A Dietitian’s Journey – a picture tells a thousand words

Sometimes a photo can say more than all the words in the world.

The two photos below are a comparison of me 11 months ago and today. I certainly haven’t “arrived”, but like any journey there are markers along the way – markers that you are headed in the right direction, markers as to how far you’ve come and markers as to how far you’ve left to go. This photo is such a marker.

Me – 11 months ago (left) and today (right)

Everybody’s road to better health is different and “A Dietitian’s Journey” tells mine. You can read my story from the beginning with all the ‘gory details’ – from my “fat pictures”, to my lab work, and everything in between.  It tells the story of my struggle with denial and how the pain of remaining the same was greater than the pain of changing, and so I changed.

I keep making small, corrective changes in my path to ensure that it time I arrive at my ‘destination’ – which for me is to have a waist circumference  (in inches) that is half my height (in inches). This is not an arbitrary goal based on vanity, but is based on me having the lowest risk of cardiovascular events (heart attack and stroke), given my lab work continues to improve, as time goes on.

A summary of where I am on this journey now is here.

If you have questions as to how I could help you achieve your own health and nutrition goals, please send me a note using the “Contact Me” form on the tab above.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

A Dietitian’s Journey – remission from Type 2 Diabetes

My journey began on March 5, 2017 when I was a fat Dietitian with all the benchmark symptoms of Metabolic Syndrome including Type 2 Diabetes, high blood pressure, high LDL cholesterol and triglycerides, abdominal adiposity (i.e. “a belly”) and high BMI (high weight for height). Physically I was a mess but my biggest problem was that I was in denial. It had been months since I had monitored my own blood sugar or blood pressure even though I had been diagnosed with Type 2 Diabetes 10 years earlier. I knew better.

I would occasionally step on the scale and weigh myself, but how my clothes fit (or didn’t) already told the story. I was overweight. Actually, I was obese.

Shortly before my own turning point in March 2017, I had two girlfriends my own age – one who I knew since high school and one since university die of preventable diet-related disease within two months of each other. Both were in healthcare and took care of others practicing their profession, just as I do. I had two degrees on the wall but didn’t take care of myself.

March 5, 2017 all that changed. That was the day that the pain of remaining the same became greater than the pain of changing. So I changed.  That story and the progress since then are in previous articles in A Dietitian’s Journey.

Like many others, I once believed that “Diabetes is a chronic, progressive, disease” and that it will only get worse in time. I realize now that if I had continued to eat more carbs than my body could handle, then it most certainly would have gotten worse but I have almost 11 month of evidence that supports that if I don’t, it CAN and DOES get better.

I am not “cured” by any means, but my symptoms are now in what the American Diabetes Association defines as partial  remission and I may very well be able to achieve full remission, as I continue to eat a low carb diet. I will only know in time.

To achieve remission with Type 2 Diabetes (T2D) is like someone being in remission with Celiac disease; we can get well and stay well provided that we don’t eat the foods that we can’t tolerate; for a Celiac that’s gluten and for someone with T2D it is more carbohydrates than their body can handle.

I do eat some carbohydrate each day, mostly as non-starchy vegetables, the occasional berries or pomegranate seeds on a salad, as well as some nuts and seeds but I am careful to keep the amount at any one time below what my body can process while maintain blood glucose control as close to a ‘normal’ (non-Diabetic) level as possible.

This article explains how and why my body is no longer able to handle more than a small amount of carbohydrate at a time.

The good news is that I no longer meet the criteria for diagnosis with Type 2 Diabetes, as demonstrated by the  Diagnostic Criteria[1] for the disease:

Abbreviations: 2hPG , 2-hour plasma glucose; A1C , glycated hemoglobin; FPG , fasting plasma glucose; IFG , impaired fasting glucose; IGT , impaired glucose tolerance; OGTT , oral glucose tolerance test; PG , plasma glucose.

Diabetes Partial Remission and Remission

It does not appear that Diabetes Canada define these concepts, however the American Diabetes Association (ADA) defines “remission” as having test results below the range for Diabetes (i.e. Fasting Blood Glucose less than or equal to 5.5 mmol/L (100 mg/dL) without taking Diabetes medications or having bariatric surgery.

Partial remission” according to the ADA is having test results lower than the range for Diabetes i.e. Fasting Blood  Glucose less than or equal to 5.5 – 6.9 mmol/L (100–125 mg/dL) or HbA1C between 5.7 – 6.4%  for at least 1 year.

  1. my Fasting Blood Glucose is less than or equal to 7.0 mmol/L , so I no longer meet the diagnostic criteria and fall in the partial remission range.  As you can see from the following picture, the average of my  twenty-four Fasting Blood Glucose readings from January 1 2018 – January 24, 2018 has  been 6.0 mmol/L. Out of the 24 glucometer readings (with a meter that I standardized with the lab when I had my tests done), only once was my blood sugar higher than the cutoff. This would indicate that I am in partial remission, by the ADA definition.

    glucometer readings average fasting
    Self monitored blood glucose – January 1 2018 – January 24, 2018 – averages

  2. I have taken seventy-five glucometer readings during the month of January so far (see photos at the bottom of this article) and none of them were greater than or equal to 11.1 mmol/L. Here is a graph of my January results:

    glucometer readings graph
    Self monitored blood glucose – January 1 2018 – January 24, 2018 – graph

3. My 3 month glycated hemoglobin test, also known as a HbA1C (or “A1C” for short) is less than or equal to 6.5 %  which means that I no longer meet the criteria for the disease and my results fall in the range for partial remission.

non-diabetic HbA1c
Glycated Hemoglobin below criteria for Type 2 Diabetes – January 23, 2018

Cholesterol and Lipids

My LDL was at the high-end cutoff two years ago, after only 4 months on a low carb high healthy fat diet, it was approaching what is considered by the existing / popular standards of “optimal LDL” for someone who is high risk (family history of cardiovascular disease).

My LDL was 2.60 mmol/L (1.14 mg/dl), my triglycerides (TG) were 0.64 mmol/L and my HDL was 1.97 mmol/L. 

Using more significant measures, my TG:HDL ratio was 0.32 (with <0.87 considered ideal). A very low TG:HDL ratio is associated with lots of large, fluffy LDL – the kind associated the lowest risk of cardiovascular disease  (CVD) such as heart attack and stroke. It is the higher density, small LDL particles that are associated with CVD.

Blood Pressure

My blood pressure has been ranging from between just below the normal range to pre-hypertension for months, but to protect my kidneys I am continuing to take a “baby dose” of Ramipril® (2.5 mg per day) that I asked the doctor to put me on until my blood pressure is consistently below normal and the meds need to be reduced or discontinued.  The dose I’m on is the smallest it comes in and my doctor has switched me to tablets, which can be split if my blood pressure is consistently on the low side.

Weight and Waist Circumference

Weight

I’ve lost 35 pounds.  I feel better about how I look than I have in many years, and I am a little more than half way there.  I am celebrating my progress, but not letting it be ‘enough’ because health-wise, it isn’t. To truly reduce my risk of heart attack and stroke, I need to lose another 25 pounds, or whatever weight will actually put my waist circumference at half my height.

Waist Circumference

I’ve loss 7 inches off my waist. That’s more than 1/2 a foot!  Crazy, eh?  I only have another 3 inches to lose off my waist for me be in the low-risk category and I am guessing that will correlate to another 30 pounds of weight loss.  Maybe it will be less, maybe more, but my weight loss goal is whatever it takes for my waist to be half my heightThe scale won’t determine my goal, the tape measure will.

My hard earned success in achieving partial remission from Type 2 Diabetes and these significant improvements in metabolic markers would be very short-lived if I began to eat more carbohydrates than my body can handle. I am still learning how much of which kinds of foods I can eat while maintaining my blood glucose levels but my own “n=1 results” seems to indicate that  full remission of Type 2 Diabetes may very well be possible. The literature seems to support that it is possible- but whether I can achieve that level has yet to be seen.  I still have much more to achieve, but I am definitely on the road to better health!

If you would like to know how I can help you on your own health and nutrition journey, please send me a note using the “Contact Me” form above.

To our good health,

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

Copyright ©2018 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.


P.S. For those that would like to see the “numbers” to understand my progress to date, below are 10 photographs showing all my glucometer readings since March 5, 2017 until today.

Blood Glucose Mar 5 2017 – January 24 2018 – pg 1

Blood Glucose Mar 5 2017 – January 24 2018 – pg 2

Blood Glucose Mar 5 2017 – January 24 2018 – pg 3
Blood Glucose Mar 5 2017 – January 24 2018 – pg 4
Blood Glucose Mar 5 2017 – January 24 2018 – pg 5

Blood Glucose Mar 5 2017 – January 24 2018 – pg 6

Blood Glucose Mar 5 2017 – January 24 2018 – pg 7
Blood Glucose Mar 5 2017 – January 24 2018 – pg 8
Blood Glucose Mar 5 2017 – January 24 2018 – pg 9
Blood Glucose Mar 5 2017 – January 24 2018 – pg 10

References

  1. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37(suppl 1):S1-S212, Chapter 3

A Dietitian’s Journey – a breakthrough

As I wrote about in a recent article, there’s more than one way to eat a low carb ketogenic diet including (1) low carb high fat (2) low carb high protein and (3) a mixed approach of higher protein lower fat during weight loss, then a moderate protein high fat during weight maintenance. Up until very recently my approach with my own weight loss has been low carb high fat – with the focus on monounsaturated fats such as olive oil, avocado oil, nut and seeds (and their oils) and omega 3 fatty acids from fatty fish. The problem has been that the last while, my weight loss and the rate at which my blood sugars were coming down has been too slow. As I do with my clients, it was time for a different approach. Since both of the other two types of low carb diet involves higher protein and lower fat I knew this is what I needed to do, but how much protein? How much fat? Do I keep carbs the same or lower them? In answering these questions, I have achieved a major breakthrough in my own ‘journey’ to better health.

I started with carbs. In discussion with my endocrinologist, I knew she supported carbs at 10% or less of my intake so I calculated my needs based on my gender, height, weight, activity level and weight loss goal – just as I do for my clients, and then figured out how many grams of carbs I could have in a day at this level. It was even lower than the amount of carbohydrate that I had been eating (which had been lowered twice over the last 10 months – from moderate, to low and now to very low), but since this ‘very low’ limit was in line with what my endocrinologist recommended, I set my carb limit at that.

Protein, rather than fat had to be the second macronutrient I needed to set and since it was to be based on lean body mass and not my total weight, I determined my fat percentage.  Then, I calculated how much protein I needed to eat per day based on the research studies. As it turned out, the lowest end of the range was considerably more than I had been eating, and only just slightly higher than what the average Canadian or American eats in a day. This was a bit of an obstacle for me, as I am not a big egg eater also not a big red-meat eater and there’s only so much chicken I can handle.  I knew I wanted to continue to eat a few ounces of cheese every day as this is a major calcium source, but that meant factoring in the fat the cheese would add, which I did. Nuts again cropped up as a significant problem – not for their carb content, as much as their fat content.  Eating lower fat and higher protein meant nuts and seeds were going to be limited to a sprinkle on a salad and cream in my coffee was limited to a little bit once a day. I needed to look at option that would work for me in terms of protein and since I don’t eat pork or shellfish, that left me focusing on freshwater and sea fishes as well as finding ways to include beef and lamb along with different kinds of poultry.

Even though I live on the West Coast, there are many kinds of fish available to me to eat besides the ubiquitous sockeye salmon and halibut. I began exploring what was available frozen and rediscovered sea fishes such as whole mullet, mackerel and milkfish, fresh water fish such as whitefish, as well as the bags of filleted cod for quick preparation (I avoid basa and talapia because they are high in omega 6 fat, which makes them pro-inflammatory). I cooked a whole salmon on Friday and have been eating the leftovers cold for breakfast, since I am not that fond of eggs.

I began to think of poultry beyond chicken and bought and roasted a turkey (which also left leftovers to eat for my early meal) and began to think of ways to cook quail and duck (minus all the fat).

Eating a wide variety of fish and poultry with some cheese thrown in there has provided me with sufficient protein on most days and for the occasional time that I just can’t handle eating more, I mix some cocoa powder with whey isolate and drink that.

I should add that when I eat, I am not trying to 'fulfill' my macronutrient distribution (gms of protein, carbohydrate and fat) but rather, I eat as much whole food protein at my two meals (one mid-morning and the other around supper time) then eat a good 2-3 cups of low carb veggies with the protein. I add a little bit of mayo, butter or cream to make things taste good, and don't "count" anything except carbs. In fact, I encourage my clients to do likewise. I focus on maximizing whole food protein within my Meal Plan and the fat that I end up with is what naturally comes with those. It's a very "easy" lifestyle to follow, once the calculations are done - and since I do those for my clients, it only makes sense for me to do them for myself, too. Leading by example, right?

The results have been astounding.

I’ve lost 4 pounds in 2 weeks and as significantly, I have seemingly lost most of it off my abdomen and not just the fat under the skin (sub-cutaneous fat), but the fat deep in my belly, around my organs (visceral fat).

This is HUGE because it visceral fat is most highly correlated to insulin resistance – which is what I am trying to reverse. Just look what’s happened to my blood sugar over the weekend:

My fasting blood sugar actually went down after it went up in the wee hours of the morning (the effects of Dawn Phenomena) which would seem to indicate that the loss of belly fat is indeed making me more insulin sensitive! When my early morning blood sugar goes up due to Dawn Phenomena, my cells are now more responsive to the resulting spike in insulin, and the excess sugar is now being taken into the cells, like it is supposed to!

This wasn’t a one-off thing either.  This is what happened yesterday and this morning;

These changes cannot be attributed to the baby dose of Metformin that I’m taking before bed (which is lowering the magnitude of the Dawn Phenomena rise), but is reasonably related to the only other change that I have made which is the increase in the amount of protein I am eating (in grams) and the reduction in the amount of fat and carbs I am eating.

We do know that over time, the body gets adapted to the changes we make – whether dietary or exercise changes and that to continue to get results at the rate that we want, we need to change the approach. I do this in my follow-up approach with my client over their weight-loss and health journeys and it was necessary for me to this for myself, as well.

While it is much ‘easier’ for me to eat a lower protein, higher fat diet as these are the foods I prefer, my goal is to reverse the symptoms of Diabetes and put myself into remission (have normal fasting blood glucose and normal HbA1C long term).

“Let food be thy medicine and medicine be thy food.”

– Hippocrates

For me, while it is not the easiest of most natural way for me to eat, increasing the amount of proteindecreasing the amount of fat and limiting my carbs to those contained in non-starchy vegetables is allowing my body to heal in the ways in needs to – allowing food to be my medicine.

The question arises “was it the lower carbs or higher protein that has made the difference?”.  I had tried a few times before to lower my carbs down to almost as low as I am now and to made up most of the extra intake (outside of my basic protein need) from fat, but this did not contribute as much to me not being hungry (i.e. satiety) as this higher ratio of protein with the rest from the same sources of fat (which is still “high” by most standards). So yes, it is partially due to the lower carb content, but reasonably to the higher protein content, as well.

My entire ‘journey’ has been (and is) about me doing whatever it takes to achieve my goals with a healthy and evidence-based diet and it’s hard to argue that with 30 years of combined research in this area that Phinney and Volek aren’t reliable in terms of evidence. It mades sense for me to do what they recommend, even it if isn’t the most “natural” way for me to eat.

My hope is that in time, when I am no longer insulin resistant, that I can switch over to a moderate protein high fat intake as Phinney and Volek recommend, but for now this is what is best because it is working and because it is in accordance with what my endocrinologist recommended, and under the supervision of my doctor.

The ironic thing is that most of my clients do really well on moderate to low carb restriction with a fairly high intake of monounsaturated and omega 3 fat and are content with their rate of progress which is great.  For those that will need, in time, to make changes to the way they pursue a low carb lifestyle, I hope by me leading by example, it will be encouraging to them.

Tomorrow I am scheduled to have my HbA1C level checked which won’t factor in much of these new changes in blood sugar levels because the test looks at the amount of glucose  which stays attached to hemoglobin (Hb) for the life of the red blood cell (i.e. glycated hemoglobin), which is normally about 120 days / 3-4 months. At my last test 3 months ago, my glycated hemoglobin was 7.0% and what I am ultimately aiming for is a HbA1C of <6.0%, which would be in the non-Diabetic range. Whether its this time or the next time isn’t really as significant is that it has been more than 10 months where I have diligently been working towards that goal.

I’ve successfully normalized my triglycerides and lipids and brought them into the ideal range and have substantially lowered my blood pressure – and both of these were done by diet alone.  It will be interesting to see the effect of these diet changes on my HbA1C, as well as have some indication of how much more I have yet to do.

It’s all about progress, not perfection and significant progress is being made, as evidenced by this recent personal breakthrough.

If you’d like to know how I can help you achieve your health and nutrition goals, please send me a note using the “Contact Me” form on this web page.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

Copyright ©2018 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 Journey Progress Report – is the glass half empty or half full?

Ten months ago, it was urgent. I had to make a choice between going on several types of medication to lower my crazy-high blood pressure, and high blood sugars, triglyceride and LDL cholesterol or to immediately change my lifestyle.  I chose to change my lifestyle. This is a progress report, going into the final two months of my first year at this.

As with other changes we undertake, there are two ways to look at things; how far we’ve come or how far we have to go. I choose to look at my progress as both. I am certainly not “there” yet, but I am nowhere near where I was!

Back in early March of this year, when I faced my own personal health crisis, it had been two years since I had any lab work done and ages since I was monitoring my blood sugar myself, even though I was Diabetic for the previous 10 years.  It really was a case of classic denial. I didn’t want to know how bad it was. That day because I didn’t feel well, I faced the truth.  I took my blood pressure (multiple times, because I couldn’t believe the readings!!) and I took my blood sugar. My blood pressure was so high, for certain had I gone to see my doctor at that point, he would have prescribed at least one type of medication, maybe two. Suffice to say it was dangerously high.

My blood sugar back in March of this year was high, but what else could it be eating a carb-based diet.  I had started eating low carb two years earlier, but life circumstances got in the way for a time and I failed to go back and pick up where I left off. As I could have predicted they would, things only got worse. My fasting blood sugar was between 13.0 mmol/L (234 mg/dl) and 9.0 mmol/L (162 mg/dl).  That’s nuts!

I was obese (BMI > 30). I’d joke about being the “fat Dietitian” but it wasn’t funny.  For the previous two years, I was teaching others to eat low carb high healthy fat in order to lower their weight and reduce their insulin resistance, but I was in classic denial when it came to myself. Yes, I knew I was fat, but I was in denial as to just how much risk I was at for a heart attack or stroke.

My LDL was high and even though my high HDL acted as a protective factor, in the context of me being Diabetic, obese and having very high blood pressure, the only place it was going to go was higher – unless I changed my lifestyle permanently.  That day I did. For me, there really can’t be any turning back as it really is a matter of life and death. I am no longer in denial.

So how am I doing?

The weight has been coming off, slowly but surely. I haven’t made any major progress in the last month, but then again I didn’t gain anything of significance over the holidays.  That’s a good thing.  Okay, it’s a very good thing. Looking at it with the ‘glass’ being half empty I am still only 1/2 way to where I need to be to have my waist circumference 1/2 my height. Looking at it with the ‘glass’ being half-full, I’ve lost 30 pounds.  I feel better about how I look than I have in many years, and I am only half way there.  I am celebrating my progress, but not letting it be enough because health-wise, it isn’t. To truly reduce my risk of heart attack and stroke, I need to lose another 30 pounds, or whatever weight will actually put my waist circumference at half my height.

I’ve loss 6 inches off my waist. That’s 1/2 a foot!  Crazy, eh?  I only have another 4 inches to lose off my waist for me be in the low-risk category and I am guessing that will correlate to another 30 pounds of weight loss.  Maybe it will be less, maybe more, but my weight loss goal is whatever it takes for my waist to be half my height. The scale won’t determine my goal, the tape measure will.

My blood pressure has been ranging from between just below the normal range to pre-hypertension for months, but to protect my kidneys I am continuing to take a “baby dose” of Ramipril® (2.5 mg per day) that I asked the doctor to put me on until my blood pressure is consistently below normal and the meds need to be reduced or discontinued.  The dose I’m on is the smallest it comes in and my doctor has switched me to tablets, which can be split if my blood pressure is consistently on the low side.

As covered in an earlier update, my triglycerides and cholesterol are now in the ideal range simply from the dietary changes I have made.

My blood sugar has been a bit frustrating, because overall it isn’t going down nearly as fast as I thought it would, or as I’ve observed other people’s to do. Everybody’s different and mine is just taking this long despite all the things I am doing right. I started out eating “low carb” (50 gm carbohydrate per day) and as it turned out it wasn’t low carb enough, perhaps because of how long I’d been Diabetic and just how insulin resistant I really am. A few months ago, I added regular intermittent fasting (IF) – fasting 23 hours from the end of supper to the beginning of supper the following day (drinking ‘bone broth’ and tea and other appropriate beverages while fasting). I have done one slightly longer fast, with careful monitoring. Along with IF, a number of months ago I also lowered my carb intake to ≤ 35 gm of carbs per day and monitor my blood sugar 5-7 times per day to make sure it doesn’t dip too low.  During the day time, towards the end of a 24 hour fast, my blood sugar will be in the low 4’s mmol/L (~81 mg/dl) just before I eat again, but in the morning, the lowest it has ever been is 5.8 mmol/L (105 mg/dl).  No matter what I do the night before (i.e. exercise, eat very low carb) my blood sugar begins rising around 3 am and continues rising until 6 or 8 am, even though I am fasting.  It is classic “dawn phenomenon” and it has been incredibly frustrating.

My HbA1C has dropped from ~9.0 % (at the beginning of March) to 7.5 %  (July 25 2017) to 7.0 % (October 11 2017) in 7 months, but for the last 3 months it has remained stubbornly at 6.8 % – almost exclusively because my fasting blood sugar remains high. This led me to a decision to ask my doctor to trial me on a “baby dose” of Metformin® only at night to see if it will help bring down my fasting blood sugar and more importantly, the corresponding insulin resistance, while I continue to eat a very low carb (ketogenic) diet and practice intermittent fasting.

After reviewing the over 400 glucose readings I took from March 5, 2017 onward and seeing that my HbA1C remains only slightly lower the last 3 months despite all my lifestyle changes, my doctor agreed to trial me on the lowest dosage of Metformin® over the next 3 months (the dose given to youth with high blood sugar).  It will be interesting to see its effect as of January 6, 2018. What many people may not realize is that while Metformin® is now a pharmaceutical (medication), it was initially derived from a plant called “goat’s rue” or the French lilac and has been used since the Middle Ages to treat the symptoms of Diabetes. It’s not unlike acetylsalicylic acid (ASA), which is the active compound in Aspirin® which was originally isolated from white willow bark.  Aspirin® and Metformin® are both natural in origin.

In addition to its natural origins and long-standing safety record, studies indicate that people with Diabetes who take Metformin® have lower  incidence of cancer and dementia and in animal models, increased longevity has also been reported.  Given all of these factors, it seemed reasonable for me to ask my doctor to trial me on a small dose of Metformin® to see if it keeps my liver from manufacturing too much glucose in the early hours of the morning, thus lowering my overall insulin resistance, while I continue to eat ketogenically and practice intermittent fasting. My doctor agreed. While it is too soon to know how much impact this small dose will have, from January 6th until today, my blood sugar is averaging 6.5 mmol/L, yet still rising from 3 am until 6 am. I will give it a few more weeks and then possibly ask my doctor to try me on the same dosage of slow-release Metformin®, to see if my morning blood sugar is improved.

It may seem strange to some that I would add medication after successfully having lost so much weight, having brought my lipids into the ideal range  for non-Diabetics, and having lowered my blood sugar to the ideal range for Diabetics (≤ 7.0%) solely by adopting a low carb lifestyle and practicing intermittent fasting. I view much it like wearing a brace or using a cane after injuring one’s knee. It’s not a permanent measure, but support and protection while the healing continues to take place.

This is my journey, and my progress and challenges are as individual as I am. Everyone is different and the degree of carb reduction and whether or not intermittent fasting may be helpful for you is something that will only be known it time as we work together.  One thing is for certain is that unless one starts the process of working towards achieving their health and wellness goals, things will not improve on their own.

Have questions?

Please send me a note using the “Contact Me” form located on the tab above.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

 

 

 

 

 

A Dietitian’s Journey – 9 months since beginning LCHF

LEFT: March 16 2017, RIGHT: December 18 2017

The photo on the left is what I looked like when I started my weight-loss and health ‘journey’ on March 16, 2017, 9 months ago.  The photo on the right, is me today.

Based on my BMI, I was well into the  Class I Obesity  category 9 months ago. Based on my BMI today, I am just 15 pounds from my weight falling in the normal range. 

At the beginning of March, my blood pressure ranged between Stage 2 Hypertension  and Stage 1 Hypertension – sometimes being dangerously high. Now, my blood pressure hovers around 125/80 mmHg mark, and I am still on the ‘baby-dose’ of Ramipril for now, as it protects my kidneys.

My triglycerides  and my LDL cholesterol (“bad cholesterol”) were high, certainly well above what it should have been for someone who has Type 2 Diabetes and had family risk factors. Thankfully, my HDL was good, offering some protection.

In the past 9 months, my morning fasting blood sugar has dropped from ±12 mmol/L (216 mg/dl) to anywhere from 5.8 mmol/L (105 mg/dl) to 6.5 mmol/L (117 mg/dl) – with the occasional 8.0 mmol/L (144 mg/dl) for seemingly no apparent dietary reason. For my fasting blood sugar to be in the non-diabetic range, it needs to be consistently below  5.5 mmol/L  (99 mg/dl).

When I began this journey, my HbA1C was ~ 9.5% and during the last 30 days, I am averaging ~6.3% which is in the non-diabetic range. This has been entirely achieved without any medication to lower blood glucose.

I was determined to reverse the symptoms of Diabetes, high cholesterol  and high blood pressure by changing how I ate and by introducing short periods of intermittent fasting and I have certainly made significant progress.

Weight and Body Measurements

I’ve lost ~25 lbs so far, but the changes in my body and face shape are even more noticeable, as evidenced by the photo above.

So far, I’ve lost;

  • 1″ off my upper arms
  • 3″ off my neck (!)
  •  1″ off my thighs
  • 4 1/2″ off my waist

This week, I reached the “goal weight” that I initially set for myself, but in order to attain an ideal waist circumference that is 1/2 my height, I probably have to lose another 20-25 pounds, which means I am half-way there.

I am entirely convinced that this is realistic and attainable.

Change only happens when the pain of staying the same is greater than the pain of changing.

Want to start your own weight loss and health journey? Why not send me a note using the “Contact Us” form above.

Wishing you and yours all the best for holiday season!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

Note: I am a "sample-set of 1" - meaning my results may or may not be like anybody else's that follows 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.

A Dietitian’s Journey – before and since

INTRO: “Before” and “after” photos are often the source of encouragement, as I progress on my journey.  This “before and since” photo serves as some Monday-morning motivation.

Yesterday, after ten days on crutches and a brace due to a torn MCL tendon, I had finally progressed to a cane and just had to get out for a bit.  With a break in the rain, one of my sons and I headed for Indian Arm, an ocean inset nearby. It was mild and humid and I really didn’t want to wear a long sleeve jacket, so I reached for a down-filled vest that I bought a number of years ago that never zipped or snapped up, and headed out.  When we arrived, there was a breeze off the salt water and instinctively, I zipped up the vest and snapped the outer snaps. Only in hindsight did I realize this was the first time I ever did that – and with a little room to spare.

We walked (actually, I hobbled on my cane) along the coast path and down to the pier and took in the fresh air and beautiful view. As we were leaving, I remembered the photo that was taken of me 2 1/2 years ago on the same pier, around the time I first learned about eating low carb high fat (LCHF) and asked my son to snap a photo of me on my phone, so I could compare them. In both photos, I was dressed in comfortable clothes, with no makeup and my hair however it was.

When we returned home, I dug out the old photo and here they are, side by side.  Even with my puffy down-filled vest and knee brace, the difference is noticeable, even though it has only been 6 months that I have been “practicing what I preach” and eating low carb, myself. Since I am very much ‘in progress’ with my weight loss and achieving my health goals, I refer to this as before and since rather than before and after.

Me – summer 2015 (left), me fall 2017 (right)

It will be interesting to take an updated photo this time next year to see the progress.

Encouragement in our health journeys come in many forms; a number on the scale, new lab results, readings on a glucometer, or photos over time.

Today I celebrate this mid-point progress in this Dietitian’s Journey and I encourage you to celebrate yours!

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Journey – progress not perfection, 7 months in

It’s been 7 months since I’ve been seriously adhering to a low carb high heathy fat (LCHF) lifestyle, but like anybody else it’s easy for me to get frustrated when I don’t reach goals as quickly as I would like. I have to stop and remind myself that I didn’t become obese and Diabetic overnight and it’s going to take time to reverse these symptoms. These updates help me take stock of my progress, because after all it’s about progress, not perfection.

Joy – class 2 obesity

At my highest weight, my Body Mass Index (BMI) put me well into the Class 2 Obesity category. I felt terrible, looked terrible and was desperately unhealthy.  Losing weight seemed impossible – or if not impossible, too difficult.

 

September 20 2015

This is what I looked like 2 1/2 years ago, when I first heard about following a low carb high healthy fat lifestyle from a retired physician-friend. At this point, I had already lost about 25 pounds by cutting portion sizes and exercising, but my weight was always fluctuating by 10 or 12 pounds and with it, my blood sugar, cholesterol and blood pressure. I was in denial about how very unwell I had become.

The sudden death of two girlfriends my own age was certainly a ‘wake up call’, but it was my blood pressure that had become dangerously high that was the final impetus for me to change. I knew that if I did nothing, I was at very high risk of having a stroke or heart attack. My choice was (1) to go on medication for high blood sugar, high cholesterol and high blood pressure or (b) change the way I ate. It was, as they say, a “no brainer”.

March 5, 2017 was the day I made the decision to change and there has been no looking back.

Change only happens when the pain of staying the same is greater than the pain of changing.

March 16 2017 – the beginning of the journey

This is what I looked like when I started.  Based on my BMI, I was well into the Class I Obesity category.

My blood pressure ranged between Stage 2 Hypertension and Stage 1 Hypertension – dangerously high.

My morning fasting blood sugar was averaging ± 12 mmol/L (216 mg/dl) and my HbA1C was likely ~ 9.5%.

My triglycerides were high and my LDL cholesterol (“bad cholesterol”) was well above what it should have been for someone who was Type 2 Diabetic and had family risk factors.

I was determined to reverse the symptoms of Diabetes, high triglycerides and high blood pressure by changing how I ate.

Progress, not perfection

Blood Glucose

When I began this journey at the beginning of March, my fasting blood glucose was averaging 12 mmol/L . My HbA1C was likely ~9.5%. Four months into eating low carb high fat, my fasting blood sugar was averaging 8.5 mmol/L and my HbA1C was 7.5% – still above the ≤ 7.0% therapeutic target for those with Type 2 Diabetes.

This week, 3 months later, my HbA1C reached the 7.0% therapeutic target for those with Type 2 Diabetes, but that is still not good enough. My goal is to get it at or below 6.0 % – below the Diabetic cutoff range. My challenge remains that my blood sugar is frequently high in the morning  when I am fasted, yet is significantly lower in the late afternoon when I have been intermittent fasting for the same length of time. I continue to suspect that cortisol remains a factor as cortisol production naturally begins to climb around midnight and reaches and is highest level between 6 am to 8 am.  

This higher blood sugar in the morning is something called “Dawn Phenomenon” which I had for a good 5 years before becoming Type 2 Diabetic. When I track my blood sugar from 10 pm until 8 am, it starts going up in the wee hours of the morning and keep rising until 6:30 or 7 am so it’s evident that my fasting blood sugar is rising with the daily fluctuations in cortisol. When I am intermittent fasting for the same amount of time during the day, my fasting blood glucose is always < 5.0 mmol/L and many times less than 4.0 mmol/L – which is usually my signal to eat something. Under the effect of cortisol combined with my liver still being insulin resistant, the glucose has no where to go and just sits in my blood.

I am going to try to get back to incorporating some form of daily activity to lower stress, which kind of fell off the radar and add some short duration, high-strength / high muscle-use exercise such as squats which can help move blood glucose into the muscle.

Blood Pressure

I continue on my low very low dose of Ramipril (Altace) and my blood pressure is averaging 127/74 mmHg. When I stop the meds for a day or two to measure my blood pressure, it is still averaging 145/82 mmHg which is still too high to discontinue the medication, but it is far better than the 160/90 mmHg that it was 3 months ago.

Weight and Body Measurements
LEFT: March 16 2017, RIGHT: October 11 2017

I’ve lost 20 lbs so far but its the change in my body and face shape that is most noticible!

In terms of “inches”, I’ve lost;

  • 1″ off my upper arms
  • 2.5″ off my neck (which really shows!)
  •  1″ off my thighs
  • 4 1/2″ off my waist (which feels amazing!)

Facial lines are more visible, but when I look in the mirror I actually recognize the face looking back.

I am now below the high end of the overweight category based on BMI and am continuing to lose weight steadily.

At the beginning of this journey, I planned to lose ~30 lbs, but I realize that to attain an ideal waist circumference that is 1/2 my height, I likely have another 30 pounds to lose now which means I am not quite half-way there, but I am making progress!

…and that is the goal; progress, not perfection.


If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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.

Reversing the Symptoms of Type 2 Diabetes – a Dietitian’s Journey

I once believed that Type 2 Diabetes was a chronic, progressive disease  because that’s what I was told, but I am seeing for myself that a reversal of symptoms is possible.

Today, after more than 10 years as someone with Type 2 Diabetes, I had an almost normal Fasting Blood Glucose reading of 5.8 mmol/L  (105 mg/dl) – when just 6 months ago, my average fasting blood glucose was between 10 – 11 mmol/L (180 – 198 mg/ml).

Fasting Blood Glucose – September 27 2017

Just 2 months ago, after eating a low carb high fat diet with no more than 50 g of carbs per day, my Fasting Blood Sugar was averaging 7.5-7.8 mmol/L (135-141 mg/dl) and at the lab on July 25, 2017, my blood sugar was still way too high, at 8.0 mmol/L (144 mg/dl) – see below.

Fasting Blood Glucose, July 25, 2017

It was at that time that I decided to lower the amount of carbs I ate and to delay the time between meals (something referred to as intermittent fasting) as these are well-documented to help lower insulin resistance, and in turn, blood glucose. It isn’t “fasting” in the classic sense and there are many things that can be consumed during this period, that don’t affect blood glucose levels or cause a release of insulin. For me, I ate a full supper every weekday and then didn’t eat until supper the next day, although I would have any one of a number of things that don’t impact insulin or blood sugar in between, if I wanted to.

Was I hungry?

Oddly, no!

I’d have a coffee in the morning (my usual cappuccino made with diluted cream, as opposed to milk as it has no carbs) and since there aren’t any carbs in it, it’s something I can enjoy when I am “fasting”…just like “bone broth”.

 

A month later, on August 22nd, for the first time, my 2 hour post-prandial blood glucose (i.e. two hours after a meal) was 5.8 mmol/L (105 mg/dl).

This was definite progress!

To put that in context for someone without Diabetes, blood glucose taken  two hours after meals should be less than 7.8 mmol/L (140 mg/dl) – so my blood sugar after supper was not only in the non-Diabetic range, it was much better than that!

The problem was, my fasting blood glucose still remained high.

I carried on with delaying the time between meals (“intermittent fasting“) during the weekdays and ate what the number of meals I wanted on weekends, keeping my carbs at a low level, and monitoring my blood glucose every two hours or so.  This is the level I discovered that I do best at.

As mentioned in a previous blog, I added a no-carb beverage before bed that I made with club soda (seltzer), apple cider vinegar and grated ginger root (and sometimes added grated turmeric root) and started seeing my fasting blood sugars come down. I dubbed it “Gingeraid“.

The last three weeks I have been playing around with drinking Kombucha during the day (which is a fermented tea beverage that is mildly acidic)  and as I found out, the acid in Kombucha is acetic acid – just like apple cider vinegar.

I was noticing a marked improvement in my fasting blood sugars!

I’ve since done some poking around in the scientific literature and have discovered that Kombucha and other fermented foods such as sauerkraut or kimchi  (cabbage fermented with ginger, green onion and chili – a Korean staple ) have been documented to have a marked effect on fasting blood glucose.

BINGO!

Most mornings the last few weeks, I’ve had a fasting blood glucose is ~6.2-6.5 mmol/L (112-117 mg/dl)

Today was a first, almost normal fasting blood glucose of 5.8 mmol/L (105 mg/dl).

I did a “happy dance”!

I will write and article documenting some of the scientific evidence that fermented products such as Kombucha, kimchi and apple cider vinegar lower blood sugar but suffice to say, in the meantime I will keep eating the same lower level of carbs and monitoring my blood sugar, continuing to delay the time between meals a few days per week (supper to supper, but eating food if hungry or if my blood sugar is low), drinking Kombucha during the day (I love it diluted 50-50 with Gingeraid), and will drink 1/2 to one litre of Gingeraid before bed.

Here is the link to the article documenting that the components of 'Gingeraid' including apple cider vinegar, ginger root, turmeric root, as well as kombucha and kimchi lower blood sugar: Food as Medicine to Lower Blood Glucose - some scientific support.

Final thoughts…

I once believed that Type 2 Diabetes was a chronic, progressive disease because that’s what I was told by my endocrinologist and by the nurses I saw at the Diabetes Clinic, but I am seeing for myself what many clinicians and researchers have discovered – that achieving remission is possible!

Am I “cured”?

No.

But if I end up without any of the symptoms of the disease, does it matter?

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Journey – two and a half years of change in photos

Like most young adults, my three sons hate when photos are taken of them, however when we gather for a holiday each year in the spring and fall,  they indulge me in a group photo.  This has provided me with visual  documentation of my progress these past two and a half years, since I first learned about a Low Carb High Fat (LCHF) style of eating. These cell phone pictures certainly aren’t the best quality photos, but they serve the purpose.

The first photo from the left with me in the plum shirt, was taken April 2015, around the time a retired-physician friend first told me about the work of Dr. Jason Fung, a nephrologist in Toronto that teaches his patients a LCHF-diet, along with intermittent fasting (IF) to reverse the symptoms of Diabetes and obesity.

The second where I am wearing a scarf was taken in September 2015, shortly after I began eating a liberal lower carb diet, but was not following a ketogenic lifestyle or intermittent fasting. I was not eating as large amounts of carbohydrate as I had been, and guess I was probably eating ~ 130 g carbs per day.

Two and a half years of change – from April 2015 – Sept 2017

The third photo, the one in the middle, was taken exactly a year ago in September 2016.  I had lost some weight, but as you can see, the crocheted cardigan I was wearing was stretched skin-tight over a striped camisole.

Quite by accident, in the fourth photo taken in April 2017, it turned out that I wore the exact same outfit as I did in the previous September. This photo was taken only a month after I had begun following a LCHF lifestyle seriously at the beginning of March (6 months ago). I wore the crocheted cardigan open, and one can see that while I lost a lot of weight on my face and neck, my abdominal circumference had decreased to a lesser degree.

Two days ago, I deliberately wore the same cardigan and skirt that I had randomly ended up wearing in the previous two photos – with the identical camisole in a different colour, underneath. What can be seen in this last photo (September 2017) is that my face and neck have continued to slim, but what can’t be seen is the huge amount of space under the crocheted cardigan. So here is a photo of that space:

The significant abdominal weight loss (~4.5″) in one year

Through the large spaces in crochet pattern of the cardigan, one can see the outline of the bottom of my skirt and my pink sandalsThere is 4″ of space all around!  The significant changes in weight, abdominal fat, and overall much lower blood sugar at all times of the day has occurred since I first lowered my daily carb intake from ~50 g per day in March to ~35 g per day in July – and began seriously intermittent fasting a few days per week, from supper to supper (except for coffee in the morning).

While I still have another ~25 pounds to go to reach what I believe will put me at a waist circumference of 1/2 my height, I am definitely “getting there”. The progress is slow, yes, but consistent.  My lab tests and daily glucose readings reflect the change. These photos serve as more evidence.

This weekend, for the first time, I forgot to take my “baby dose” of Ramipril one night and decided to measure my blood pressure at several points the next day, to see whether it was coming down compared to 3 months ago when I began temporarily taking it, by choice. My systolic blood pressure without medication was 15 mmHg lower than it was three months ago and my diastolic blood pressure is ~5 mmHg lower. I’m going to continue taking this medication until my blood pressure is ideal without it, but it is encouraging that I am much closer to that goal.

I am sharing these photos to encourage others that for me, following a low carb high fat lifestyle has made a huge difference – and the more seriously I limited the amount of carbs I ate, the more significant my changes have been.  Had eating 50 g of carbs per day produced the results I sought with respect to my insulin resistance and weight loss, I would have stayed at that level, but it became evident that I don’t process carbs at all well.  For me, it was necessary to lower the amount of carbs I ate, but it is certainly worth it. There are days, such as holidays that I choose to eat more than 35 g of carbs per day but I choose to avoid going higher than 50 g per day.

I consider my intolerance to carbohydrates to be no different than if I was wheat intolerant or lactose intolerant. Some people who are lactose intolerant, for example can consume some lactose and their bodies can  digest it. Others lack the ability to digest significantly smaller amounts of lactose and necessarily limit it in order to feel well. The inability of my body to process carbohydrates is no different.

Everyone is different in terms of the amount and even the types of carbohydrates their bodies can process without impacting their insulin levels, blood pressure, lipids or weight, which is why there is no one-size-fits-all “low carb diet“. What is ideal for someone else will be different than what’s ideal for me. My role as a Dietitian is to work with clients and their physicians to help determine what level of carbohydrate intake works best for them – in order to lower insulin resistance (and in turn blood glucose), lower high triglycerides and cholesterol, as well as blood pressureWeight loss is a natural byproduct of addressing these.

Want to know how I can help you? 

Please send me a note using the “Contact Us” form on this web page.

I’m Joy Kiddie, practicing what I preach.

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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.

Food as Medicine; dramatically lower blood sugar – a Dietitian’s Journey

I am not one for popular remedies for health issues.  I don’t believe in “cleanses” and I don’t “eat clean” – or do I? If not eating any dairy is “clean” then I eat “dirty” because I use cream in my coffee, but if not eating gluten or grains is “clean”, then my eating is pristine.

The problem with popular beliefs around food and eating and word-of-mouth remedies is there is no standardized means to define them or evaluate their effectiveness.

Folk Remedies

Folk remedies, on the other hand, are in a different category. These practices, on which many nutraceuticals and even pharmaceuticals are based have GRAS standing (“Generally Recognized As Safe”) and have been used by cultures around the world for hundreds, if not thousands of years.

Here’s are two examples of folk-remedies in this category;

Swallow’s Nest

The Chinese have made soup out of the nest of a particular swallow which builds its home on high cliffs. This “bird’s nest soup” is highly prized and very expensive to make, but considered to have restorative properties for those with breathing difficulties.  As it turns out, this particular swallow’s nest is high in theophilline, a compound that has come to be used in Western medicine as therapy for respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma. Bird’s nest from this swallow has a GRAS standing and can legally be purchased in traditional Chinese medicine stores. One can take medication or food containing the same active substance, and in both cases one’s symptoms improve.

Bitter Melon

Bitter melon or bitter gourdkarela is widely grown in Asia, Africa and the Caribbean – both for food (prized for its bitter taste) and for its medicinal properties. In both Ayurveda, the traditional medicine (Hindu) of India and in Traditional Chinese Medicine (TCM) different parts of the bitter melon plant are brewed as a beverage and taken as a treatment for Diabetes. As it turns out, bitter melon, which has GRAS standing, contains polypeptide-p which is an insulin analogue.

Apple Cider Vinegar

I’ve been hearing about the use of apple cider vinegar (ACV) since I first started reading about low carb high fat diets in early 2015, from Dr. Jason Fung, a nephrologist (kidney specialist) from Toronto. He recommended that 1 Tbsp. of unpasteurized ACV be taken in a glass of water prior to meals and that it be add it to broths, soups and marinades. He’d said that it inactivates the production of digestive enzymes and slows down the rate of digestion, stabilizing blood sugar levels. Since the recommendation to use ACV at the time did not come with any scientific evidence, I summarily dismissed the idea of using it.

Persistently High Fasting Blood Glucose

For those who have been following my own progress following a Low Carb High Fat style of eating over the past 6 months (posted on the tab “A Dietitian’s Journey”) you know that despite losing weight, significantly lowering both my triglycerides and LDL cholesterol and my overall blood sugar levels coming down significantly, I had two ongoing problems;

(1) my morning fasting blood glucose (FBG) remained high, and

(2) my blood glucose would only drop into the 5-point-something mmol/ L range (~94 mg/dl) or to the 4-point-something mmol/ L range (76 mg/dl) range after an entire day of intermittent fasting.

Since there are physiological risks associated with high blood glucose, I was very motivated to find out why they were high in the morning and to do something about them.

I decided to keep detailed food records for 3 weeks to see if there was a patter, and ruled out diet. 

Then, I decided to take my blood sugar several times each night, from midnight until 8 am, over several days, to see when it rose. As it turned out, it would drop nicely after supper (as it would after eating at any other time of the day), to 7-point-something mmol/l (~130 mg/dl) after an hour or so, and then to 6-point-something mmol/L (121 mg/dl) around midnight, and then it would gradually begin to rise from ~2 am, reaching its highest point around 8 am, following the circadian rhythm of cortisol.

Since it seemed that my high morning blood sugar was due to cortisol rising after went to bed until 8 am, and since cortisol can be affected by many things including stress, I took up going for a walk after supper. It did help!  My morning blood sugars were in the mid-6-point-something mmol/L (~117 mg/dl), which was a far-cry from the 8.0 mmol/L (144 mg/dl) level it had been!

The evening walks, however, were short lived due to a shift in the winds and the raging forest fires in and around the Lower Mainland which caused the skies to fill with Fine Particulate Matter, know as PM2.5 (as the are 2.5 micrometers or less, in size).  Since these can enter the lungs and the blood stream resulting in ill-effects, my walks stopped. In fact, if I did have to go out, it was with a vented N-95 mask. The smoke briefly cleared being replaced by stifling heat in the mid- to high-30 Celsius (100 F) for 10 days, followed by more smoke, so I began to look for something- anything that might lower my morning blood sugars, which at this point were hovering in the 7.6 mmol/L mmol/L (137 mg/dl) range!

At first I tried doing a short workout on my Nordic-track or using my “step” before bed, but it didn’t do much for my blood sugars and made me far too awake to fall asleep.

Having some unpasteurized, unfiltered ACV in the house, I decided to try it.  It tasted terrible!! I tried adding it to water and it was still awful! I couldn’t bring myself to drink it!!

From Masking the Taste to Food as Medicine

A few years ago, in an effort to drink more water each day, I began drinking Club Soda / Selzer and then purchased a Sodastream machine, to carbonate my own (filtered) water.

I usually drink it plain, but have been known to put a twist of fresh lemon or lime in it.

 

ACV Ginger-aid

I tried adding 1 Tbsp of unpasteurized ACV to 1 litre (quart) of carbonated water but I still couldn’t drink it! All I tasted was sour!

Needing to mask the taste, I decided to grate a bit of fresh ginger root into it and “ACV Gingeraid” was born!

 

The first time, I drank a litre (~ quart) of “ACV Gingeraid” mid-morning, and my blood sugar dropped from 7.3 mmol/L  (132 mg/dl) to 6.6 mmol/L (119 mg/dl) in an hour. I thought to myself that maybe it would have dropped the same amount if I had done nothing.

I hadn’t had anything to eat or drink (except a coffee with only cream in the morning) but presumably under the effect of cortisol and my body’s own making of glucose from fat stores, my blood sugar continued to rise from 6.6 mmol/L (119 mg/dl) at 5:30 AM, to 7.7 mmol/L (139 mg/dl) just before 10 AM.

That was just too high – and I hadn’t eaten! 

So, I made and drank a second bottle of ACV Ginger-aid and in 1.5 hrs, my blood sugar had dropped to 6.3 mmol/L (114 mg/dl). Then by 4:00 PM, and drinking no additional ACV Ginger-aid, it was 4.8 mmol/L (86 mg/dl).

I would previously only get to those kinds of numbers just before dinner, when I was on an intermittent fast day.  This was 2-2.5 hours earlier.

That couldn’t be, I thought…

Several days in a row, the same thing would happen, with only slightly different numbers, some of them lower.

My blood sugar would be around 7.3 mmol/L (137 mg/dl) 2 hours after dinner and I would drink most of a bottle of ACV Ginger-aid before bed, and in the morning my FBG would be in the 6’s mmol/L (~119 mg/dl). Could it be because of the drink?

One day, quite by chance, I had some fresh turmeric root in the house (because I use it in cooking and because I like the taste). As well, is a potent antioxidant and the curcumin (the active compound in turmeric) has been demonstrated to have anti-carcinogenic properties).

I decided to add a little bit of grated turmeric root because I thought the turmeric would taste good with the ginger (it did!).

I also added a bit of freshly ground black pepper to the Turmeric-ACV Ginger-aid, because I had read that black pepper makes the curcumin in the fresh turmeric root 2000 times more bio-available. 

Turmeric ACV Ginger-aid

The drink tasted delicious!

But what happened to my blood sugars was quite surprising.

It became evident that for me, using “food as medicine” has had some very impressive results!

 


Just 3 days earlier, I was impressed because by 4:00 PM my blood glucose was 4.8 mmol/L (86 mg/dl) – which was a good 2.5 hours earlier than usual.

Since adding the turmeric to the ACV Ginger-aid, I was getting numbers in the mid-4 mmol/L (i.e. 4.6 mmol/L / 84 mg/dl) by 2:30 in the afternoon!

By drinking the Turmeric-ACV Ginger-aid  before bed, my morning FBG is consistently in the low 6’s mmol/L (~110 mg/dl) and on a few occasions, ”ve been getting numbers in the high-5s mmol/L (103 mg/dl). I was considering Metformin to get these kinds of results!

This is by consuming ordinary food found in my kitchen!

I continue to eat LCHF and I usually intermittent fast breakfast, as I’ve never been much of a “breakfast person”. I occasionally don’t eat until mid-day as that is when I usually first feel hungry.

My blood sugars are the best they’ve been since I started measuring them.

Now, 2 hours after meals my blood sugar is usually in the low 6’s mmol/l (~110 mg/dl) and the ONLY change has been adding this beverage before bed and occasionally one plain ACV Ginger-aid through the day.

Just to be a ‘good scientist’, last night I deliberately ate 1/2 a dark chocolate bar (72% cocoa) and drank 3/4 of a bottle of plain AVC Ginger-aid (no turmeric) and tested my blood glucose this morning. It was 6.6 mmol/L (119 mg/dl).  That’s crazy! I was expecting 10 or 11 mmol/L.  That’s what it used to be just a few weeks ago, when I’d eat a little bit of dark chocolate!

NOTE: I wanted to see what would happen if I ate the same way but discontinued the beverage. My blood sugar went up to 8.8 mmol/L the first morning after not having any the previous day and was 8.6 mmol/L the following morning. The third day, I drank only one bottle in the afternoon and on at night before bed and the following morning, my fbg was 7.2 mmol/L (still way too high, but much lower). I anticipate it will continue to drop as I have 2-3 bottles of the mixture per day.

Even thought I am NOT exercising (first because of the smokey conditions outside and because I fell back into old “bad-habits” of getting up early and working at my desk with my coffee), my blood glucose is what I would have anticipated would have occurred if I had taken Metformin.

Keep in mind, I am “a sample-set of one”. There’s no saying that others will have the same, or even similar results. In addition, I do NOT encourage people to make any changes in the amount of medication that a doctor prescribed without being told by that doctor.  This drink is NOT a substitute for medication that has been prescribed!  That being said, for those who are not taking medication but have persistently high blood sugar readings does it not make good sense to consider trying such food as medicine?

NOTE: I decided to find out if there was any scientific evidence for the anti-glycemic properties of ACV and did find a 2015 study, suggesting that it increases insulin-stimulated glucose uptake in those with Type 2 Diabetes (T2D), which I have. I then decided to look and see if ginger had anti-glycemic properties and found a 2015 study that reported that ginger significantly reduced FBG as well as HbA1c, along with Apo B, Apo B/Apo A-I, MDA and increased the level of Apo A-I in T2D patients. Naturally, I looked to see if turmeric was known to have anti-glycemic properties and sure enough, it did!  I found a 2013 publication that indicated it is well-known that turmeric has a stimulatory action on pancreatic β-cells, and that this may be the mechanism by which it lowers blood sugar in those with T2D. Whether these substances used together have a far greater effect on blood sugar than any of them used separately would certainly make for an interesting study!

WARNING: Given the possibility of these ordinary foods resulting in a dramatic drop in blood sugar, if you have Type 2 Diabetes or pre-diabetes, first discuss incorporating these foods into your diet with your doctor. As well, be sure to monitor your high blood sugar often if you drink these.

ACV Gingeraid Recipe

Click on the link under “Recipes” for ACV Gingeraid with Variations – food as medicine. Enjoy!


If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

References

Mitrou P, Petsiou E, Papakonstantinou E, et al. Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes. Journal of Diabetes Research. 2015;2015:175204. doi:10.1155/2015/175204.

Khandouzi N, Shidfar F, Rajab A, Rahideh T, Hosseini P, Mir Taheri M. The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, Apolipoprotein B, Apolipoprotein A-I and Malondialdehyde in Type 2 Diabetic Patients. Iranian Journal of Pharmaceutical Research : IJPR. 2015;14(1):131-140.

Zhang D, Fu M, Gao S-H, Liu J-L. Curcumin and Diabetes: A Systematic Review. Evidence-based Complementary and Alternative Medicine : eCAM. 2013;2013:636053. doi:10.1155/2013/636053.

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/

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.

A Dietitian’s Journey – the 25 week breakthrough

Finally!  Like anyone else who’s been working long and hard towards achieving their health goals, I’m so excited that I’ve finally made a significant ‘breakthrough‘! I didn’t think it would take this long, but when I think that it has taken me close to 20 years to become this insulin resistant, it only makes sense that it is going to take some time to become insulin sensitive again!

Last night, for the first time since I was diagnosed with Type 2 Diabetes (T2D) ten years ago, my 2 hour post-prandial blood glucose (i.e. two hours after a meal) was 5.8 mmol/L (105 mg/dl).

To put that in context for someone without Diabetes, blood glucose taken two hours after meals should be less than 7.8 mmol/L (140 mg/dl) – so my blood sugar after supper was not only in the non-Diabetic range, it was much better than that!

This means that the delaying the time between meals that I have been doing each weekday is starting to have its effect.

‘Hearing’ for the first time

When insulin was released after I ate dinner last night, my cells responded to insulin’s signal and took up the glucose from my blood, into my cells! This is what is supposed to happen, but from years and years of eating a diet that had far to many carbs (mostly as “healthy” fruit and milk), my cells had become non-responsive to insulin’s signal. The glucose (the blood sugar produced after food is digested) would stay at high levels in my blood because even though sufficient insulin was being produced and released by the βeta-cells of my pancreas, my cells had become insensitive to its signal. My cells had become insulin resistant – they were ‘deaf’ to insulin’s signal.

Last night, for the first time that I’ve observed, my cells responded to insulin properly!  Like a hearing-impaired person hearing for the first time, my cells could ‘hear’!

Still “hearing-impaired”

My cells aren’t yet ‘healed’. They and my liver are still insulin resistant which is evidenced by the fact that even though I haven’t eaten anything since dinner last night, my blood glucose is high.

As it is supposed to do in response to both a low-carb diet and intermittent fasting, my body is breaking down my fat stores for energy (lipolysis) and the free fatty acids that are released are being used to produce glucose for my blood (in a process called gluconeogenesis) and ketones for my other organs, including my brain.

My blood glucose should increase from the gluconeogenesis, but it shouldn’t stay high! 

In a perfect world, my blood glucose should be maintained around 4.0 mmol/L (72 mg/dl) when I am intermittent fasting, but it is much higher than that.  The VERY good news is, it is falling to these ideal levels earlier and earlier each day, as I continue to intermittently fast Monday to Friday.

Intermittent Fasting – the missing ‘key’

It used to be late in the afternoon before my blood glucose would finally fall to 3.9 – 4.2 mmol/L, but over the six days it has been falling to these levels earlier and earlier each day.

blood glucose readings July 25 – August 23, 2017

 

Last Thursday, while checking my blood glucose every 2 hours, it dropped to 3.2 mmol/L at 1:55 PM and I immediately ate some carb-containing food, but the next day, late in the afternoon it only reached 4.8 mmol/L at 4:00 PM, despite me delaying the time between meals, both days. As someone with Type 2 Diabetes, I have to monitor my blood sugars every few hours when I am delaying meals, to be sure my blood sugar is being maintained by my body breaking down fat.

Monday, my blood glucose was 3.7 mmol/L (67 mg/dl) at 4:00 PM and yes, I ate something immediately.

Tuesday it was 4.6 mmol/L (83 mg/dl) at 2:30 PM

Today (Wednesday) it was 4.5 mmol/L (81 mg/dl) at noon!

Best of all was that last night, 2 hours after eating, my blood glucose was only 5.8 mmol/L (105 mg/dl) – not just ‘normal’, but well below the non-Diabetic cutoffs! This is what I have been waiting for!

Tracking Ketosis

Ketones (also called ‘ketone bodies’) are naturally occurring molecules (acetoacetateβeta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced for energy while people are sleeping, or when they haven’t eaten for a while. Ketone production is natural and normal and occurs to everyone – otherwise we would need to get up at night to eat!

Ketones are picked up the body’s tissues and converted into something called ‘acetyl-CoA’ which then enters the citric acid cycle and is burned in the cell’s mitochondria (the ‘powerhouse’ of each cell) for energy. When we are sleeping, or are eating low-carb high health fat or simply not eating for a while, this is what our body uses as fuel instead of glucose. When eating low carb over an extended period of time, the body makes the little bit of glucose it needs for our brain and blood from fat and uses ketones for the rest.

A Ketostix® urine test strip (from several weeks ago)

Ketones can be easily  and inexpensively detected in urine using a test strip, such as Ketostix®.

When people are at a low level of ketosis, they produce both acetoacetate and βeta-hydroxybutyrate in approximately equal quantities. These ketones are used by the muscle cells for energy. Ketostix® only measures the amount of acetoacetate in the urine.

For those that choose to eat very low carb and remain in ketosis for a while, their body’s will take the acetoacetate and convert it to βeta-hydroxybutyrate. Since Ketostix® only measures acetoacetate, the strips may become lighter and lighter because there is less acetoacetate in then urine. This is when blood ketone strips becomes helpful.

Abbott Laboratories® produce a small serum monitoring system that can test either blood glucose levels or serum β-ketone levels, using different test strips. The glucose strips cost about the same as glucose test strips used with other glucometers, but the β-ketone test strips are quite costly, costing between $3-$5 each, depending on where they are purchased.  I don’t use them very often – only to make sure I don’t let my ketones get too high.

Note: I take a rather conservative approach to low carb eating and don't see any need to lower carbs to such a point as people are producing large amounts of ketones. I encourage insulin-resistant clients who are eating low carb to monitor both their blood sugar and ketone production often and to discuss their results with their doctors.

The β-ketone test strips measure the amount of βeta-hydroxybutyrate in the blood.

β-Ketone test strip, measures βeta-hydroxybutyrate in blood sample

This morning, about an hour after I measured my fasting blood glucose at 7.8 mmol/L, I measured my fasting β-ketones (which measures the amount of βeta-hyroxybuterate in my blood) at 1.6 mmol/L.

A low level of serum βeta-hyroxybuterate is considered 0.34 mmol/L and a mid-range level of serum βeta-hyroxybuterate  is considered 2.36 mmol/L, so I was in the low-mid range level, which is the highest level that I go. I am also monitoring my blood sugar every two hours to make sure that my blood sugar level is being maintained adequately.

Note: as they say on TV "don't try this at home".  Be sure to discuss following a low carb diet with your doctor first and also discuss whether there are any health reasons to avoid remaining in mild ketosis for any period of time.

At these levels, my body is happily breaking down my own fat stores for energy and the free fatty acids that are being released are being used to produce glucose for my blood (via gluconeogenesis). This is evident by my blood glucose being 7.8 mmol/L around 9:30 AM today.

This morning’s workout ‘selfie’

My body produces ketones (as evident by my βeta-hyroxybuterate being 1.6 mmol/L) an hour later and these ketones are being picked up my body’s tissues and are being converted into acetyl-CoA, which is being burned by my cells mitochondria for energy.  These ketones not only fuel my brain, so I can work, they also fuel my body so I can exercise.

Yes! I aim to do some kind of exercise for 30-45 minutes most days.

This is the BIG difference between “starving” and “fasting”. I’m fat-adapted and I have plenty of fat stores to burn, so my body is really quite happy burning my own fat stores for energy while maintaining my blood sugar using the carbs in my diet and the glucose synthesized from my fat.

‘Getting moving’ and occasionally ‘breaking a sweat’

When I speak of ‘exercise’, it’s not crazy intense, but it is my getting my body ‘moving’.

All my morning walks (with and without Nordic poles) – from the very first one 5 1/2 months ago, have been done fasting.

Yesterday I did 15 minutes of aerobic exercise and 30 minutes of lower body resistance training – not in a gym, but at home. I was fasting…and continued to fast until late in the afternoon. Remember, my body is breaking down my fat stores for energy and I have plenty of those!

all the “gym” I need!

I’m not a member of a gym.

I have a corner of one room set up with my Nordic Track ski-machine, a few free-weights (2#, 5#, 10# and for the future 20#), a floor mat, 3 levels of resistance bands, and a “step“.

If I use my Nordic Track, I listen to music while I work out, and have a water bottle with homemade club soda (seltzer) close at hand. I have a Sodastream® machine, so I always have a steady supply.

I am using the “step” or doing aerobics of some kind, I use some videos I found on You-Tube of a TV show I used to exercise to years ago. I always liked them because they gave lots of instructions so that only one muscle group at a time is being worked.  That way, only one part of my body needs to recover, and I can work other parts the following day.

If I am doing my free weights, I follow the routine I learned from a kinesiologist friend, when I took off the first part of the weight 5 years ago.

I keep it simple and simply make part of every day doing something that requires me to ‘get moving‘ and 3 times a week I aim to make that activity something that ‘breaks a sweat‘.

I don’t exercise to ‘lose weight’ – I’m active because it’s part of a healthy lifestyle.  It’s good for my heart, for reducing stress and to increase muscle tone – and it makes me feel terrific.

Sure, I still have a long way to go but a each week and each month passes, I am closer to my goal that I was the week or month before.  I am certainly closer than had I never started!

Here’s some more proof…

These three photos were taken on this date (August 23) in 2015, shortly after I had heard about low carb high fat eating from a retired physician-friend, last year in 2016 and today 2017. While there isn’t a huge difference weight-wise between last year and this year (14 pounds), the difference one can’t see is becoming evident.

Me – August 23 2015, 2016 and today 2017

Yes, the progress it is painfully slow and it would be easy to get discouraged except that I have read the studies and seen the results that other clinicians have obtained with their patients. It’s twenty-five weeks since I started – just about 1/2 a year, but my hard work and determination to ‘stick with it’ is paying off.  Last night, for the first time since I was diagnosed as having Type 2 Diabetes, my cells provided evidence that they are beginning to respond to the signals from insulin the way they are supposed to.

This afternoon, they did it all again!  

This was my blood glucose 3 hours after lunch (which I decided to eat today, because I felt hungry). As mentioned above, 4.5 mmol/L (81 mg/dl) is well below the ‘normal’, non-Diabetic post prandial glucose level of 7.8 mmol/L (140 mg/dl)

This was even better than after dinner, yesterday!

It took longer than I expect, but it’s happening!

So, one day at a time, one week at time, the weeks add up to months and the months to half a year and in half a year, I have measurable progress!

Oh, did I forget to mention that my weight is down again?  I am seeing “numbers” I haven’t seen since I gave birth to my children!

Slow, yes – but very sure.

Now let’s see what I’ll accomplish in the second half of this year!

Have questions?

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

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/


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.

 

A Dietitian’s Journey – living on Tatooine

For the last two weeks, I have been living on Tatooine.  Not really, but it certainly has felt like that – with smoky, red sunrises and sunsets, inhospitable heat and high levels of ground-level ozone.  British Columbia, where I live, remains under a state of emergency as 148 wildfires continue to burn across the province, with this being BC’s worst fire season in almost sixty years. As a result, the air quality in many communities, including mine, has deteriorated to dangerous levels.

This is what the sunrise has looked like from my backyard the last two weeks:

There have been high concentrations of fine particulate matter known as PM2.5  in the air, which are solid or liquid droplets with a diameter of ≤2.5µm (micrometres). Due to their small size, these particles easily penetrate indoors, even when windows are closed and are small enough to pass from the lungs into the bloodstream – putting people with lung or heart disease, Diabetes or asthma at risk.

In addition to the smoky air, temperatures each day have been in the low- to mid-thirties Celcius (90-95 degrees Fahrenheit) which is highly unusual. Here in the Greater Vancouver area, we’ll get a few days in a row like that once or twice each summer, but not for two weeks solid!  Thankfully I have air conditioning, but it has been brutal to be outdoors.

Concentrations of ground-level ozone have reached and stayed at advisory levels.  This is formed when pollutants given off by the forest fires and compounds from the solvents used to put out the fires react in the air, in the presence of sunlight.

Even wearing an N95 mask outside which is designed to filter out the small smoke particles, I have found my breathing very laboured.

Needless to say, my morning and after-dinner walks have been impossible. I tried exercising indoors, but my lungs were simply too irritated from the small smoke particles.

I have continued with delaying the time between meals (referred to as “intermittent fasting“)but for shorter periods of time as my body is under physiological stress and I continue to eat a low carb high fat diet. My weight has dropped another pound over these last two weeks, despite no exercise at all. My blood sugar on the other hand is considerably higher without the walks.

An air quality analyst with Metro Vancouver has reported that the weather is expected to shift this coming weekend, allowing some of the smoke to begin to dissipate. Until then, part of taking care of my health is not to exercise. 

Reporting from Tatooine, British Columbia, I’m Joy Kiddie, practicing what I preach.


If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Journey – 5 month update

It’s been 5 months since I began my own weight-loss journey, following a low carb high healthy fat diet and here is a short update. 

Fasting Blood Glucose

When I began this journey at the beginning of March, my fasting blood glucose was averaging 12 mmol/L. Four months into eating low carb high fat, my fasting blood sugar was averaging 8.5 mmol/L. 

July 25th, it was measured at the lab and on my home glucometer as 8.0 mmol/L – still way above the cutoffs for those with Type 2 Diabetes of 6.0 mmol/L, and way above the normal levels of 4.5-5.5 mmol/L.  

It is highest is in the morning, I believe due to cortisol’s effect (see 4 month update, for details).

2 hour Post-Prandial Blood Glucose

I’ve been tracking my blood glucose regularly since I started implementing the dietary and lifestyle changes 5 months ago, and my 2 hr post prandial (after a meal) glucose had been averaging ~7.2 mmol/L, which is much better than the 7.7 – 8.6 mmol/L which is what it was at the beginning of March, but still no where good enough!

…but I noticed that after I go for my brisk 3-4 km each morning, it is 5.4 mmol/L. This gave me an idea (see below).

Blood Glucose through the night – effects of Cortisol

For about a week, I measured my blood glucose at 1 AM and 4 AM and 6 AM (in the interest of science, of course!) with a brand new glucometer that I standardized at the lab, when I had my fasting blood glucose and fasting insulin done on July 25th. My morning fasting blood glucose would rise to ~6.6 – 6.8 mmol/L (119 – 123 mg/dl) from the 5.4 mmol/L it was when I went to bed, even though I hadn’t eating or had anything to drink.  This had to be the effect of cortisol!

Fasting Cortisol

I had my fasting cortisol assessed the same day that I had my fasting blood glucose assessed (July 25 2017) and it was, as I suspected, high421 (125-536) nmol/L 

…and this is with walking 4 km / day and sleeping 8 hours (restful sleep). 

I need to come up with some additional strategies for lowering stress.

Fasting Insulin & Calculating Insulin Resistance

I also had my fasting insulin assessed the same day that I had my fasting blood glucose and fasting cortisol assessed (July 25 2017).

Based on the July 25th lab work, I calculated my Insulin Resistance using both Matthews (1985) Equations (HOMA1-IR), as well as using Oxford University Center for Diabetes, Endocrinology and Metabolism  homeostasis model assessment (HOMA2-IR)  calculator (2013).

From when my fasting insulin and fasting blood glucose was last tested 2 years ago in August 10, 2015, my insulin resistance  calculated by HOMA2-IR had gone down from 3.06 to 2.77, but it’s still too high because my fasting blood glucose remains high.

Average Insulin Resistance – in the normal population

One study reported that the average HOMA2-IR in the general (non-Diabetic) population is 2.1 +/- 2.2 (Diabetes Care, Volume 24, Number 3, March 2001), so I am guessing that a HOMA2-IR of 1.00 would be a healthy target – one that will likely take me a year to approximate.

Whether that will be possible with diet and lifestyle change alone, has yet to be seen.

That is my goal.

High Morning Glucose – assessing the problem

I believe the reason that my blood glucose remains high in the morning is due to a combination of residual hepatic (liver) insulin resistance (from years of eating way too many carbs) and high cortisol that is stimulating an overproduction of waking glucose.

Effect of Walking

The last 5 months, my fasting blood glucose has been consistently high at 8.0 – 8.5 mmol/L (144 – 153 mg/dl) and my 2 hour postprandial is fine for a Type 2 Diabetic at ~7.2 mmol/L – but a far cry from the non-Diabetic range I am seeking.

…but I noticed that after I go for my brisk 3-4 km walk each morning, my fasting blood glucose is 5.4 mmol/L (yes, I go fasting).

The effect of moderate exercise seems substantial, so I decided to see what effect there would be on my early morning fasting blood glucose levels if if I took a short walk after dinner.

The results were dramatic!

For the last week and a half, my blood glucose drops to ~5.2 – 5.4 mmol/L (94-97 mg/dl) after a very leisurely 15-20 minute walk around my neighbourhood.

High Morning Glucose – assessing the solution

Based on my high fasting blood glucose of 8.0 mmol/L on July 25th, my physician’s colleague naturally recommended that I go on Metformin, but I have decided to hold off on introducing it for 3 months provided that;

(1) I continue the dietary and lifestyle changes I have been doing for the last 5 months and…

(2) I add a 20-minute walk after dinner.

Plan to Reassess in Three Months

I am requesting that my physician provide me with a requisition to have my fasting insulin and FBG re-run in October, when I update my HbA1c, so I can recalculate my HOMA2-IR again and see how much less insulin resistant I am by then.

I want to know the magnitude of the insulin levels dropping, not just the fasting blood glucose, which I expect, will drop…after all, the goal is to lower the very high levels of insulin. High blood glucose is a symptom – the cause is too much insulin being released, due to insulin resistance.

Blood Pressure

As mentioned previously, I asked to be started on a very low dose of Ramipril (Altace) about 6 weeks ago, as my blood pressure had begun to creep up again. When I saw 160/90 mmHg two days in a row, I went to see my doctor.

10% of the time I am ≤ 119 / 79 mmHg, considered normal blood pressure

64% of the time I am ≤ 120/80 mmHg, categorized as “Prehypertension”.

…and 26% of the time, measured before I take my medication, I am ≤ 138/90 mmHg, categorized as “Stage 1 Hypertension”.

I will continue to take the blood pressure medication as a temporary measure to offer some protection against heart attack, stroke and kidney damage until I lose some more weight, and my blood pressure stays down on its own.

Weight

Overall, in the last 5 months, I have lost 12 pounds and ~3 inches off my waist. I’ve lost about the same number of inches off my neck circumference  (3 inches) which has had a dramatic effect on how I look.  I have a neck and ONE chin.

I’ve lost overall about an inch off my mid-arm, an inch off on my thighs (gaining muscle and losing fat, at the same time) and lost around an inch off my chest.

Lowering Stress, Lowering Insulin

I need to get my cortisol levels down, as these are driving my high morning fasting blood glucose levels. Walking in the morning has been good, adding the short evening walk even better. Now I am adding (on alternate days from my 3-4 km walks) a workout with 5 and 10 pound weights and other forms of resistance training. I am even jumping rope (which has gotten much harder since when I last did it at around age 16!).

The goal is to get my insulin levels down, and I am already doing everything that needs to happen for that; eating only the carbs necessary to have a nutritious diet, with no excess protein and extending the time between meals (intermittent fasting) a few days per week.

It is going to take time

Over the next 3-6 months, I expect fasting insulin will keep falling.

My goal over the next year is to reach a ‘normal’ 2 hour postprandial peak of 60 mIU/L (430.5 pmol/L) as determined by Dr. Kraft’s Insulin Response curves, which should be an Insulin Resistance (HOMA2-IR) of between 1.0 and 2.0.

Over time, the fat in my liver (“hepatic adiposity“) will continue to decrease, and the derangement which took time to develop will resolve.

While the rate of resolution to for me to achieve normal insulin metabolism is unknown, I know if I keep doing what I am doing, it should happen. It doesn’t always occur, but I won’t know if I don’t try.

Have questions?

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

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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!


If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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.

A Dietitian’s Journey – what’s that on the floor?

This morning, as I was getting ready to go out for my walk, I noticed something on the floor.  As I started to bend down to pick it up, I realized it was my own toes! There they were – peeking out from under my shrinking abdomen! It shouldn’t be that the sight of one’s own toes while standing elicits such a surprised reaction, but it did.

As usual, I went walking this morning – something that has become a routine, since I fractured a rib 5 weeks ago (washing a bathtub, of all things!).  It was supposed to reduce the associated muscle pain (which it did) and after a few weeks, I realized I was really enjoying this “me” time, walking around a local lake. This week, I started Nordic walking (using Trek poles) and have really enjoyed the full-body exercise.  Even the drizzle wasn’t going to stop me today. After all, that’s what rain shells are for.  In fact, the one I grabbed this morning was the one I bought two years ago online, but that was too small, but today I put it on and zipped it right up. Finally, my body is changing! After 4 months of seeing very slow progress, the progress is becoming more and more evident.

Three weeks ago, at the encouragement of a local area physician whose practice focuses on low carb eating, I decided to take some body measurements, to track my progress.  I measured mid arm circumference  (between the point of my elbow and the pointy part of my shoulder blade), the my midpoint on my neck, my chest (where a brassiere would sit), my thigh (midway between my knee and my hip, at the widest part) and my abdomen at my umbilicus (or belly button) – which I have been tracking from the beginning.

[I don’t bother tracking my “waist” because this is smaller than the umbilicus, and what I want to assess is abdominal fat, which is better measured at the belly button.]

In the last three weeks, I’ve lost:

1/2 inch off my mid-arm

2 inches off my neck (yes I checked and rechecked this one!)

1 inch off my chest

1 inch off my umbilicus circumference

and gained 1/2 inch (of muscle) on my thighs.

Also during the last 3 weeks, I’ve lost 2 1/2 pounds and my fat percent has dropped 1.2%.

And today, I saw my toes!!

Yes, I have a long way to go, but I am not focusing on the destination but on the journey.  

I am enjoying eating real food and not feeling uncomfortably full afterwards (something absent since I gave up eat carb-based foods!).

I enjoy being able to delay the time between meals (intermittent fasting) without feeling hungry, tired, grumpy or deprived). Since I’m a Dietitian, I talk or write about food all day during the work week and most days I eat only supper.  Today I was hungry, so I ate a meal at 11am – but I still had a 16 hour ‘fast’ from supper last night until I ate today, where I hadn’t eaten anything. This time is so important, to enable my insulin levels to fall, and lower my insulin resistance that had been created by me previously eating 3 meals and 2-3 snacks per day, all centered around complex carbs – for years.

I like the feeling of being active; having gone from being totally sedentary (inactive) to being moderately active (45 minutes 5 days / week). I don’t exercise in order to lose weight, but because it is good for my heart and brain and it lowers my stress level (lowering cortisol).  This in turn is good for my blood pressure and for overall health. I enjoy doing it early in the morning and enjoying the feeling of well-being and satisfaction all day long.

For the first time in many years, I don’t eat because I am craving something, I eat because I am hungry!  In fact, I don’t crave anything!  I eat a small amount of dark chocolate each day (for health, of course) and even while intermittent fasting, I can walk through a bakery section of a store and not be the slightest bit interested in any of it.  My body is happily burning my own fat (which I have plenty of!) so I’m good.  I’m always drinking sparkling water (which I make at home) and usually finish 2 litres (a little less than 2 quarts) by the time I return from my morning Nordic walk.

I am sleeping so much better than I have in many years and have discontinued the prescription that I would keep on hand for the frequent nights I was unable to fall asleep. I still wake up sometimes because of my healing fractured rib (if I roll over) but other than that I wake up rested.  What a thought – waking up rested AND seeing my toes! I can get used to this.

Have questions?

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

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

NNote: 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 Journey – four month update (with lab test results)

It’s been 4 months since I began my own weight-loss journey, following a low carb high healthy fat diet and I’ve been to the lab and had my blood tests.  Here is an update on my progress to date.

Blood sugar

Fasting blood sugar

When I began this journey at the beginning of March, my fasting blood glucose was averaging 12 mmol/L – and this was when I was eating the ‘standard recommended diet’ for someone with Type 2 Diabetes. My diet was high in complex carbs, and low in saturated fat. Also, as has been traditionally recommended for someone with Type 2 Diabetes, I ate 3 meals per day and made sure to have 2 – 3 snacks per day (each with complex carbs and some protein).

Now, four months into eating low carb high fat, my fasting blood sugar is averaging 8.5 mmol/L. It is significantly better, but not what I had hoped which was to be at or below 6.0 mmol/L (below the Diabetic cutoff range) in this time.  There were factors that I was not considering.

Firstly, my blood sugar has been persistently high in the morning since I have been in nutritional ketosis – significantly higher than 2 hours after a meal.  At first, I couldn’t figure out why. I’d been tracking my blood glucose at various times of the day; fasting, before I eat, 2 hours after I eat, before bed etc., but regardless what I ate the night before, it was highest in the morning.  It was then that I began to suspect that the effect of the hormone cortisol might be a factor. 

Cortisol is our “fright and flight” hormone and under stressful conditions, such as being chased by someone or something, cortisol  provides the body with an immediate source of glucose by breaking down our glycogen stores in our muscle and liver (a process called glycogenolysis) and uses them to manufacture glucose in the liver (a process known as gluconeogenesis).

All hormones have a natural cycle of rising and falling throughout the day and this is known as a hormone’s circadian rhythm and over the course of the night, cortisol production begins to climb around midnight and reaches and is highest level between 6 am to 8 am.  When I began to track my blood sugar from 10 pm until 8 am, I noticed that it would start going up in the wee hours of the morning and keep rising until 6:30 or 7 am, am when I would take it. It was then that it became evident that my fasting blood sugar was rising with cortisol.

Chan S, Debono M. Replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy. Therapeutic Advances in Endocrinology and Metabolism. 2010;1(3):129-138. doi:10.1177/2042018810380214.

When we sleep, our body breaks down the glycogen stored in our muscle and liver and converts it to glucose for our blood – an entirely normal process. Since I am following a low carb high fat diet and have been in nutritional ketosis for while, my body uses ketones as its primary fuel source and make all the glucose it needs for my blood from the protein and fat in my diet. When it runs out of that, it burns my stored fat for fuel – which is exactly what I want it to do! Since I’d been keeping my carbohydrate intake consistent but not very low, when cortisol levels would rise over night, my body would break down my glycogen first, then my own fat stores to make glucose for my blood, which I suspect is the origin of my high fasting blood glucose. That, combined with my liver still being insulin resistant, the glucose has no where to go.

This made sense to me and explained why my fasting blood glucose remained high, despite no carb creep (more carbs than planned for).

Since I’m keeping myself in nutritional ketosis, I’m not concerned about my fasting blood glucose remaining higher, although I may try distributing my carbs differently – with fewer at night. Since my goal is lower insulin resistance, I am going to continue to focus on that. High blood sugar is a symptom.  The problem is insulin resistance.

My blood glucose 2 hours after meals has been getting better. It is now averaging around 6.0 mmol/L (sometimes hovering around 5.5 mmol/L) which is much better than 7.2 – 8.6 mmol/L which is what it was at the beginning of March. My goal is to see it consistently below 5.0 mmol/L after meals by mid-November.

HbA1C – glycosolated Hemoglobin

Glycosolated hemoglobin (HbA1C) is the hemoglobin in our red blood cells that gets sugar molecules attached to it proportional to the amount of sugar in our blood. It is used to measure the three-month average plasma glucose concentration, based on the fact that the lifespan of a red blood cell is four months (120 days). The advantage of this test, is that one does not need to be fasting to have it.

HbA1C is most strongly correlated with fasting blood glucose (as opposed to pre-meal blood sugar or to 2 hour post-meal blood sugar) and since my fasting blood glucose has been consistently high, my HbA1C results naturally reflected this.  Lab tests indicate it is 7.5%, which is above the upper cutoff for Type 2 Diabetics of 7.0% – and higher than what I was aiming for, which was below 6.0%, the Diabetic range cutoff. However, since neither fasting blood glucose nor HbA1C  measure what I am trying to change (which is insulin sensitivity), I’ve decided that in November, I will pay to have my fasting insulin re-assessed.  After all, the goal is to lower insulin – which underlies the high blood sugar!

Lowering Stress

I knew that I needed to get my cortisol levels down, as cortisol drives appetite, which drives eating which in turn, causes insulin to be released. More insulin means my body will be focused on fat storage, not fat burning which is the opposite of what I want. Since my goal is lowering insulin resistance, lowering cortisol makes sense. Since I can’t change cortisol’s natural circadian rhythm, I had to focus on lowering the whole curve!  Lowering stress wasn’t going to happen sitting at my desk working. I had to get moving.  More on that, below.

Blood Pressure

As mentioned in my last update, a month ago I asked to be started on a very low dose of Ramipril (Altace), as my blood pressure had begun to creep up again. When I saw 160/90 mmHg two days in a row, I went to see my doctor.  He wasn’t there, but the locum agreed with my assessment that it was wise to protect my heart, brain and kidneys while I continued to make the dietary and lifestyle changes.  She asked me to delay getting my blood work for a few weeks, to assess my electrolytes (sodium and potassium) level which can be affected by the medication.

Even two years ago, my potassium was at the high end of normal – and this was when I was dutifully eating a diet high in complex carbs and low in saturated fat, as I ate a diet high in potassium-rich foods.

This time my potassium was at the upper normal limit, so I’m tracking my intake of it and keeping it approximately 1/3 to 1/2 of what it was previously.

Taking the blood pressure medication is a temporary measure that I decided on in order to offer some protection against heart attack, stroke and kidney damage until I lose more weight, and my blood pressure stays down on its own.

Thankfully, my overall kidney function is now better than it was 2 years ago, although I did need to make a few dietary changes to be sure that I avoid getting kidney stones (something that runs in my family).  When I started exercising regularly a month ago, I didn’t adequately increase my water intake – which I’ve since corrected.  I had also added a calcium supplement when I stopped drinking milk in March and which was binding with certain food components in the veggies and nuts I was eating.  This was probably what was resulting in calcium-oxalate being detectable in my urine. I’m no longer taking the calcium supplement and have added more hard cheese into my diet, instead.

Cholesterol

My LDL was at the high-end cutoff two years ago, but after 4 months on a low carb high healthy fat diet, it is approaching what is considered by the existing / popular standards of “optimal LDL” for someone who is high risk (family history of cardiovascular disease). My LDL is 2.60 mmol/L (1.14 mg/dl), my triglycerides (TG) were 0.64 mmol/L and my HDL was 1.97 mmol/L

Using more significant measures, my TG:HDL ratio is now 0.32 (with <0.87 considered ideal). According to several studies (that I will go into more detail in an upcoming article), a very low TG:HDL ratio is associated with lots of large, fluffy LDL – the kind associated the lowest risk of cardiovascular disease (CVD) such as heart attack and stroke. It is the higher density, small LDL particles that are associated with CVD.

Walking

A month ago, I began walking every morning during the weekdays.  I had just fractured a rib (slipping washing a bathtub!) and read that walking was good to reduce pain. Since reducing pain was high up on my “to do” list, I started with walking 1 km each morning during the week, before I began my office hours.  I gradually increased it to 2 km. The last week and a half it has been 3 km.

At the beginning of last week, I saw a fellow who was in very good shape using Nordic walking poles, so I asked him why he used them. He explained that as he digs the poles into the dirt on the path and pushes himself off of them, it gives him a good upper body as well as the lower body workout that comes from walking briskly. I decided to get myself some.

I researched what height they needed to be and decided whether I would get adjustable height ones or not, and purchased them on Friday and over the weekend, I read about how to use them properly. It seemed as thought it would be pretty intuitive for me, given that I have (and use) a Nordic Track ski machine when the weather is not conducive to going out to exercise.

Nordic Walking Poles

I was skeptical that using them could actually increase the calories I burned by 30%, for the same distance walked until I tried them this morning.

I am no longer skeptical!

I was very well aware of how much better a workout I had gotten after 2 km, but did another 1 km anyways.  I can’t wait to go again tomorrow.

Getting Even More Serious

Reducing Carbs

A month ago my weight was still ‘stuck’ at its 6 pound weight loss, so I decided to reduce my carbs slightly but consistently and to monitor my intake of nuts and dark chocolate, which could easily cause me to exceed my carb ceiling.

Bingo!

Intermittent Fasting

Monday – Friday I wasn’t hungry in the morning, because I would eat a very satisfying meal the night before (with adequate protein and lots of healthy fats and low carb veggies), so I was and am quite content to have only a coffee and cream for breakfast, and then go for my walk.

When I come home, most days I’m really not hungry, because my body had finally figured out how to burn my own fat stores for energy!

At first when I started exercising (nothing crazy…I was just walking briskly!) and delaying the time between meals, I needed to monitor my blood sugar even more often as it could get quite low in the late afternoon before dinner (+/- 4.0 mmol/L) – at which point I would eat something as I prepared dinner, to raise my blood sugar.

Here is a graph showing my blood glucose since I started walking and intermittent fasting;

Blood glucose since beginning walking and intermittent fasting

Weight Loss

In the last 3 weeks, my weight has dropped another 4 pounds, making it a total weight loss of 10 pounds, in all so far.  I expect as I continue to walk 4 days a week and intermittent fast most weekdays and limit my carbs, that the weight and inches will continue to come off.

I am not suffering in any way!

As a Dietitian, I talk about or write about food all day long and I’m intermittent fasting and feel just fine! I’m not hungry.  As I jokingly posted last week;

“My body has finally figured out how to make glucose from my fat on a low carb high fat diet. I may potentially have found the source of immortality.

Final Thoughts…

I still have at least another 30 pounds to go to get to the “goal weight” that I set at the beginning of this journey, and am now aiming to lose another 40-45 pounds instead in order to reach my ideal (healthiest) waist to height ratio. I clearly won’t accomplish this by mid-November, but if I reach close to my initial goal weight, I will be quite content.

They say a picture speaks a thousand words, so below are two photos. The one on the left, with the blue shirt is me at the beginning of this journey.  The one on the right, with the burgundy shirt is me now. I am starting to see a face I recognize.

Have questions?

Want to know how I can help you reach your own nutrition goals? Please send me a note using the “Contact Us” form above, letting me know how I can help.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Journey – how I got my weight moving again

INTRO: After a seeming endless 6 week plateau with my weight barely budging, I decided to do some serious intermittent fasting and lower my carbs and bingo – my weight is dropping nicely!  Not only that, my fasting blood sugar is the best it has been since I was diagnosed as Diabetic ~10 years ago. Here’s an update.

Yesterday was my third day of intermittent fasting (IF) this week – where I didn’t eat anything after supper at night, until supper the next day.  This is my second week of doing intermittent fasting Monday to Friday and eating a regular, low carb high healthy fat supper at night.

Here’s an example of what I ate on one night, to give you an idea.  It was some Thai chicken thighs that had been marinated in coconut milk, red curry paste and curry and grilled on the barbecue, along with a huge mixed green salad, with some shaved Parmesan, raspberries, pepitas (pumpkin seeds) and homemade raspberry vinaigrette (great thing to do with over ripe berries!) that was made with Dijon mustard, wine vinegar and extra virgin olive oil. To start with, I also ate about a cup of snap peas with ~ 1  1/2 Tbsp of taramasalata (Greek carp roe spread) that didn’t have any of the usual bread in the recipe.

Keeping in mind that I am only a “sample set of 1”, here are my results;

Last week, which was my first week of regular IF, my fasting blood sugar, which had been stuck at the high to mid- 6 mmol/L (117 mg/dL) range for weeks, dropped to the mid- 5 mmol/L range (~99 mg/dL) for several days in row.

 

Yesterday, which was my third day of IF this week, my blood sugar just before dinner was the lowest it has been since I was diagnosed as Type 2 Diabetic ~10 years ago.

While I felt totally fine and had been working a full clinical day, I knew it was time to eat something!  I ate about 10 salted almonds and went about preparing dinner.

Blood glucose values from June 22nd until June 29th, inclusive

I should add, that last week I also started walking daily ~ 2-3 km (1  1/4 -2 miles) around a local man-made lake (I posted a video below, so you can see it).  The first two days I could only go once around, as I had fractured a rib last Friday and it was still quite painful.  I starting walking daily because it was supposed to be good to alleviate the muscle pain accompanying my injury and I found it helped a lot, so I kept doing it each morning.  Then I realized how great it felt to be walking in such a beautiful place, so now it has become a morning routine.

My blood pressure is doing amazing now.

It had stalled between Stage 1 hypertension and pre-hypertension for about a month, but when it creeped back up to Stage 2 hypertension for two days in a row, I decided to go see my doctor and get prescription for a ‘baby-dose’ of Ramipril (2.5 mg).

 

There is a strong family risk of heart attack and stroke, and a blood pressure that hit 160/90 was not something to fool around with.

I plan to staying on the meds until I lose another 20 pounds, or until my blood pressure becomes too low – whichever comes first.

Look at my blood pressure now.

The only day that was high (Stage 1) was last Friday, before I started on the lowest dose of Ramipril.

The rest of the time I am in pre-hypertension and one day was totally normal! I am looking forward to seeing the continued dietary changes, bring it down even further.

As I planned to do 3 months after I started eating low carb, I have a requisition for blood work and an appointment for mid-July to have that done.  I will be getting my HbA1C checked and my cholesterol, along with some liver and kidney function tests as well as electrolytes (important on this hypertensive medication).

One of the other dietary changes that I made, besides the intermittent fasting, was that I cut my carbs considerably. I was not doing well on 50 gm of carb per day, my weight loss had been stalled, my blood pressure as well and it had been a month of no significant progress, even though I was in low stage ketosis. I cut my carbs down to 35 gms per day (sometimes a little less), but making sure to have lots of non-starchy vegetables and protein and of course, plenty of healthy fats in the form of olive oil, coconut milk and nuts.

In short, I feel amazing.

The weight is dropping, the inches are dropping, my blood sugar is approaching more normal values and my blood pressure is being kept in check, while I continue this process of eating low carb high healthy fat and daily walks. I’m not hungry during the day even though I am not eating, because my body is happily accessing my own fat stores for energy. I think the limiting factor at this point is that my body is not quite used to synthesizing the enzymes needed for it to make glucose from my stored fat (a process called gluconeogenesis), so I will be monitoring my blood sugar closely, to make sure it doesn’t get too low.

I want to encourage you, that if your weight is staying stable for longer than you’d like, I’ve posted some things on the blog that would be helpful (located under the Food For Thought tab). One article is on tracking carbs, and the next one is on where calories factor in.

If your weight has plateaued, and you’ve been eating low carb high fat and your not losing weight as you’d like to, these two articles should help.

If you’d like to learn more about how I can help you accomplish your own weight loss or insulin-resistance lowering goals, please send me a note using the “Contact Us” form above.

Keep in mind that for the month of July only, I am offering a substantial savings on taking both an assessment package and a weight management package, so please visit the front page to find out more about the Canada Day special.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Low Carb High Fat 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 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. 


follow me at:

 https://twitter.com/joykiddieRD

  https://www.facebook.com/lchfRD/

 

 

A Dietitian’s Journey – a few thoughts on “exercise”

There are two words that I’ve noticed aren’t talked about much in low carb high fat (LCHF) circles; one is “calories” and the other is “exercise“. I think that’s because both have been tied to the old “calories in, calories out” model.

I think it’s important to reframe both of these within a LCHF context, because both have a role to play in us being successful in improving health as well as losing weight, even though the reasons for that are very different than in the “calories in, calories out” model.

In the traditional high carb, low fat paradigm, restricting calories and increasing exercise are seen as the foundation of weight loss – based on the assumption that “calories out” is only the calories we burn in activity.  As explained in this week’s blog on “Do Calories Matter When Eating Low Carb“, there are other demands on the energy we take it (calories) that are higher priority than exercise, such as regulating our body temperature and providing energy to keep our heart pumping.

(You can read about that here: https://www.lchf-rd.com/2017/06/19/do-calories-matter-when-eating-low-carb/)

In the low carb, high fat model, overall calories need to be understood within a diet that is 70% fat and <10% carbohydrate and exercise needs to be understood within the context of lowering stress levels (i.e. cortisol), as well as increasing metabolic rate so that fat stores continue to be burned long after activity ends.

Below is a very short video from my morning walk, with a few thoughts on “exercise”.

To our health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 or heard in our content. 

A Dietitian’s Journey – 3 month update

Today marks 3 months since I started my own weight-loss and getting-healthy journey and so I’m posting this short update.

While I’ve only lost 7 pounds, I’ve lost a remarkable 4 inches off my waist, which is greatly encouraging, as I still have another 6 inches to lose (based on my height-to-waist ratio). I know without a doubt that this is entirely ‘doable’!

I look in the mirror and recognize the person looking back. I recently bought new jeans that are a full size smaller and when the weather has been hot, I’ve not only worn shorts, but I’ve wore them out of the house.

My blood pressure is very stable and now fluctuates between stage 1 hypertension and pre-hypertension; a dramatic improvement from the wildly erratic fluctuations between stage 2 and stage 1 hypertension, with a hypertensive emergency thrown in for excitement. It was that crazy high blood pressure which started me on this journey, but what keeps me on it, is how I feel. I feel great!

My blood sugar has been great after meals, but recently has become quite a bit higher several hours after eating, even though I have not eaten or drunk anything except water. From the reading I’ve been doing in the literature, this has been reported in those who previously had what is called “dawn syndrome” (high morning fasting blood glucose – which I had) after they’ve adopted a low carb high fat diet.  It seems that the second of the two stages of insulin release is suppressed in those such as myself,  causing blood glucose to remain higher for a longer period of time. One way of addressing this is via exercise, so it seems I will be doing this more than once in a while to manage this.

This morning it was gorgeous out; clear sky, cool temperatures and the track was beckoning me, and so I went. I haven’t worked out more than 2 or 3 times a month since I began my journey, but despite that, I noticed a huge improvement in my fitness level today. I can only attribute that to the loss of fat around my middle. I did an extra two rounds on the track at a pretty decent clip, with a total distance of 3.2 km (2 miles). I could have done another round (maybe two) but thought I might be too stiff tomorrow, and since my goal is to do this more often to address my second stage insulin suppression, I decided to ‘call it a day’ after 3 km. As I was leaving the track, I decided to take a short video to post along with this 3-month update. Have a look at the video which is posted below, and compare it with the one from 3 months ago (http://tinyurl.com/yb3unuff). My progress is evident.

Want to know how I can help you accomplish your own health and fitness goals?

Please send me a note using the “Contact Us” form above and I’ll be happy to reply.

To our good health!

Joy

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 Low Carb High Fat 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 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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

 

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 https://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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 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

If you would like to read well-researched, credible “Science Made Simple”  articles on the use of a low carb or ketogenic diet for weight loss, as well as to significantly improve and even reverse the symptoms of Type 2 Diabetes, high cholesterol and other metabolic-related symptoms, please  click here.

you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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.