From the beginning of my ‘journey’, I’ve said that I had no specific “ideal weight” in mind — that my goal was to reach a body weight where my waist circumference was half my height; whatever weight that was. This week, I reached that goal; 21 months from when I began.
This story began March 7, 2017. I was sitting at my office desk and didn’t feel well. I dug out my blood pressure machine (sphygmomanometer) which I had not used in ~ 2 years and took my blood pressure. The reading defied comprehension. I rested a bit and took it again. It was nominally lower, but still in the “hypertensive emergency” category. A hypertensive emergency is where the top number (systolic pressure) is at or over 180 millimeters of mercury (mm Hg) and the bottom number (diastolic pressure) is at or above 120 mm Hg, or higher. Mine systolic pressure was significantly higher than 180 mm Hg! I was seriously concerned that I could have a stroke! I was scared. Then I went to dig out my glycometer to measure my blood sugar.
Hint: it is never a good thing when someone with Type 2 Diabetes does not know where their sphygmomanometer or glycometer are!
I should have known where my glycometer and sphygmomanometer were and should have been using them regularly, but I was in denial. After all, I was eating “properly”; lots of fruit and vegetables, whole grain bread and rice and while I was overweight, my weight had been stable for a long time. Okay, I was obese, but was consistently fat. Like I said, I was in denial!
My blood sugar after lunch was 13.0 mmol/L (234 mg/dl). That was bad. I was clearly not tolerating the amount of carbohydrate in the fruit and whole grain crackers and it didn’t matter how many salad vegetables and lean protein I ate with it! I was carbohydrate intolerant.
A few months earlier, two women I had known from school died suddenly. Both were in healthcare. One was a public health nurse who retired on the Friday and was dead on the Monday and the other was a care aid working in long-term care who died alone in her home of a massive heart attack. She had been diagnosed about 8 months earlier with Type 2 Diabetes and was working with her “Diabetes Dietitian” and was diligently following the recommendations and eating 65 g of carbohydrate at each meal and 45 g at each snack. When I mentioned I had been doing a lot of reading in the literature about the application of a low carbohydrate diet in controlling Type 2 Diabetes, she said “I’m going to follow this for one year. If it doesn’t bring my numbers down enough, I will look into it“. She didn’t live long enough for either.
Obviously she didn’t die from following the recommendations, but I have to wonder what difference 6-months on a well-designed, supervised low carb diet might have had.
The fact is, I was no example! Why should she listen to me? I was as overweight as she was (okay, we were both obese!) and I had Type 2 Diabetes for 10 years. Who was I to suggest it if I wasn’t actually doing it? All the scientific literature and knowledge isn’t convincing coming from an obese Dietitian.
As I sat there March 7, 2017 reflecting on my astronomical blood pressure and blood sugar, I realized I could be next in having a heart attack or stroke if I didn’t DO something. As I’ve said many times before in this blog, I should have gone to my doctor and let him prescribe blood pressure medication, medication for lowering my blood sugar and the statins for my cholesterol that would have come along with them (as he’d been recommending those for a while), but I didn’t. What I did instead was immediately adopt a low carbohydrate diet. I designed myself a Meal Plan, as I do for my clients, based on the best evidence at the time. I’ve never looked back.
Without using any medication, here is what I was able to accomplish in one year’s time, as it appeared on Diet Doctor.
The full measurements are there, but in short, I had lost 32 pounds and lost 8 inches off my waist. I still had 4 inches to go until my waist circumference would be half my height, but I no longer met the criteria for Type 2 Diabetes and my blood pressure ranged from between normal and pre-hypertensive. My triglycerides were ideal and I had excellent cholesterol levels.
Here is my “before” and “after” pictures now, at 21 months. I’ve lost the additional 4 inches off my waist – a foot in total! I lost a FOOT off my waist!!
In total, I’ve lost 45 pounds.
My 3-month average fasting blood glucose is 5.1 mmol/L (92 mg/dl) and 3-month overall average blood sugar is 5.4 mmol/L (97 mg/dl). I am below the diagnostic criteria for Type 2 Diabetes provided I limit the amount of carbohydrate-based foods I eat. I expect these numbers will continue to improve now that (based on my waist circumference being half my height) it is unlikely I have fatty liver (NAFLD) disease. It will still take more time for my liver to continue to get well, as well as my pancreatic beta-cells, if recovery is possible.
I am not an “angel” when it comes to eating. I do indulge in some dark chocolate after meals each weekend and I do taste non-low carb treats like pizza and cake. After all, this is not a diet, but a lifestyle and to be a lifestyle, it has to be sustainable. The question for me is the same as for anyone: “how much” and “how often”.
Was it difficult? No. It really wasn’t…isn’t.
I eat real, whole food that can be as simple or complicated as I feel like preparing. It can be some store-bought BBQ chicken and a boxed salad or moussaka from scratch (which is what I’m making for dinner, tonight). I eat animal-based sometimes, plant-based other times, I eat nuts and seeds, fish, poultry of all types and a wide range of vegetables and some fruit and I include some “starchy” vegetables like winter squash and yam from time-to-time. I eat dairy such as cheese and plain Greek yogurt and I occasionally eat eggs (I am not a big “egg person”!). I eat grass-fed beef when I get it and supermarket meat, pastured chicken and the one that goes on sale when I’m picking up staples. My butter is regular, local and unsalted (not fancy imported butter) and I don’t slather it on everything. It is just one of my fat choices along with really good olive oil and other pressed oils such as avocado oil and the occasional macadamia nut oil. If I’m craving a really good pizza, I make my Crispy Keto Pizza which is 85% the texture of a yeasty flour-based pizza. If I feel like one that’s a little less rich, I make my Crispy Cauliflower Pizza (see Recipe tab).
I usually don’t make “low carb bread”, although one of the most popular recipes on my recipe blog are my Low Carb Kaiser buns. Here’s a picture, so you can see they are pretty legit for a sandwich and are great as hamburger buns.
I even make the occasion dessert, with my most requested being my low carb New York Style Cheesecake (also under Recipes).
Low carb or not, I think desserts are “sometimes foods”, not “everyday foods”. As a formerly obese person, I don’t think it’s helpful to think of dessert as a necessary part of an everyday meal. I think they’re great for a special occasion, and make special occasions…well, special. After all, what’s not to love about a slice of cheesecake with the same number of carbs as a slice of bread, but the added fat, above and beyond what is found in the whole foods I eat is still an ‘extra’.
I invent recipes for myself that my ethnic clients find really helpful, including things such as Low Carb Roti (Indian flatbread) and Low Carb Chow Mein Noodles because I believe that a low carb lifestyle is not a “one-sized-fits-all”.
Everybody’s nutritional needs are different based on their stage of life, age, gender and health conditions and people have different food preferences. What works for me may not be what’s best for you. I design people’s Meal Plans based on the evidenced-based principles and their own preference, because it has to be sustainable.
Low Carb as a Maintenance Lifestyle
So, I’ve finally entered that wonderful phase known as “maintenance”; of needing to balance intake so I don’t continue to lose significant amounts of weight, but continue to achieve a more idea body composition (less extra fat, more muscle). That involves adjusting my “macros” (the percentage of protein, fat and carbohydrate) as I do for my clients when they reach this stage, and continuing to engage in activity that challenges my muscles.
It’s also about continuing to evaluate (as I do for my clients) which carbohydrates I can or cannot successfully eat, and in what quantities. I know that from research studies, carbohydrate is best tolerated after eating some protein and low carb veggies (you can read more about that here) but even then a 2105 study showed that each person’s response to carbohydrate is very different (discussed in this article). For example, I found that my blood sugar is great with whole, cooked chickpeas cooked from dried but is terrible with hummus as the grinding of the chickpeas makes the starch in them more available to digestion and absorption (you can also read more about that here). So, just like I follow-up my clients who are seeking long-term weight loss and healthy improvement, I do the same for myself.
Low carb is not “magic”. It’s not like the food you eat somehow doesn’t “count”. It has more to do with the different way our body metabolizes carbohydrate, compared with protein and fat and finding the mix of those that best achieves our goals. For me, that setting my intake in a way that maximized lowering my blood sugar and blood pressure and achieving a normal body weight. For someone else, it will be different. That’s why I say there is no one-sized-fits-all “low carb (or ketogenic) diet.
What are your weight loss and nutrition goals? Depending on your health and metabolic conditions, most can be realized using a well-designed, individualized, low carbohydrate Meal Plan.
Why not send me a note using the Contact Me form on the tab above and I will reply as soon as possible. Remember, I provide both in-person services as well as via Distance Consultation, using Skype or phone.
To our good health!
NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.
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