A Dietitian’s Journey – defeating discouragement

For the last month I haven’t lost any weight and on top of that, my HbA1C went up a bit (from 6.4% to 6.5%, despite the fact that I’m eating the way I’m supposed to, tracking my macros and exercising. Like anybody else, I was a little discouraged. Defeating discouragement often involves me asking myself what I would I say to a client who was in the same position.

My “Dietitian self” reminded “me” that March 5th, at the beginning of my second year living a low-carb lifestyle, I began resistance training and have been doing it regularly since and muscle weighs more than fat.

In fact, 5 lbs of fat and 5 lbs of muscle take up very different amounts of space, and I’ve certainly lost “inches” this last month, especially off my abdomen.  Loss of fat from deep inside my gut is very likely related to loss of the dangerous and metabolically active visceral fat (the fat around my organs and in my liver).  This is good! At the same time, I’ve gained significant amount of muscle on my arms and legs that I can feel.

So what happened to the fat?

Here is the Science Made Simple explanation:

The fat (triglycerides) in my liver was broken down into glycerol and free fatty acids and the free fatty acids were then moved into my blood and sent to my tissues, which used them for fuel. Since I have been eating a ketogenic level of carbohydrates for approximately 5 months now, my main fuel source is fat and ketones.

The mitochondria in my tissues broke the free fatty acids down using a process known as β-oxidation and the end result is a product called acetylCoA. This acetylCoA was used in a metabolic pathway called the Citric Acid Cycle to make an interim source of energy called NADH2 which then went to the electron transport chain in my mitochondria (the powerhouse of the cells) where it was made into ATP, the energy that the entire body runs on.

Once the glycogen in my muscles was all used up and as I continued to exercise to muscle failure, ketones were made from the AcetylCoA and used as fuel in the mitochondria of all my organs, including my brain.  The brain always has some glucose uptake but that can be made from the same source as the glucose used to maintain blood sugar; from the breakdown of amino acids from protein and the breakdown of fatty acids.

So is that why my blood sugar went up?

When I am doing High Intensity Training (lifting weights very slowly until muscle failure) my body first uses up all the glycogen stored in those muscles.

(Remember, glycogen is the short-term storage location for energy.)

As I keep exercising faster than my body can produce energy via the electron transport chain in my mitochondria, lactic acid builds up. This lactic acid goes to my liver and makes pyruvate which gets converted to glucose – and it’s this glucose which raises my blood sugar. Ahhh, yes. The good ‘ol Cori Cycle and gluconeogenesis (literally “making new glucose”).

During the last month, I lost approximately 5 pounds of fat and gained about 5 pounds of muscle which I estimated from the visible amount of fat lost mostly from my abdomen (also from other areas), and the amount of muscle I gained over the same time period.

Above is a representation of what those 5 pounds of fat looks like in a garbage can – where they belong, not around my organs!

To see the approximate 5 pounds of muscle I gained, I took a ‘selfie”.  Not great, but compared to what I looked like before I changed my lifestyle, it’s certainly an improvement. I’m a work in process.

In case I forgot what I looked like before I changed my lifestyle, yesterday I found a picture of myself barbecuing out back from a year and a half ago.

This photo is quite the glaring reminder of what I looked like before I adopted a low carb lifestyle (Mar 5 2017).

…and here is the thirty pounds of fat (not counting the estimated 5 pounds of additional fat that I lost this month and gained in muscle) – also in a garbage can, where it belongs!

That is a lot of fat.

So, even if I can’t “see” the 5 pounds of fat that I lost this month on the scale, I can see it off my abdomen. At the same time, I can see the 5 pounds of muscle that I gained in the mirror and I weigh the same. The math is easy.

This isn’t ‘water’ loss, as I am well into my weight loss journey.

While I’m not thrilled that my HbA1C went from 6.4% to 6.5% during the last 3 months, it is explainable from the exercise that I am doing which breaks down glycogen to make glucose for my blood.

Increasing my muscle mass in time will make me less insulin resistant, eventually enabling me to lower my blood sugar more quickly after a meal.  As well, as the visceral fat continues to be decreased, my liver should become more insulin sensitive, as well.  This is both a good thing and a challenging thing.  It is good, because it will enable my liver to take glucose out of my blood more efficiently than it can now, but it will be challenging, because the main role of insulin is as a storage hormone. If I eat more than my body can use, it will be stored again in my fat cells (both under my skin and the bigger problem; back in my liver and around my organs).  I will develop the symptoms of Type 2 Diabetes again, and likely the high cholesterol and high blood pressure that I had before. That is why this is a lifestyle and not a “diet”.  It’s easy to do something as if your life depends on it, when it does.

As long as I maintain the lifestyle I have adopted, I can continue to reverse the symptoms of my Type 2 Diabetes and despite the naysayers, this is a very sustainable way to live.  One look at the Science Made Simple articles that I’ve written about the wide range of food we can eat, my food posts with pictures of some of the meals I’ve made and the range of recipes I’ve developed, one can see I am not being deprived and neither are others that follow a well-designed low carb eating style.

Much of what I do as a Dietitian in helping people be successful at losing weight and turning around symptoms of chronic disease is determining how much of which kinds of food will both provide them with the nutrients they need and also enable them to reach their weight loss and health goals.  But I also provide coaching which supports people to be successful over the long term and this is very satisfying work. Sometimes ‘coaching’ may involve ‘tweaking’ their Meal Plan or helping them find some breakfast options or eating-out-at-restaurant options, and other times it is helping them understand why they haven’t loss weight and what approach might be best to turn that around.

Do you have questions about what’s involved with having me design a Meal Plan for you? Please send me a note using the “Contact Me” form located on the tab above and I will reply shortly.

To our good health,


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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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