A Dietitian’s Journey – visibly evident progress after 5 months

For the last 2 weeks, the Lower Mainland has been covered in smoke due to hundreds of wildfires in the area.  The very poor air quality had made going for a walk impossible.

Everywhere I went, I needed to wear an N95 mask to filter out the particulate matter and with the excessive heat and reddish-yellow skies, I had no desire to be out any longer than I needed to.

Over the weekend, cool marine finally air arrived and the air cleared for the first time in weeks. Finally it didn’t look like I was living on Tatooine.

When I woke up yesterday, the first thing I wanted to do was go for a morning walk. I walked 3 km around the local track and today I went again and decided to make a short video. When I went to upload it, I noticed how very different my face looked than from my first walk, 5 months ago (March 16 2017).

LEFT: March 16, 2017 | RIGHT: August 15 2017

I’ve only lost 13 pounds in the last 5 months since I began eating Low Carb High Healthy Fat, but the difference in how I look and how I feel is quite evident.  As I’ve covered in previous “A Dietitian’s Journey” blogs, my blood work has certainly reflected the change.

I don’t really do any exercise outside of walking and even then, I only started doing it regularly 7 weeks ago (June 22, 2017) and not for the last 2 weeks (due to the air quality advisory). Five weeks of walking has helped me tone my muscles a bit and lower my overall blood sugar, but not had any significant impact my weight loss. While for the last 8 weeks, I’ve delayed the start of my first meal (intermittent fasting) which has impacted my fasting blood sugar, it hasn’t really impacted my weight, as I consume the same amount of protein, fat and carbs per day, just over a shorter period.

My weight loss has really only been accomplished by doing what I have been teaching my professional clients to do over the last 2 yearseating low carb and high healthy fat. I was tired of being the “fat Dietitian”! Now I’m now “practicing what I preach”.

Is it hard?  Not at all! This has to be the easiest way to eat and requires little, if no culinary skill. Sure, one can get pretty creative making all kinds of exciting ethnic foods if they know how to cook, but it is certainly not required!

The difference in how I feel is truly all the motivation to keep doing it! Losing weight is a bonus.

Want to know how I can help you achieve your own health and nutrition goals? Why not send me a note using the “Contact Us” form above.

To our good health!

Joy


Here is the short video that I made today:

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.

 

Fasting Blood Glucose – the evening walk

As I’ve made it a habit to do each weekday, this morning I went out for my walk, using Nordic poles.  I had an appointment to keep, so I kept it to 3 km at a brisk pace, around that beautiful lake that I’ve previously posted a video update from.

Despite eating quite low carb and delaying the amount of time between meals each weekday, my fasting blood sugars remain high.  I’ve noticed that after I walk in the morning, they come down significantly, so I’ve decided to integrate a short walk around my neighbourhood after dinner, to see if my fasting blood glucose lowers.  It should, which leaves me to determine how long a walk is ideal. I don’t want to make it a “workout”, as that can interfere with sleep, but I also don’t want to make it so short that it doesn’t have any effect.  Today I started with a 15 minute walk at a comfortably brisk pace.  Tomorrow, I’ll try longer, to see if it changes the results in the morning, and if so by how much.

As I began my walk, I realized that I’ve lived in this neighbourhood for several years, yet never walk around it.  I guess it’s time I get to take in the beauty that is all around me.

Practicing what I preach!

Joy

UPDATE

It turns out, that a leisurely 20 minute walk after dinner results in my blood glucose dropping to ~5.2 – 5.4 mmol/L  (94-97 mg/dl) and staying that way through the night (measured at 1 AM and 4 AM and 6 AM in the interest of science, of course!).

This is now part of my routine!


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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.

Low Carb / Keto Ice Cream

This recipe is posted as a courtesy to those following a variety of low-carb and ketogenic diets (not necessarily Meal Plans designed by me). This recipe may or may not be appropriate for you.

The last few days have been rather hot and humid out and one of my young adult sons wanted ice cream.  Since we both eat low-carb now, this necessitated me inventing a low carb ice cream. Not having an ice cream maker, I tapped into my years of cooking experience for the “how to”. The two flavors I made were both were delicious and super easy to make. 

Carb Content

Japanese Black Sesame Keto Ice Cream

The Japanese Black Sesame Keto Ice Cream had only 3.5 gms of carbs per serving (2 1/2 grams of carbs per serving from the touch of date syrup as sweetener and 1 gm of carbs from the 20 gms of Black Sesame Paste. The only other ingredient was whipping cream (no carbs!).

Keto Coffee Chip Ice Cream

The Keto Coffee Chip Ice Cream had 10 gms per serving, as more date syrup was needed to offset the bitterness of the the concentrated powdered espresso powder.  There were 8 grams of carbs per serving from the date syrup, but less could be used if you don’t want as intense a coffee flavor as I did. There were 2 gms of carbs from the 1/2 of a dark chocolate bar that I pounded into chocolate “chips”.

 

The “Recipe”

The recipe to make Keto Ice Cream is more of a method, than a recipe. It can be used for any variety of keto ice cream flavors you or I can dream up.

Ingredients

1 1/2 cups (12 oz) heavy whipping cream

4 oz heavy whipping cream

1 – 3 Tbsp Silan (also called Date Syrup or Date Molasses – available at most Middle Eastern grocery stores)

Either:

(A) 2 Tbsp black sesame paste (available from a Japanese, Korean or some Chinese grocery stores)

OR

(B) 1 – 1.5 Tbsp powdered espresso powder 

& 45 gms of dark chocolate pounded into small “chips” 

Method

In a stand mixer or using a large bowl and a hand-mixer, whip the 1 1/2 cups of heavy whipping cream into soft peaks.*

* don’t over beat it, or it will become butter!

In a separate bowl, beat the 4 oz heavy whipping cream to soft peaks.

With a rubber spatula, gently fold in the flavoring you are using (in this case, either the black sesame paste or the espresso powder and chocolate chips). Fold gently, so as not to deflate the whipped cream.

Now gently fold the flavored whipped cream into the bowl of plain whipped cream, just until blended.

Pour the soft mixture into a freezer-safe, 1 quart / 1 litre glass container with a locking lid.

Freeze for 6 hours or overnight.

(For softer ice cream, stir mixture every hour and a half, scraping down the sides with a spatula and continue freezing).

Enjoy!


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Oh Nuts!

One of the challenges with trying to lose weight is reaching a plateau – where one’s weight stays the same for an extended period of time. When eating a low-carb or ketogenic diet, some foods such as nuts are a common pitfall. Despite being a rich source of heart healthy monounsaturated fats, some nuts contain high amounts of carbohydrate.


Carbs Per Serving of Nuts

Serving Size

A serving size* of nuts is generally considered one ounce (1 oz.) which is about a handful of an ‘average-sized hand’. The problem with using this kind of measurement is that not all nuts have the same mass per volume, nor does everybody have the same size hand!

Here are the number of nuts per ounce for common varieties:

  1. Cashew 16-18 nuts per ounce
  2. Pistachio 45-47 nuts per ounce
  3. Almond 22-24 nuts per ounce
  4. Pine Nuts ~3 Tbsp. (160 kernels) per ounce
  5. Hazelnut 1012 nuts per ounce
  6. Walnut 8-10 halves per ounce
  7. Peanut 27-29 nuts per ounce
  8. Macadamia 10-12 nuts per ounce
  9. Pecan 16-18 halves per ounce
  10. Brazil Nuts 6-8 nuts per ounce

* When eating shelled nuts, many people eat a few palm fulls, so I’m going to indicate the carbs for a 1 oz and 3 oz serving.

Carbs are listed as “net-carbs” (i.e. once fiber (which is not digestible) has been subtracted from the total amount of carbohydrate).

Carbohydrates per Ounce

  1. Cashew 
    Cashews aren’t actually “nuts” but are the fruit of a cashew apple, and contain 9 gms of carbs per 1 oz (~17 nuts) – that’s 27 gms of carbs for 3 oz (~ 3 average handfuls). To think of this in terms of “carb foods”, that’s about the same number of carbs as in 2 slices of bread!


2. Pistachio 
Pistachios contain 6 gms of carbs per 1 oz serving ~ 46 nuts – that’s 18 gm of carbs in an average 3 handful serving (3 oz) a little more than a slice of bread.


3. Almonds

Almonds contain approximately 3.5 gms of carbs per ounce ~23 nuts, which amounts to 10 gms of carbs for 3 oz (~3 average-sized handfuls).


4. Pine Nuts 

Pine nuts (also called pignolias) contain 3 gms of carbs per oz. (which is about 3 Tbsp.)

 


5. Hazelnut 

Hazelnuts (~11 nuts per ounce) contain ~2 1/2 gms of carbs for a 1 oz serving (~11 nuts) / 7 gms of carbs for 3 oz / 3 average handfuls.

 


6. Walnut 

An ounce of walnuts (9 halves per ounce) contain the same amount of carbs as an ounce of hazelnuts (~2  1/2 gms of carbs for a 1 oz serving / 7 gms of carbs for 3 average handfuls or ~ 27 halves.


7. Peanut 

An ounce of peanuts (~28 shelled peanuts per ounce) also contain the same amount of carbs as an ounce of hazelnuts or walnuts (~2  1/2 gms of carbs for a 1 oz serving.

 


Top three low carb high fat / keto-friendly nuts:

Macadamias, Pecans and Brazil nuts are the 3 most low-carb and keto-friendly nuts – having between 4 and 5 gms of carbs for a 3 oz serving! That’s far better than the 27 gm of carbs for 3 oz of cashews and 18 gm of carbs for 3 oz of pistachios!

8. Macadamia

Macadamias have slightly more than 1  1/2 gms of carbs for a 1 oz serving (~11 nuts) / 5 gms of carbs for a 3 oz serving.

 


9. Pecans

Pecans have 1.3 gms of carbs for an ounce of nuts (~17 halves) / 4 gms of carbs for a 3 oz serving .

 

 

 


10. Brazil nuts

 

Brazil Nuts also have only 4 gms of carbs for a 1 oz. serving (~ 7 nuts)

 


A Tough Nut to Crack

Back in the day, eating nuts meant cracking nuts.

It was common to see living room tables with bowls of nuts in their shell, with nutcrackers and nut-picks readily available for use.

Each house had its preference for the style of nutcrackers they insisted were the best.  Growing up, we had ones like those above.

Nuts and “Carb Creep”

Carb creep” is when we think we are eating low carb, but hidden sources of carbs are sneaking into our diet without us being aware of it.

When I was pondering why I had reached my own weight plateau, I knew carb creep had to be the reason – but from where?

After analyzing my diet, it seemed that nuts might be the source and it was.

My biggest single downfall was that I like to crack and eat pistachios on the weekend, while working on my foreign language studies – and it is WAY too easy to crack them and eat copious amounts!  In fact, I am somewhat of an expert at shelling them, as my brother and I were placated by our parents with bags of pistachios, on long car trips. To get my “fair share”, I learned to be quite efficient at shelling them and so it seems, I haven’t lost that ‘skill’.

Over the course of several hours I can shell and eat 1/2 to 1 lb of pistachios without really noticing eat, and in the worst case scenario that’s almost 100 gms of hidden carbs!

Add to that a handful or two of almonds a day (another hidden 10 gm of carbs per day) and the source of my “carb creep” became clear.

Portioning

Of course to try to prevent eating too many, nuts can be portioned out in 1 oz or 3 oz ‘servings” and the rest put away for another time, but it is still way too easy for someone who is hungry or tired to mindlessly reach for a handful or two of nuts. It seemed to me that having large containers of shelled nuts that are too easy to reach for, may not be the best solution.

Unshelled Nuts

Replacing shelled nuts with nuts in the shell, like we ate in the “old days”, turns out to be a far more effective solution.

It’s very hard to over eat nuts you have to shell first.

It is much s-l-o-w-e-r to crack and then eat these almonds than these: 

 

…or to crack and eat these Brazil nuts  than these: 

Bingo!

Since pecans are a much lower carb nut than pistachios, they have become my go-to nut from the nut-bowl…and let me assure you, it takes quite a while to shell 17 halves for a mere 1.3 carbs! In fact, I’m pretty sure I expend more energy cracking them, than I take in, eating them.

The Right Tools for the Right Job

Despite having a variety of nutcrackers, I found pecans a “very tough nut to crack” – with them frequently flying out of the standard pinch-style cracker.

I found out that there is a special “pecan cracker” that one can order that apparently does the job very well and looks like this:

…but the little contraption below that I invented in my garage (with a d-clamp and a stick-on felt pad, works great, and I use it for pecans, walnuts and even hazelnuts. Even eating walnuts, which are a higher carb nut – it takes quite a while to shell 9 halves (2  1/2 gms of carbs).

How I can help

For the last 2 years, I have helped my clients lose weight and keep it off using a low-carb approach. More recently, I am ‘practicing what I preach‘ (as you can read about in the blogs titled “A Dietitian’s Journal”). The things I am learning “doing it” adds to what I know academically – which makes me able to coach people much more effectively.

Have questions?

Why not send me a note using the “Contact Us” form on the tab above.

To our 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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The Limitations of Common Ways of Determining Weight Loss

People who are eating differently in an effort to lose weight often hop on the scale daily to see how they’re doing. What they fail to consider is that an average adult’s body weight can fluctuate by as much as 4  1/2 pounds per day — solely as a result of changes in the amount of water they are retaining or excreting.

The Limitations of Using a Scale to Determine Fat Loss

An 80 kg person has, on average 48 liters of water in their body. The problem with using body weight as an assessor of fat loss is that the human body does not precisely regulate body water content.

Above 49 liters of water, the kidneys of an 80 kg person will clear the excess water by causing the person to urinate more and below 47 liters of water, the 80 kg person will feel thirsty and increase their fluid intake. People’s “weight” is affected by this change in body water content of ~2 liters per day — which weighs approximately 2 kg or 4.4 pounds! Put another way, each day our “weight” can fluctuate by this amount solely due to the difference in retained or excreted water.

Since there is no way to measure this daily change in water weight in non-clinical settings, the standard scale is a very imprecise way to measure fat loss over the short-term.

Waist Circumference

Many people know that carrying excess weight around the middle increases one’s risk of cardiovascular disease, including heart attack so they measure their waist circumference frequently. Even if waist circumference is measured halfway between the lower rib and the top of the hip bone, with a fully relaxed abdomen, their are limitations to using this as a short term measure of weight loss.

The Limitations of Using a Tape Measure to Determine Fat Loss

Since the average person’s body weight fluctuates by as much as ~4 1/2 pounds per day due only to changes in body water, a tape measure fails to capture decreases in waist circumference stemming from the kidneys excreting water.

That said, waist circumference is helpful as a long-term indicator of weight loss, just not a short-term one.

Body Fat Percent

Some people have bathroom scales that have body fat analyzers built in and think that what it is measuring is the amount of fat they are carrying, however a number of factors can influence this reading.

The Limitations of Using a Body Fat Analyzer to Determine Fat Loss

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 as a short-term measure than a standard bathroom scale, without it.

HOW TO Assess short-term weight loss

How one’s own clothes fit and comparative ‘before’ and ‘after’ photos are a much better short-term assessor of fat loss than a scale, a tape measure and a body fat analyzer. Since body water fluctuates considerably on a low carb high fat diet due to changes in sodium levels, I recommend that people eating a low carb high fat diet weigh themselves once every two weeks on the same day of the week, at the same time of day and measure their waist circumference at the same time. If they have a scale that assesses body fat percent once every two weeks is sufficient for taking these measurements.

None of these will provide much information on actual fat loss over the short term…so why rely on them for that, but they will be helpful measurement over the longer term.

Sodium and Body Water Content

As mentioned in a previous article, by eating only when hungry and only until no longer hungry, insulin levels have the opportunity to fall to baseline – something they do naturally after not eating for 12 hours.

On days where the time until eating is extended by a few hours (i.e. “intermittent fasting”), insulin levels stay low for an even longer period of time.  In response, our kidneys excrete sodium in a process called naturesis.

Failing to supplement sodium while eating low-carb high fat can result in intense headaches – and if sodium remains low, potassium will also be excreted to keep the necessary sodium-potassium balance. This drop in potassium often results in irregular heart beats, known as arrhythmia.

Phinney and Volek (The Art and Science of Low Carbohydrate Living) recommend 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 salt or sea salt provides 1000 mg or 1 gram of sodium.

Final Thoughts

Since hopping on the scale daily or even several times a week won’t provide any useful information, nor will measuring our waist circumference or using a body fat analyzer too often – why do it? Part of ‘getting healthy’ ought to include having a healthy body self image – something that won’t be nurtured by obsessing about such “numbers”.

Short-term measures of success

Short-term success is best measured visually – with comparative photos taken from the same distance away, from the same relative height and wearing the same clothing.

How one’s clothes are fitting is another way.

A person who is insulin resistant or Type 2 Diabetic should be seeing both their fasting blood glucose and post-prandial (2 hours after a meal) glucose levels gradually coming down. If they aren’t then they should schedule an appointment with their Dietitian to find out why that is.

Medium-term measures of success

Medium-term measures of success in eating low carb high fat can be measured both subjectively and objectively. Subjective measures include weighing oneself and taking one’s own waist circumference once every two weeks. Objective measures include having your Dietitian weigh you on a clinical scale, having her assess your waist circumference and body fat percentage using both a device that measures electrical impedance, as well as using good old-fashioned calipers, that measure subcutaneous (under the skin) fat, in 3 or four specific locations on the body.

A person with high blood pressure should be seeing both systolic (the first number) and diastolic (the second number) blood pressure coming down and Type 2 Diabetics or those with insulin resistance should be continuing to observe lower fasting blood glucose and post-prandial (2 hours after a meal) glucose levels.

Longer-term measures of success

After 6 or 8 months eating low carb high fat, both subjective and objective measures should be continuing to lower in a reasonably linear fashion. Of course there will be times where a ‘plateau’ is reached, but if that lasts more than two or three weeks, then its important to check in with your Dietitian to make sure the amount of carbs you think you are eating is what your Dietitian has been determined as being best for you.

A Type 2 Diabetic should be seeing both their fasting blood glucose and post-prandial (2 hours after a meal) glucose levels approaching more normal levels and both Type 2 Diabetics and those with insulin resistance (“pre-diabetes”) should have their HbA1C assessed at a lab every three months, as this provides insights into one’s 3-month average blood glucose level. Fasting blood glucose provides a ‘snap-shot’ of blood sugar in the morning after not eating, and should be done twice a year by a lab, especially if one is Diabetic. Comparing lab test results to previous lab test results is an objective indicator of the effect that eating low-carb high fat is having on specific markers and provides an opportunity to determine if the amount of carbs being eaten may still be too high.

The most accurate assessor is a 2 hour glucose tolerance test, however few doctors will requisition this after one is diagnosed as Type 2 Diabetic.

Finally, every year or so, it is helpful for those who have been diagnosed as Diabetic to have their fasting insulin, C-Protein and AM Cortisol levels assessed and compared to previous results. For these, your doctor may refer you to an Endocrinologist.

Remember, achieving health is a journey and takes time and like most journeys, it is best not done alone.

Have questions about how I can help or about the services I provide?

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

To your good 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.


follow me at:
 https://twitter.com/joykiddieRD

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