypertensive emergency. It was that which started me on the journey, but what keeps me on it, is how I feel. I feel amazing.

My blood sugar is continuing to fall gradually, and for the last 2 weeks I’ve been in mild ketosis and am now “fat adapted”.

I no longer wake up with stiff, swollen fingers and for the first time in years, I fall asleep easily. Yes, I wake up several times to use the washroom, but I can certainly live with that.

This update, I am not going to post any statistics, no graphs, no fat percentages – in fact, I haven’t even taken it since last time.  I’m not obsessing over every pound, every inch, or every percent.  I’m just doing what I know to do and letting the results come as they come.

Two weeks after I started (March 16, 2017), I posted a video of me walking at the local track. It wasn’t “pretty” but it was real. The reason I posted it was because I believe it removes the barrier that somehow because I’m a Dietitian with a post-grad degree that I can’t really understand what it is like for my clients.  I do.

I have to get healthy and make lifestyle changes, the same way as everybody else…one day at a time.

So instead of statistics, and charts and graphs, I am going to post the two videos.  They’ve not been edited in any way – they are as-shot.

Want to know more?

Please send me a note using the “Contact Us” form above, and I’d be happy to get back to you.

To your health!

Joy

 


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Walking at Town Centre Track – March 19 2017

https://youtu.be/6VjayL5UOTc

 

 

 

Nordic Track workout – April 29 2017 (6 weeks later)

https://youtu.be/qrqxzuNj7YA

 

 

 

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.

A Dietitian’s Journal – seven weeks eating a low carb high fat diet

It has been a little over seven weeks since I started eating a low carb high healthy fat diet, so here’s an update on my progress.

Weight

In 7 weeks (1 March – 16 April), I’ve lost ~6 lbs, which is quite a reasonable weight loss for someone who was not obese. Most of my weight loss was in the first few weeks, which according to Phinney and Volek (The Art and Science of Low Carbohydrate Living) is quite common for numerous reasons, not the least of which is that our bodies excrete sodium as our insulin levels fall and as a result we lose excess water.

But as mentioned in the previous article, a scale is not an effective measure of short-term changes as the average adult’s weight can fluctuate by as much as 4  1/2 pounds per day, due to water alone.

[see http://www.lchf-rd.com/2017/04/20/the-limitations-of-common-ways-of-determining-weight-loss/]

WAIST CIRCUMFERENCE

From 1 March – 16 April, I lost 2 inches off my waist. That is alot, but is it significant?

Since it is unknown how much of that decrease was due to water excretion and how much due to fat loss, the decrease in my waist circumference does not provide much information in the short-term.

BODY FAT PERCENT

Based on a Body Fat Analysis, my body fat percentage is down from 40.2% to 39.0% – a decrease of ~ 1.2% but as mentioned in the previous article, Body Fat Analyzers use electrical impedance to determine fat percentage, and this measurement is affected by a number of conditions, including environmental (room) temperature, a person’s hydration status, as well as emotional stress.

Since hydration status can fluctuate by ~4 pounds per day, a body fat analyzer is no more accurate a short-term measure than a standard bathroom scale.

As a result of the limitations of a scale, tape measure and body fat analyzer to capture short-term weight loss, I was left with two ways to assess my progress:

(1) people’s observations of me having lost “so much weight”

(2) how my clothes fit.

VISUAL ASSESSMENT

Over the last number of weeks, I have had quite a number of people remark about my ‘significant weight loss’, but given that I (seemingly) lost a nominal amount, this surprised me.  Over the same period, I’ve been comfortably wearing clothes I could not even get into previously. Surprisingly, it was an inadvertent ‘before’ and ‘after’ photo that provided the most accurate measure of the effect low-carb eating has had on my body weight.

In filing a photo that was taken last week, I found another picture that was taken just before I started eating low carb – where I happened to be wearing the exact same outfit.

The difference was evident.

In progress – before and after

They say the “camera never lies“.

In retrospect, I would have deliberately taken ‘before’ pictures.

CLOTHES

Prior to coming face-to-face with my own denial, I was wriggling into most clothes – particularly pants.  I had set aside some clothes because I simply could not get into them. Wash day always raised the uncertainty as to whether I would be able to get my clean clothes on after they came out of the dryer. 

Now there are no clothes that I own that I can’t wear.  That does not mean they all look great (by no means!), but I can easily close buttons, zippers and actually sit in them! Some clothes that I fit ‘before’ are now beginning to feel loose.

OTHER MEASURES OF LOW CARB SUCCESS

Fasting Blood Glucose

Five weeks ago my monthly average fasting blood glucose was 8.8 mmol/L. Two weeks ago, it was ~8.6 mmol/L. Now it is 8.0 mmol/L.  The last time I had it taken by the lab (a year and a half ago), it was 9.7 mmol/L!

I am aiming for a fasting blood glucose of 5.0 mmol/L by November of this year.

Post Prandial blood glucose (2 hours after a meal)

My blood sugar 2 hours after lunch has dropped from 7.4 mmol/L to 7.0 mmol/L and after dinner, it has dropped from 7.7 mmol/L to 7.3 mmol/L. This is well below the target of < 10.0 mmol/L for a Type 2 Diabetic.

I am aiming for a 2 hour post-prandial blood glucose of between 5.0 – 6.00 mmol/L by November of this year.

BLOOD PRESSURE

For those that have been following my journey over the last 7 weeks, you may recall that it was a ridiculously high blood pressure that was the impetus to change the way I ate.

I’ve gone from ~30% Stage 2 Hypertension, 50% Stage 1 hypertension 15% pre-hypertension and the rest a hypertensive emergency (yikes!) to 80-85% Stage 1 Hypertension and 15-20% pre-hypertension.

This last week (week 7) my blood pressure has been 100% Stage 1 Hypertension, which one would think at first glance was a “setback”, but I don’t view it that way. Firstly, blood pressure that fluctuates a lot is much harder on the heart than blood pressure that is stable.

Secondly, the last two weeks I have been supplementing sodium to eliminate the headaches I had been getting and the periodic arrhythmia (irregular heart beats) that I started to get.

Phinney and Volek (The Art and Science of Low Carbohydrate Living) explain that if one is eating less than 60 gms of carbs per day, that 2-3 grams of sodium should be added to the diet (provided the person is not taking any diuretics or other blood pressure medication). A half a teaspoon of table or sea salt provides 1000 mg or 1 gram of sodium.

Failing to supplement sodium in a low-carb diet can result in really bad headaches and if sodium remains low, potassium will also be excreted to keep a necessary sodium-potassium balance. The drop in potassium can result in irregular heart beat, a condition known as arrhythmia.

Currently, I seem to do best on 1 to 1  1/2 tsp of sea salt, which provides 2 – 2.5 grams sodium. Of course, once the weather starts getting warmer or my exercise starts becoming more strenuous, I will need to increase that.

The ‘side effect’ of keeping my sodium levels constant is that my blood pressure has stabilized – and this is a good thing.  Now I can watch it fall over time, without the wild fluctuations I had been experiencing when I was eating a high carb diet.

OTHER MEASURES – FASTING INSULIN, AM-CORTISOL AND C-PEPTIDE

Fasting Insulin

A year and a half ago, I asked my GP to assess my Fasting Insulin and Fasting Cortisol and he would not as he said he was unable to provide interpretive information. Instead, he referred me to an Endocrinologist.

The Endocrinologist assessed my Fasting Insulin (August 2015) and it was 49 pmol/L (20-180 pmol/L) – but she would not provide me with interpretative information, either. So I had this number, that meant nothing to me at the time. 

I did some ‘digging’ in the literature and found a 2009 study from the European Journal of Endocrinology [European Journal of Endocrinology (2009) 161 223–230] which reported that Fasting Insulin was a strong and independent contributor to cardiovascular risk and atherosclerosis and that women with Fasting Insulin in the lower quartile (25 pmol/L) had significantly lower risk of systemic atherosclerosis, than those in the higher quartile (44 pmol/L).  Now my Fasting Insulin result had some meaning – and it wasn’t good! My fasting insulin was above the higher quartile (49 pmol/L).

My goal is to lower my fasting insulin to at or below 25 pmol/L by November of this year- and the way to lower insulin is by (1) eating a low-carb diet and through (2) intermittent fasting which is what I have been doing.

Now I have even more motivation to stick with this long-term.

My journey is more about health and reduced cardiovascular risk than it is about looking good.  Looking better is a great side benefit.

C-Peptide

Elevated C-peptide (not the same as C-Reactive Protein) is reported to be associated with the higher level of heart disease, including myocardial infarction and coronary artery disease – even in those whose fasting glucose is not impaired (Reference: Diab Vasc Dis Res. 2015 May;12(3):199-207).

Since my C-Peptide was 569 pmol/L (325-1090 pmol/L) a year and a half ago, my goal is to bring that number much closer to the lower end of the range (~350 pmol/L). I will be researching in the literature to determine what factors affect C-Peptide the most.

Cortisol

Cortisol, the so-called “stress hormone” is highest between 6 and 8 AM and it gradually falls during the day, reaching its lowest point around noon. A year and a half ago, my AM Cortisol was 451 nmol/L (140-690 nmol/L) and since cortisol is the hormone that is responsible for mobilizing glucose as part of the “fright and flight response”, it may contribute to my fasting blood glucose being so high.

My goal will be to look into ways to lower my AM Cortisol levels through diet, exercise and stress management.

Final Thoughts

This is a “journey”; one which is as much about the process of getting to my destination as the destination itself.

It is about having a healthy relationship with food and about eating when I’m hungry; not because “it is time to eat”.

It is about the process of enabling insulin levels to fall simply by delaying when I eat and what I eat. 

It is about addressing my body’s inability to process carbohydrates – no differently than I would address an inability to tolerate lactose or inablity to tolerate gluten.  Instead of lactose intolerance or Celiac disease, I have carbohydrate intolerance and as a Dietitian, the path forward is clear. I limit carbs to those contained in non-starchy vegetables, nuts and seeds and use healthy fats as my predominant fuel source.  This allows my insulin levels to fall, lowering insulin resistance and enables me to access my own (abundant) fat stores for energy.

For the first time in years, I am sleeping well and the inflammation in my joints that plagued me for years, is largely gone. Just as a newly-diagnosed Celiac feels well for the first time once they eliminate gluten from their diet, so too do I feel so much better without eating carbs, as carbs.

Have questions about how I can help you?

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

To your good 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:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/


 

A Dietitian’s Dichotomy

Two years ago, the paradigm from which I’ve understood nutrition shifted dramatically. That was when a friend, a retired physician, asked my professional opinion on the approach that Dr. Jason Fung was expressing in his blog, Intensive Dietary Management. I began to read it from the beginning and after almost 3 weeks of reading, I concluded that the physiology was what we learned in our undergraduate degrees – and promptly set aside when we specialized in our respective professions. As healthcare professionals, we talk about “evidenced based decisions” and at that point, I had to decide whether the evidence was sufficiently strong to change the way I thought and practiced.  This was this Dietitian’s dichotomy.

Fast forward 2 years, and the learning-curve continues as I read through further studies and watch conference talks from some of the leading researchers and practitioners in the low carb high fat world.

Five weeks ago, I started practicing what I preached, and began eating what I call a “low carb high healthy fat” diet, myself.

So how’s that been going?

Well, I am definitely out of denial. I am overweight, insulin resistant, my LDL was too high and so was my blood pressure – and no matter how I looked at it last week, I had 30-40 more pounds to lose.

But here it is a week later, and I still have 30-40 pounds to lose. Am I discouraged or concerned? No. Here’s why;

Weight and Waist Circumference

I had to ask myself – or shall I say, ‘re-ask’ myself “how do I measure success”? If it is by the scale or a tape measure alone, then clearly I am ‘failing’. But am I?

My fat percentage is down from 40.2% to 39.8% – which means, despite NO CHANGE in my weight or my waist circumference, I’ve lost body fat.

How was that accomplished if I didn’t lose weight or “inches“?

Ketone sticks – for measuring ketones in urine – high

This past week, I’ve been maintaining a higher level of ketones then I did last week, so my body has been breaking down triglycerides (fat!) in my liver and fat cells, to make ketones for my brain and to synthesize glucose for my blood. I check my blood sugar every few hours to ensure it doesn’t drop too low.

Electrolytes and Water Balance

Something that has been slow for me to grasp hold of, is the need to add salt to my food.  I have been used to eating fresh foods with no added salt and preparing foods with the minimum of salt, but with insulin levels falling, so does the kidney’s retention of sodium.

By eating only when hungry and only until no longer hungry, my insulin levels have the opportunity to fall to baseline – something they do naturally after not eating for 12 hours. On days where I extend the time until I eat by a few hours (i.e. “intermittent fasting”), my insulin levels stay low for an even longer period of time.  In response, my kidneys excrete sodium, in a process called naturesis.

The one thing that has to be monitored closely – even for people like myself who are not on any kind of medication for Diabetes or high blood pressure, is that my sodium levels don’t fall too low, as well as potassium, calcium and magnesium. Sodium and potassium and calcium and magnesium are used in pairs in a number of systems in the body and I’ve learned quickly how important these are. All the more important for anyone taking medication to lower blood sugar or blood pressure! After having one or two excruciating headaches from letting my sodium fall too low, I learned quickly that if I feels certain symptoms, I need to take some salt. As well, I’ve learned that people that let their potassium get to low sometimes experience heart palpitations – not a pleasant feeling. I already was supplementing Calcium and Magnesium (along with Vitamin D) prior to adopting a low carb high fat diet, but how to get adequate sodium and potassium?

“KETO-WATER”

It’s fairly difficult to meet the potassium Dietary Reference Intake on a regular diet, but even with a very high non-starchy vegetable intake, it is still hard.  Many of the good sources of potassium, such as potato and yams are not part of the low carb high fat diet. I do eat a lot of mushrooms (high in potassium) but am severely allergic to avocado, one of the best sources, so I make what I call “keto-water”.  Keto-water is club soda (I make mine at home with my Sodastream!) to which 1/8 tsp of half-sodium / half potassium salt has been added. I put a tiny twist of lime or lemon to round out the taste and also to add a source of Vitamin C to my diet and voila, “keto-water“!

Keto-water salts

Provided I drink two liters of “keto-water” per day, I feel great!

No doubt, drinking keto-water has resulted in my body retaining more water, along with the sodium (which is what it is supposed to do!) which would account for my loss of fat, with no change in my weight or waist circumference.

Note: do NOT use "keto-water" if you are taking medications such as Altace (Ramipril) or other medications that cause potassium retention.

MY BLOOD SUGAR

Here is a snapshot of what has occurred with my blood glucose over the last 5 weeks.

My fasting blood glucose started off averaging 8.6 and then went up, as I began to mobilize fat reserves to supply my blood glucose. Now, my average fasting blood glucose is 7.4 – with dips as low as 6.2 (this morning!) and higher levels in the low 8’s.

My postprandial (2 hours after a meal) blood glucose is great after lunch, a bit higher later in the day (I’m guessing due to the circadian rhythms of cortisol) but then drops nicely before bed. Keep in mind, these results have been realized in only 5 weeks of eating a low carb high healthy fat diet!

BLOOD PRESSURE

Now this is a beautiful thing! For those that have been following this journey over the last 5 weeks, you may recall that it was a crazy-high blood pressure that was my impetus to change the way I ate.

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

The 4th week my blood pressure was;

~81% Stage 1 Hypertension

~19% pre-hypertension 

It has been pretty steady the last 2-3 weeks but certainly down from what it was.

Week Five – this week

Look at this!

From 3 weeks in a row stalled at ~80% Stage 1 Hypertension and ~20% pre-hypertension, it is almost 60% / 40% now…and that is WITH taking sodium and potassium “keto-water”!

This is how I measure success.

Final Thoughts

Success is about achieving goals and my goals have been about lowering my insulin resistance and blood pressure and losing weight and inches in the process.  Success is attained when you measure the appropriate outcomes.

Have questions? 

Wonder how I might be able to help you accomplish your goals?

Whether you live in the Lower Mainland or hundreds of kilometers away, I have service options to meet a wide variety of needs. Please send me a note using the form on the “Contact Us” tab, above.

To your 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:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/


 

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:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/


 

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.

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/