Two Year Anniversary of Adopting a Low Carb Lifestyle- a short video update

Tomorrow will be two years since I began what I’ve called “A Dietitian’s Journey” — which is my personal journey to restore my health and then to achieve optimal health.

My journey began March 5, 2017 when I felt unwell just sitting at my office desk. I didn’t know what was wrong, although in retrospect I should have given that I was a Registered Dietitian.

I took my blood pressure and it was astronomically high — so high, that had I gone to my doctor at that point he probably would have sent me directly to the hospital in an ambulance. He certainly would not have let me drive!  After checking my blood sugar for the first time in ages (even though I was diagnosed with Type 2 Diabetes 8 years earlier) it was also ridiculous.

The very first step of my ‘journey’ was 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 neglecting to find out the magnitude of reality, so in psychological terms, I was in denial. Taking my blood pressure and blood sugar two years ago was a huge dose of reality. I had no choice but to face the fact that I was metabolically very unwell!

As I’ve said many times on podcasts and written in my blogs, what I should have done at that point was go straight to my doctor’s office and let him either treat me with multiple medications himself or send me to the hospital to be treated and released with medications, but I didn’t. I was scared…no, I was terrified. In the preceding months, I had two girlfriends who spent their lives working in healthcare die of natural causes within 3 months of each other; one from a massive heart attack and the other from a stroke. I knew if I didn’t do something I was at very high risk of being next.  When I say I changed my lifestyle “as if my life depended on it” it’s because quite literally it did.

The short video directly below was taken during my first walk at the local track 2 weeks after I had adopted a low carbohydrate lifestyle on March 5, 2017. It’s clear how obese I was and how difficult it was for me to walk and talk at the same time.

Last night I decided that the most appropriate way for me to ‘celebrate’ my two year anniversary of reclaiming my health was to go back to the very same place and make an updated short video, which is what I did this morning — even though it was really cold out this morning (for March in Vancouver, that is)!

Before you watch the updated short video, here is a summary of what I was able to accomplish this time last year — after following a low carbohydrate lifestyle for only a year;

March 5, 2018

By March 5, 2018, I had lost;

  • 32 pounds
  • 8 inches off my waist
  • 2 inches off my chest
  • 3 inches off my neck
  • 1 inch off my arms
  • 1/2 inch off my thighs
  • I no longer meet the criteria for Type 2 Diabetes (achieved without the use of medication)
  • I had blood pressure that ranges between normal and pre-hypertension without medication
  • I had ideal triglycerides and excellent cholesterol levels achieved without any medication.

As of today, March 4, 2019, I have lost;

selfie taken March 3, 2019 in the smallest jeans I have (size 12)
  • 55 pounds
  • 12- 1/2 inches off my waist
  • 3 -1/2 inches off my chest
  • 6 -1/2 inches off my neck
  • 4 inches off each arm
  • 2- 1/2 inches off each thigh
  • I met the criteria for partial remission of Type 2 Diabetes 3 months ago*
  • My blood pressure still ranges between normal and pre-hypertension**
  • I still have ideal triglycerides and excellent cholesterol levels

* My dad was diagnosed with Alzheimer’s disease in August (sometimes referred to as Type 3 Diabetes), so even though my HbA1C was 6% at the time, my endocrinologist agreed to start me on Metformin. ** I started on a ‘baby dose’ of Ramipril in October 2018 to protect my kidneys from the residual high blood pressure.

Here is the video taken this morning, after two years of following a low carbohydrate diet (of which the last 14 months was ketogenic).

If you would like to know how I can help you or a family member with weight loss or reversing the symptoms of Type 2 Diabetes, high blood pressure or high cholesterol, please click on the Services tab to learn more. If you have questions please send me a note using the Contact Me form located on the tab above and I will reply as soon as I am able.

To your good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

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          https://www.facebook.com/lchfRD/

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Copyright ©2019 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.

Why I Posted My “Before” Pictures When I was Still Obese

INTRODUCTION: It is not uncommon for people to post their “before” pictures after they’ve reached their goal weight to show how much they’ve accomplished, but why on earth did I post pictures of myself when I was still obese and metabolically unwell? That’s a good question.

There’s a saying that “it is not the healthy who need a physician, but the sick” and while people will consult with Dietitian for many different reasons, those who are significantly overweight find it very difficult to take that first step when it is weight loss they’re seeking. Why?

People feel ashamed of being overweight or obese.

Oftentimes, overweight people feel that they are assumed to be undisciplined or lazy — that their condition is their own fault. They have heard over and over again that;

“If only they would eat less and move more they wouldn’t be so fat!”

or

“If only they ate ‘real food’ instead of ‘junk food’ they would be so much slimmer!”

Really?

If it were that simple, why would 1 in 4 Canadians (and 1 in 3 Americans) be obese?

Because it’s not that simple.

It’s been my experience that many overweight people and obese people often eat what has traditionally been thought of as a “healthy diet”; plenty of fruit and vegetables, low fat dairy products and only brown bread, rice and pasta and they feel frustrated and ashamed of being what is perceived as “a failure”.

Some have told me that sometimes their own healthcare providers have given them the impression that they must be being untruthful about what they’ve been eating because surely if they were eating the way they say, they would have been losing weight. In other words, they are not believed, or in stronger words, they are thought to be lying or at least incapable of accurately assessing how much they are ‘really’ eating.

Why would an overweight or obese person seek help in losing weight from a healthcare professional that views them as undisciplined, lazy or unrealistic about what they are eating?

They don’t.

Often people will try various diets that they read about online because no one will see them try and more importantly no one will see when they give up, feeling once again that they are ‘failures’.

I don’t think that overweight and obese people are failures. I believe many are doing what they’ve been told is the “right thing” but for different reasons. it is not working for them.  My role as a Dietitian is to help people understand what isn’t working and to enable them to be successful — without judgement.

It is for just such people that I posted my “fat pictures” online before I started to lose weight!

I wanted people to see me as no different and certainly no better than they are, because I’m not. Sure, I have an undergraduate and graduate degree in nutrition, but I don’t get any “free passes” when it comes to losing weight and turning around my own metabolic health. I needed to do it just like everybody else.

I’ve lived each step of my weight loss and metabolic health recovery journey in public (logged under “A Dietitian’s Journey”) because I wanted people to experience in “real time” my frustrations and my victories. I wanted people to see that the path is not linear; that there are twists and turns and stalls, but yes it is possible to be successful. It just takes time and some dedicated work to get well and achieve a healthy body weight.

I look at it this way;

If it took me 20 years to become metabolically unhealthy and obese, what’s a couple of years to become metabolically healthy and normal weight?

Everyone’s weight loss and health restoration journey will be different.

There are no “magic bullets” or “super diets”— but there are different dietary and lifestyle options that can be pursued for success.

I can help. 

If you would like to learn more about how I can help you or a family member achieve and maintain a healthy body weight and metabolic health, please send me a note using the Contact Me form located on the tab above.

To our good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

Copyright Ltd. ©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.

My Weight Loss Progress to Date

Today, a photo memory popped up on Facebook from a year ago which was a composite photo from the 2 1/2 years previous to that along with an updated photo at the bottom from that day, February 12 2018. At first I thought I hadn’t changed much from a year ago until I added a “bathroom selfie” that I took on Sunday, beside it.  Without a doubt, there has continued to be significant progress. This post is about my weight loss and non-scale progress to date.

My weight loss progress to date

All of the photos in the composite were taken with the same cell phone, so while they aren’t great shots they document my journey to date — A Dietitian’s Journey.

The first photo from the left at the top, with me in the plum shirt was taken April 2015, around the time a retired-physician friend came to talk to me about the therapeutic use of a low carbohydrate diet for reducing the symptoms of Type 2 Diabetes and for weight loss.

The second photo. where I am wearing a ivory silk scarf was taken in September 2015, shortly after I began eating a liberal lower carb diet of ~130 g carbohydrate per day.

The third photo in the middle was taken exactly a year after the second one, in September 2016.  While it’s clear I had lost weight, the crocheted cardigan I was wearing was still quite stretched.

The fourth photo at the top was taken in April 2017, only a month after I had begun following a low carbohydrate lifestyle on March 5, 2017 — which in three weeks from today will be two complete years. I happened to be wearing the same outfit as I had the previous September because at that weight I had no interest in buying new clothes and didn’t go out much. Even after only a month of eating low carb, my face, neck and abdomen were beginning to show signs of progress.

In the fifth photo taken September 2017, 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’t be seen easily unless one looks at the very bottom of the crocheted cardigan, is the space between it and me that was previously  filled with my belly fat. At this point there was a space where fat used to be! I still had ~ 25 more pounds to lose to reach a waist circumference that was 1/2 my height but I knew this was entirely achievable and maintainable.

The photo on the left at the bottom was taken exactly a year ago today, February 12, 2018. That’s why it popped up in “memories” on Facebook.  When I first saw it, I thought looked pretty much the way I do now until I decided to put the bathroom selfie from Sunday beside it.  Admittedly, the 20 additional pounds I have lost in the last year “shows”.

I am 2 pounds from my ‘goal weight’ which I am pretty sure I will reach by three weeks from now, on my 2-year anniversary of beginning my journey.

I am in remission of Type 2 Diabetes and have an ideal waist-to-height ratio. My lab tests reflect my progress as much as as the reflection in the mirror and best of all, I feel great.  I shoveled snow for an hour yesterday and since we had a second snow storm, I did it all over again this morning — without getting out of breath or even sweaty! Two years ago, I could barely walk around the track at Town Center without being totally out of breath!  Check out this video to see what I looked and sounded like when I started! There have been huge changes.

This “journey” has never been about losing weight for vanity’s sake; but about reclaiming my health from chronic illness (Type 2 Diabetes and hypertension) that was brought about by eating what most would see as a very “healthy diet” but that was way too high in carbohydrates for someone as metabolically unwell as I was.

As I’ve written about in previous journal entries, I had two girlfriends my age drop dead within 3 months of each other from similar health conditions as I had and when I took my blood pressure and blood sugar on March 5 2017, I knew that if I didn’t change my lifestyle, I could literally be next.  I changed my lifestyle two years ago because my life literally depended on it.

When I look in the mirror each day I am reminded that two of my girlfriends no longer have the opportunity that I do; to do things differently. I am fortunate and blessed and don’t take my reclaimed health for granted.

If you have questions about how a low carbohydrate approach may be helpful for you to achieve weight loss, or put your own high blood sugars or Type 2 Diabetes into remission, then please send me a note using the Contact Me form located on the tab above.

For more information about the hourly consultations and packages I offer, please check under the Services tab, or in the Shop.

To our good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

Copyright ©2019 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.

 

Different Ways to Measure Success – a Dietitian’s Journey

There are different ways to measure ‘success’ and not all of them involve weight.

Six weeks ago, I wrote about my overall progress in reaching the non-diabetic range for HbA1C after ten years since being diagnosed with Type 2 Diabetes, my improvements in blood pressure and other markers.

A month ago, I wrote about my changes in body measurements over the last 12 months and where the 25 pounds I lost came from.

Two weeks ago ‘success’ was documented with a series of composite of photos from when I was obese until now, along with some other details.

 

Last week, ‘success’ was comparing a series of videos that I have taken since the beginning of my journey until now.

 

 


Just have look at me in the first video (just a little over 1 minute long, link below) and even the first few minutes of the most recent video (a little over 1/2 an hour, link below) back to back!

This first video was taken March 16, 2017, just two weeks after I began my health and weight-loss journey. As significant as my size, listen to how out of breath I was!

This most recent video was filmed a week and a half ago (January 4, 2019) for the Keto-Solutions Bootcamp in Charlottetown, Prince Edward Island. Sure, I’m not walking in this one but trust me, I can do that and so much more now without getting winded!

Weight loss update

Yesterday, my weight dropped to a BMI of 24 (well into the normal weight category) which was pretty exciting given when I started it was around 32 (in the obese category) and as I suspected from the number of times I needed to get up last night, my weight dropped again today. I normally weigh myself only once a week, unless I know my weight has dropped.

Body Mass Index (BMI) changes from January 2018 – January 2019

With the drop in weight over the last few days (even with adjustments for body water fluctuation) and am around 3  1/2 pounds from my goal weight — well actually my third goal weight.

When I first started my journey, I set as a preliminary “goal weight” as the weight I would like to get to, if possible.  That was the weight I was a year ago!

Having achieved that, last January I set a new “goal weight” of what I’d like to get to where I thought my waist circumference would be 1/2 my height. Once I reached that weight, I revised my “goal weight” downward — closer to the lowest adult weight that I was where I once looked best. Currently, I am just a little over 3 pounds from that weight.

Below is a graph of what my weight loss progress looks like over the past year (since the beginning of January 2018).

I’ve lost 27.5 more pounds on top of the 24 pounds I lost from March 5, 2017 until January 2018.

Weight loss – January 2018 to January 2019

To date, I’ve lost a total of 51.5 pounds and to be honest I have no idea what my final weight will be!

My focus over the next several months is on achieving optimal health and that is about building additional muscle and continue to lose about 10 pounds of excess fat. It’s hard for me to know what “weight” I will be when I’ve accomplished that, but in the end, I don’t think it matters much.

Building muscle for me is all about health — and of reducing my risk of sarcopenia as I age (you can read more about that here). Continuing to lose the excess fat is all about further reducing any insulin resistance and continuing to lower my HbA1C even lower into the normal range with the goal of achieving full remission from Type 2 Diabetes (you can read more about that here).

At this point in my journey it is about striving for “optimal” rather than some measure of “ideal”.

The way I look at it, optimal is what makes sense for a ‘woman of a certain age’ who is newly in remission from Type 2 Diabetes almost 10 years after being diagnosed.  Optimal is based on the exercise I am capable of doing now — after having both knees operated on in the past, as well as a back injury 8 years ago. Given my age, my knees and my back, what is optimal won’t be anywhere near what I was capable at 25 years old when I was doing 10 hours of karate a week! Those days are gone, but what is ahead is whatever I make of it now.

Pushing for the muscle gains now will factor into what what kind of “old age” I will live and losing the rest of the fat may enable me to achieve full remission from Type 2 Diabetes. This is more important than how I look!

And so begins another calendar year in my journey – a journey now focused on achieving optimal, not ideal.

If you’d like to know more about how I can help you accomplish your health and nutrition goals please have a look at the Services tab to learn more about the sessions and packages I offer and feel free to send me a note using the Contact Me form located on the tab above, if you have specific questions about how I can help.

To our good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

Copyright ©2019 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.

 

Beyond Appearance to Health – 22 months of A Dietitian’s Journey in video clips

Tomorrow will be 22 months to the day (March 5, 2017-January 5, 2019) that I realized that I was metabolically very unwell; having a resting blood pressure in the hypertensive emergency category and uncontrolled blood sugar which was topping 13 mmol/L (235 mg/dl) after a meal. As I have said in every podcast and interview that I have done since and have written in several articles, what I should have done at that point was to go straight to my doctor and let him put me on the medications required and then have changed my diet and lifestyle, but I was frightened with the prospect of coming out of denial and decided instead to immediately change how I ate and recover my own health. That was a risky thing to do as my risk of heart attack and stroke was very high and in retrospect it is not what I would have done.  It is certainly not something I would recommend anyone else to do! Knowing what I know now, I should have started on medications and then adopted the same dietary and lifestyle changes and as my health improved, had my doctor lower the dosages and then eventually discontinue them. But that as they say is water under the bridge now.

In my first entry in “A Dietitian’s Journey” simply titled “The Beginning” I set the following goals;

I want;

(1) blood sugar in the non-diabetic range

(2) normal blood pressure

(3) normal / ideal cholesterol levels

(4) a waist circumference in the “at or below” recommended values of the Heart and Stroke Foundation

Will I meet all these goals?  Who knows?! But I won’t know if I don’t try and the alternative of a life of medication for blood sugar, blood pressure and eventually cholesterol too does not appeal to me!

March 16, 2017 I posted my second entry titled The Road to Better Health about why I decided to add a walking routine to my dietary changes and this was where I posted my first video.

You have to see this to believe it!

It’s not only how I look but how I sound!  Its evident that I am unable to walk at a reasonable pace and talk without being out of breath.

Here is my second video, posted July 25, 2017, just 4 months into eating a low carbohydrate (not ketogenic) diet.  As you can see, I had already lost some weight and could talk without being totally winded while walking.

At this point, I had lost 10 pounds, my HbA1C (3 month average blood sugar level) was down from an average of 12 mmol/L to 8.5 mmol/L. My blood pressure which had dropped to ~140/80 mmHg had begun to rise to in the 160/90 mmHg range so I decided to ask my doctor to put my on Ramipril (Altace) until diet and weight loss is sufficient to maintain it at a normal level on its own. My goals at that point were;

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.

By my one-year anniversary of following a low carbohydrate diet, this is what I had achieved;

So far, I’ve lost;

  • 32 pounds
  • 8 inches off my waist
  • 2 inches off my chest
  • 3 inches off my neck
  • 1 inch off my arms
  • 1/2 inch off my thighs.
  • I no longer meet the criteria for Type 2 Diabetes
  • I have blood pressure that ranges between normal and pre-hypertension
  • I have ideal triglycerides and excellent cholesterol levels.

While I’m still overweight and have approximately another 20 pounds to lose to reach a healthy waist circumference, I am not as desperately unhealthy as I was this time last year.

I am alive, much healthier and committed to continuing this journey.

July 25, 2018, a full year after the previous video above and 16 months into A Dietitian’s Journey, I posted the next video update. By this point I had lowered the amount of carbohydrate in my diet down considerably in order to achieve the metabolic recovery I sought. The difference between the very first video from March 16, 2017 and this one is remarkable; not just in the way I look, but how I sound!

By this date, I had lowered my fasting insulin from when I began where it was 54 pmol/L (7.8 μU/ml) to 33 pmol/L (4.8 μU/ml) which was in the ideal range, between 2-6 μU/ml. My HbA1C had dropped from 7.5% to 6.3% which was finally below the cutoffs for Type 2 Diabetes, which is 6.5%. Using diet alone and without taking any medication, I was finally in partial remission of Type 2 Diabetes.

This brings us to today. Five months have passed since the last video update above and tomorrow will be 22 months since I began A Dietitian’s Journey. I recently achieved my last two health goals of (a) having my waist circumference that is half my height and (b) having lost the last 20 pounds. Yesterday, my doctor took my blood pressure and it was in the normal range (still taking a “baby dose” of Ramipril) and next week I will be having my HbA1C done, which will be the first time since I voluntarily started on Metformin after having reached partial remission from Type 2 Diabetes with diet alone. I chose to do this for several reasons, including my dad’s recent Alzheimer’s diagnosis and it’s relationship to glucose dysregulation, as well as because I was still having difficulty lowering my early morning fasting blood glucose due to my liver’s gluconeogenesis (making glucose) in the wee hours of the morning.

Yesterday I taped a 1/2 hour talk with a Pharmacist colleague in Prince Edward Island who is holding a one-day workshop in Charlottetown on Saturday, January 12th, called Keto Solutions Bootcamp. Since I was unavailable to appear ‘live’ that day, I taped the segment yesterday that will be shown during my scheduled slot.

I gave her my word that I would not post the video until after the workshop but posted a screenshot instead.

UPDATE: January 13, 2019

Here is the link to the video:

Some final thoughts…

I have also demonstrated that even for someone who was overweight and obese for YEARS, it is entirely possible to achieve a healthy body weight eating whole, real food.

I didn’t deprive myself. I ate burgers and pizza, Chinese, Thai, Indian and Canadian food, and even some treats once in a while like batter fried fish and New York Style Cheesecake; all adapted to be low carb (see the recipe section for details).

As I coach my clients to do, I ate if I was hungry but didn’t eat just because it was “time” if I wasn’t. I ate delicious real food with a wide range of diversity in tastes and textures and made sure to get sufficient micronutrients (vitamins and minerals) not just “macros” (protein, fat and carbohydrate).  I didn’t have bulletproof coffee once and never ate a “fat bomb”. Yes, there is a lot more to a low carbohydrate diet than bacon, cream and butter!

If you’re curious to learn more, please have a look around my web page.  Have a read of some of the articles under the Food for Thought tab. Most are fully referenced and written in my “Science Made Simple” style so that anyone can understand.

If you are interested in knowing more about the packages and hourly consultations that I provide, please click on the Services tab to find out more.  Should you decide you want to get started, everything you need is there, including the Intake and Service Option Form to download and complete.  If you would like a password protected one to secure the completed information so you can email it to me, please drop me a note and I will be glad to send it to you.

Finally, if you have questions about how I can help you, please send me a note using the Contact Me form on the tab above and I will reply as soon as possible.

My “A Dietitian’s Journey” is my “sample set of one” (n=1) account of what I was able to accomplish, but everyone’s journey is different.  Some people take less time than I did to reach their goals and some take more depending on where they start from, but this is about recovering one’s health and achieving a healthy body weight and the way I look it is if it took us years to get to the place of ill-health we begin from, are we not worth the investment to take whatever time it takes to get well?  I think so!

Please let me know if I can help you restore your own health or help a loved one.

To your good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

Copyright ©2019 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.

2018 in Review – a Dietitian’s Journey

This morning I went to do my exercises and realized that it’s been 10 months since I took my last photo in gym clothes and decided it was a good time for an update.

During the first year of my “journey”, I didn’t exercise at all except for walking and had set the goal of implementing some weight and resistance training beginning March 5th, 2018 (my one year “anniversary” of adopting a low carb lifestyle). I was inspired by some doctor colleagues in the Canadian Clinicians for Therapeutic Nutrition group and decided to start slow HIT (slow high intensity training) following the method of Dr. Doug McGuff (Body By Science) but in hindsight, given my age and the number of years I had not exercised, I probably should have started by retraining major muscle groups and strengthening my core first.  I didn’t and ended up aggravating an old back injury and spent most of the summer going through physiotherapy for that. I was in so much pain that even walking was difficult at first, so exercise outside of daily physio was set aside.

As a result of my back injury, I engaged the help of a terrific kinesiologist, and asked her for exercises to build up my knees and shoulders, as well as my back as I knew these were “weak links”.  I faithfully worked on training one of those areas daily, until I ended up injuring one of my knees (also an old injury!) getting out of one of my son’s low-slung car! Sheesh, I felt like I couldn’t ‘win’. Years ago I had each of my knees operated on (torn meniscus in each) after various injuries from years of dance, horseback riding and karate, so my best made plans for exercise this year did not turn out as I  intended.

February 2, 2018 – December 30, 2018

Even without doing most of the exercise that I planned to do during this past year, my body shape evolved, as can be seen in these two photos.  The one on the left was taken February 2, 2018 and the one on the right, this morning (Dec 30, 2018).

For the last 6 weeks, I have been both resting my knee injury as any amount of weight bearing hurt and only worked to gently build up the supporting muscles in that knee. Last week after much patience and frustration, I was finally able to walk up the stairs without pain (provided I didn’t try to carry anything heavy at the same time)!

Since I didn’t want to overdo it but knew I needed to start moving forward with my exercise commitment, I began by doing a few slow deep-knee bend squats each day; first 5 at a time.  The last week, I began adding a set here and there whenever I went upstairs for something (a random excuse which served as a reminder).  By the end of this week I was doing 20 – 30 full-knee bend squats per day, 5 at a time.  This is HUGE progress! My goal now is to begin exercising regularly WHILE NOT injuring anything by not being adequately focused on my body mechanics!

While my exercise plans this year didn’t turn out as I hoped, in the end I did end up strengthening my core muscles and building up my knees, lower back and shoulders (one of which is still causing me a bit of grief). I am not letting these setbacks deter me — any more than I let past weight loss stalls deter me.

My goal is to get as healthy as I can and that takes me being dedicated to the process regardless of setbacks.  Setback happen.  They happen to everyone.

Here’s my recap of my progress so far;

In the first year (March 5, 2017 – 2018) I lost a total of 32 pounds and lost 8 inches off my waist. I no longer met the criteria for Type 2 Diabetes (when I began my blood sugar was uncontrolled) and at the end of the first year my blood pressure ranged from between normal and pre-hypertensive  (when I began it was dangerously high). At the end of the first year, my triglycerides were ideal and I had excellent cholesterol levels (details here).

This past year, I lost an additional 18.5 pounds and another 4 inches off my waist; making it a foot in total! My waist to height ratio is now below .50 so I am satisfied. I am 1.5 inches from my final goal weight and am trying to decide if I want to lose another 5 pounds or if I want to focus on toning up my muscles, or both.  For details on exactly what I lost from my arms, legs, belly etc. you can read more here.

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

Twenty-two months ago this coming week, I was an obese, metabolically very unwell Dietitian with Type 2 Diabetes, very high blood pressure and abnormal cholesterol.

February 2, 2018 – December 30, 2018

I certainly haven’t “arrived” by any means, but I am a whole lot healthier and feel better than I have in years.

As I tell my clients, its about “progress”, not “perfection”.

 

 

I hope my journey has inspired you that losing weight and getting healthy can be done and while it’s not a straight-forward line of progress all the time, and stalls and setbacks do occur, goals that are realistic set CAN be accomplished. Sometimes they just take a little longer than planned.

If you’d like to know more about how I can help you accomplish your health and nutrition goals this coming year, please have a look at the Services I offer and if you have questions, please send me a note using the Contact Me form located on the tab above. If you’d like some help setting some realistic goals for this coming year, please have a look at the special package I put together which is at a special price during the month of January.

Wishing you and yours the very best for a healthy and happy New Year!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

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.

 

Where the Last Twenty-Five Pounds of Weight Came From

When I set out on my “journey” on March 5, 2017 I didn’t have a particular weight loss goal in mind.  I just knew that I was metabolically unwell and very overweight and that something needed to change (you can read a summary of that story here)!  For years, I’d look in the mirror and long to see someone that looked like “me” looking back.

Over the first year since adopting a low carbohydrate and then a ketogenic therapeutic diet (March 2017-March 2018) I lost 32 pounds, put my Type 2 Diabetes into remission and significantly improved my blood pressure, but I didn’t reached the goal of getting my waist to height ratio (i.e. waist circumference half my height) so I knew I wasn’t “done” yet.

Since last December, I’ve lost 25 pounds (45 pounds in total) and today while cleaning a shelf over my desk, I found a piece of paper on which I had been keeping track of my body measurements since June 2017, including those taken from this time last year.  That’s when I decided to see where on my body these last 25 pounds came from.

Of course, where my body took the weight from is specific to me, but for those reading this who are ‘women of a certain age’ or the friend of one, you might find this encouraging.  It was a physician who teaches a low carbohydrate approach to her patients who suggested two summers ago that I take my measurements periodically to see where I am losing fat from and suggested measuring at my umbilicus*, chest (under my bust-line), neck, bicep and thigh. And so I have.

*umbilicus isn’t the same as “waist”.  Waist is measured in a particular location explained in this article and umbilicus is the region where one’s “belly button” is.

taken November 2017

Since December of last year, I lost 6.5 inches off my umbilicus region. That’s pretty cool and yes, it shows as I recently had to punch 4 holes in my belt which I hadn’t worn since then. I’ve lost an additional 1 inch off my chest and 1 inch more off my neck (that shows too), 1.5 inches off my bicep (while adding muscle!) and here’s where it’s crazy; I lost 4 inches off my thighs — also while gaining muscle. In the first year I had only lost a total of a 1/2 an inch off my thighs, as can be seen here.

taken November 2018

When I look at these measurements over the last year and a half (from June 2017 until now), it is very encouraging.  I’ve lost 9 inches off my umbilicus region, 2 inches off my chest (below my bust-line), a whopping 4 inches off my neck, 2.5 inches off my bicep while gaining muscle, and 4.5 inches off my thighs also while gaining muscle.

It’s my opinion that weight loss, like improved metabolic health is best done gradually but consistently.  I don’t promote “rapid weight loss” even though a low carbohydrate or ketogenic diet is often promoted that way in the media.  I also don’t believe that a ketogenic diet is necessary for all people, or even for most people. In fact, those who do not have significant metabolic health issues often do just great on a low carb diet, so my view is why limit good whole-foods that happen to contain carbohydrates if it is not needed to improve metabolic outcomes?  In the four and a half years that I have been teaching this lifestyle, I have only had a handful of clients who were metabolically unwell enough for a long period of time that needed to keep lowering their carbohydrate intake down, some to a ketogenic level. Necessarily, each is being overseen by their own doctors — especially when it comes to monitoring (and adjusting the dosage of) their medications.

I approached my health as if I were my own ‘client’, so I didn’t start off at a ketogenic level of intake. I started “low carb” and only lowered the level of my carbohydrate intake gradually and only as much as necessary to achieve the metabolic improvements necessary.  Since I had been overweight for 25 years and was diagnosed as Type 2 Diabetic 10 years earlier, I ended up needing to lower my carbohydrate intake to a ketogenic level but did so under the supervision of my doctor and with the oversight of my endocrinologist.

Whether you have a few pounds or like I did — many to lose or want to put one or more metabolic conditions such as high blood pressure, blood sugar or cholesterol into remission, you may want to find out more about how a low-carbohydrate approach can help, and why.

Feel free to send me a note using the Contact Me form above and I will reply as soon as I’m able.

To our good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

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.

 

Twenty One Months – a major goal achieved

From the beginning of my ‘journey’, I’ve said that I had no specific “ideal weight” in mind — that my goal was to reach a body weight where my waist circumference was half my height; whatever weight that was.  This week, I reached that goal; 21 months from when I began.

This story began March 7, 2017.  I was sitting at my office desk and didn’t feel well.  I dug out my blood pressure machine (sphygmomanometer) which I had not used in ~ 2 years and took my blood pressure.  The reading defied comprehension. I rested a bit and took it again.  It was nominally lower, but still in the “hypertensive emergency” category.  A hypertensive emergency  is where the top number (systolic pressure) is at or over 180 millimeters of mercury (mm Hg) and the bottom number (diastolic pressure) is at or above 120 mm Hg, or higher. Mine systolic pressure was significantly higher than 180 mm Hg! I was seriously concerned that I could have a stroke! I was scared.  Then I went to dig out my glycometer to measure my blood sugar.

Hint: it is never a good thing when someone with Type 2 Diabetes does not know where their sphygmomanometer or glycometer are!

I should have known where my glycometer and sphygmomanometer were and should have been using them regularly, but I was in denial. After all, I was eating “properly”; lots of fruit and vegetables, whole grain bread and rice and while I was overweight, my weight had been stable for a long time. Okay, I was obese, but was consistently fat.  Like I said, I was in denial!

My blood sugar after lunch was 13.0 mmol/L (234 mg/dl). That was bad. I was clearly not tolerating the amount of carbohydrate in the fruit and whole grain crackers and it didn’t matter how many salad vegetables and lean protein I ate with it!  I was carbohydrate intolerant.

A few months earlier,  two women I had known from school died suddenly. Both were in healthcare.  One was a public health nurse who retired on the Friday and was dead on the Monday and the other was a care aid working in long-term care who died alone in her home of a massive heart attack.  She had been diagnosed about 8 months earlier with Type 2 Diabetes and was working with her “Diabetes Dietitian” and was diligently following the recommendations and eating 65 g of carbohydrate at each meal and 45 g at each snack. When I mentioned I had been doing a lot of reading in the literature about the application of a low carbohydrate diet in controlling Type 2 Diabetes, she said “I’m going to follow this for one year. If it doesn’t bring my numbers down enough, I will look into it“.  She didn’t live long enough for either.

Obviously she didn’t die from following the recommendations, but I have to wonder what difference 6-months on a well-designed, supervised low carb diet might have had.

The fact is, I was no example! Why should she listen to me? I was as overweight as she was (okay, we were both obese!) and I had Type 2 Diabetes for 10 years.  Who was I to suggest it if I wasn’t actually doing it?  All the scientific literature and knowledge isn’t convincing coming from an obese Dietitian.

As I sat there March 7, 2017 reflecting on my astronomical blood pressure and blood sugar, I realized I could be next in having a heart attack or stroke if I didn’t DO something. As I’ve said many times before in this blog, I should have gone to my doctor and let him prescribe blood pressure medication, medication for lowering my blood sugar and the statins for my cholesterol that would have come along with them (as he’d been recommending those for a while), but I didn’t.  What I did instead was immediately adopt a low carbohydrate diet. I designed myself a Meal Plan, as I do for my clients, based on the best evidence at the time. I’ve never looked back.

Without using any medication, here is what I was able to accomplish in one year’s time, as it appeared on Diet Doctor.

The full measurements are there, but in short, I had lost 32 pounds and lost 8 inches off my waist.  I still had 4 inches to go until my waist circumference would be half my height, but I no longer met the criteria for Type 2 Diabetes and my blood pressure ranged from between normal and pre-hypertensive. My triglycerides were ideal and I had excellent cholesterol levels.

Here is my “before” and “after” pictures now, at 21 months. I’ve lost the additional 4 inches off my waist – a foot in total! I lost a FOOT off my waist!!

In total, I’ve lost 45 pounds.

My 3-month average fasting blood glucose is 5.1 mmol/L (92 mg/dl) and 3-month overall average blood sugar is 5.4 mmol/L (97 mg/dl). I am below the diagnostic criteria for Type 2 Diabetes provided I limit the amount of carbohydrate-based foods I eat.  I expect these numbers will continue to improve now that (based on my waist circumference being half my height) it is unlikely I have fatty liver (NAFLD) disease. It will still take more time for my liver to continue to get well, as well as my pancreatic beta-cells, if recovery is possible.

I am not an “angel” when it comes to eating.  I do indulge in some dark chocolate after meals each weekend and I do taste non-low carb treats like pizza and cake. After all, this is not a diet, but a lifestyle and to be a lifestyle, it has to be sustainable.  The question for me is the same as for anyone: “how much” and “how often”.

Was it difficult? No. It really wasn’t…isn’t.

I eat real, whole food that can be as simple or complicated as I feel like preparing. It can be some store-bought BBQ chicken and a boxed salad or moussaka from scratch (which is what I’m making for dinner, tonight). I eat animal-based sometimes, plant-based other times, I eat nuts and seeds, fish, poultry of all types and a wide range of vegetables and some fruit and I include some “starchy” vegetables like winter squash and yam from time-to-time. I eat dairy such as cheese and plain Greek yogurt and I occasionally eat eggs (I am not a big “egg person”!). I eat grass-fed beef when I get it and supermarket meat, pastured chicken and the one that goes on sale when I’m picking up staples. My butter is regular, local and unsalted (not fancy imported butter) and I don’t slather it on everything.  It is just one of my fat choices along with really good olive oil and other pressed oils such as avocado oil and the occasional macadamia nut oil. If I’m craving a really good pizza, I make my Crispy Keto Pizza which is 85% the texture of a yeasty flour-based pizza. If I feel like one that’s a little less rich, I make my Crispy Cauliflower Pizza (see Recipe tab).

I usually don’t make “low carb bread”, although one of the most popular recipes on my recipe blog are my  Low Carb Kaiser buns. Here’s a picture, so you can see they are pretty legit for a sandwich and are great as hamburger buns.

I even make the occasion dessert, with my most requested being my low  carb New York Style Cheesecake (also under Recipes).

Low carb or not, I think desserts are “sometimes foods”, not “everyday foods”.  As a formerly obese person, I don’t think it’s helpful to think of dessert as a necessary part of an everyday meal.  I think they’re great for a special occasion, and make special occasions…well, special. After all, what’s not to love about a slice of cheesecake with the same number of carbs as a slice of bread, but the added fat, above and beyond what is found in the whole foods I eat is still an ‘extra’.

I invent recipes for myself that my ethnic clients find really helpful, including things such as Low Carb Roti (Indian flatbread) and Low Carb Chow Mein Noodles because I believe that a low carb lifestyle is not a “one-sized-fits-all”.

 

 

 

 

 

Everybody’s nutritional needs are different based on their stage of life, age,  gender and health conditions and people have different food preferences. What works for me may not be what’s best for you.  I design people’s Meal Plans based on the evidenced-based principles and their own preference, because it has to be sustainable.

Low Carb as a Maintenance Lifestyle

So, I’ve finally entered that wonderful phase known as “maintenance”; of needing to balance intake so I don’t continue to lose significant amounts of weight, but continue to achieve a more idea body composition (less extra fat, more muscle).  That involves adjusting my “macros” (the percentage of protein, fat and carbohydrate) as I do for my clients when they reach this stage, and continuing to engage in activity that challenges my muscles.

It’s also about continuing to evaluate (as I do for my clients) which carbohydrates I can or cannot successfully eat, and in what quantities. I know that from research studies, carbohydrate is best tolerated after eating some protein and low carb veggies (you can read more about that here) but even then a 2105 study showed that each person’s response to carbohydrate is very different (discussed in this article). For example, I found that my blood sugar is great with whole, cooked chickpeas cooked from dried but is terrible with hummus as the grinding of the chickpeas makes the starch in them more available to digestion and absorption (you can also read more about that here). So, just like I follow-up my clients who are seeking long-term weight loss and healthy improvement, I do the same for myself.

Low carb is not “magic”. It’s not like the food you eat somehow doesn’t “count”.  It has more to do with the different way our body metabolizes carbohydrate, compared with protein and fat and finding the mix of those that best achieves our goals.  For me, that setting my intake in a way that maximized lowering my blood sugar and blood pressure and achieving a normal body weight.  For someone else, it will be different. That’s why I say there is no one-sized-fits-all “low carb (or ketogenic) diet.

What are your weight loss and nutrition goals? Depending on your health and metabolic conditions, most can be realized using a well-designed, individualized, low carbohydrate Meal Plan.

Have questions?

Why not send me a note using the Contact Me form on the tab above and I will reply as soon as possible. Remember, I provide both in-person services as well as via Distance Consultation, using Skype or phone.

To our good health!

Joy

NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

You can follow me at:

       https://twitter.com/lchfRD

         https://www.facebook.com/lchfRD/

          https://plus.google.com/+JoyYKiddieMScRD

https://www.instagram.com/lchf_rd

 

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.

 

 

I Did This – a short summary of a Dietitian’s Journey

me – May 2015

Today I reached “normal body weight” according to Body Mass Index (BMI) classification  no longer obese and not even overweight. Normal. It seems surreal.

When I began my health and weight loss journey on March 5, 2017 (19 1/2 months ago) I was obese. My weight bordered between Class I and Class II Obesity and I had multiple metabolic health issues. I was diagnosed with Type 2 Diabetes 10 years earlier, had elevated blood pressure and abnormal lipids (cholesterol).  Most significantly, I was in denial as to just how ill I really was. The undergraduate and post graduate degrees on my wall did not inform reality. The mirror did.

I didn’t feel well that day and took my blood pressure. It was dangerously high— classified as a hypertensive emergency. I decided to take my blood sugar too and it was way too high. I sat and considered the numbers of both and considered my options. At the time, I only saw two choices; I could go see my doctor who would have immediately put me on multiple medications or I could change my lifestyle. In hindsight the safest option would have been to do both, but I chose instead to begin to “practice what I teach”.

You see, I had two girlfriends suddenly die of natural causes within 3 months of each other just previous to that day; one of them I had known since high school and the other since university. They were both my age, both chose careers in healthcare, just like I did, and both died from preventable causes. They spent their lives helping others get well, yet unable to accomplish the same for themselves.  It was not for lack of trying, but for not having found a solution before death ended both of their lives. March 5, 2017, I realized that if I didn’t change I would likely die of heart attack or stroke, too. Their deaths may have saved my life.

I began a low carbohydrate diet immediately. I cut refined foods, ate whole unprocessed foods, didn’t avoid the fat that came with whole foods but didn’t add tons of fat either. While it helped a great deal, after several months I realized that I needed to lower my carbohydrates further in order to achieve the remission from Type 2 Diabetes that I sought.  I didn’t simply want to lose weight — I wanted to get healthy!

I consulted the experts and continued to make dietary modifications that got me closer to my goal. The first significant improvement was in blood pressure followed by blood sugar. I lost weight and more significantly lost inches off my waist.  While I hadn’t been formerly diagnosed with non-alcoholic fatty liver disease based on my lab work I more than likely had it. I tweaked and adjusted my Meal Plan many times over the last 19 1/2 months — each time moving myself closer and closer to my goal. Ten days ago I was within an inch of my waist circumference being half my height and now I am within 3/4 of an inch of it. It’s happening!

Body Mass Index (BMI) October 17 2018

Two days ago, I got on the scale and saw a series of digits that I had not seen since my twins were born 26 years ago tomorrow. I decided to crank some numbers.  I was almost there.  The photo on the left shows the weight category form two days ago. Today it was in the normal range!

I am not one of those people that the press frequently writes about that pursued a low carbohydrate or ketogenic diet for “quick weight loss”.  I wanted to get well. I chose a low carbohydrate diet for therapeutic reasons because it was my underlying high insulin levels which drove my high blood glucose and high blood pressure. To get well, I needed to address the cause, not the symptoms.

So here I am, having reached normal body weight!

Did I think at the beginning that I would actually get to this point? I wasn’t sure. I knew it was possible because I had helped others achieve it, but had never tried myself, so I didn’t know.

For health reasons, I no longer had the option of doing nothing!

At first, I set my preliminary goal as “no longer being obese“. Then I revised it to “being less overweight“.

I found some old photos recently of what I looked like as a young adult and realized what the weight was where I felt and looked my best then reset my goal weight once again. I knew it was entirely doable!

I am almost there!

Then the hard work begins.

Losing weight has been challenging, but not difficult.  Sure, I needed to determine what was holding things up at various stages of my journey and make dietary adjustments just as I do for my clients, but it’s much easier to do that for someone else than for oneself. The “hard work” will be finding out how to eat where I don’t lose any more weight, while maintaining my blood sugar and blood pressure at the best possible level.

If possible, I want to achieve full remission from Type 2 Diabetes and if not, I will learn how to maintain full reversal of symptoms.

I’ve documented the entire process throughout “A Dietitian’s Journey”, including “fat pictures” and lab test results to demonstrate the therapeutic benefit of a low carbohydrate diet and that this lifestyle is both practical and  sustainable.

Perhaps you would like to find out how I can help you achieve your own health and nutrition goals?

Please send me a note using the form on the Contact Me tab above and I’ll be happy to reply.

To your good health!

Joy

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.

 

19 month update – A Dietitian’s Journey

This week has been 19 months since I started a low carbohydrate lifestyle and 10 months since I began following a ketogenic diet with my doctor’s and endocrinologist’s oversight and I’m very close to reaching most, if not all of my health and weight loss goals.

Weight

When I began my health and weight loss ‘journey’,  I had 30 lbs to lose to get to the preliminary weight goal that I set for myself — which was still in the overweight classification, but was the only goal that seemed theoretically attainable at the time.

When one is obese, it’s difficult to imagine being anything but “only overweight”, even for a Dietitian. As I do with my clients, I set a preliminary weight target that seemed it may be attainable.

I reached my preliminary goal weight in February of this year and said to myself “okay, now what“?  My waist circumference was still not 1/2 my height (associated with the lowest risk of cardiovascular disease, described in this article) so I carried on.

So far this year, I’ve lost 15 additional pounds and 4 more inches off my waist.

As I jokingly quipped on social media recently;

“my waist circumference is FINALLY half the height I was before I started shrinking… does that count?”

Based on my current height (an inch less than I was as a younger adult), I have another inch to lose. I’m so close!

I’m also 10 pounds from the weight I was before I had children — and given my twins will be 26 years old soon and my singleton will be 25 at Christmas, achieving my “pre-baby weight” has been a long time coming!

Me with my 3 sons in 2002

What We Believe is What We Achieve

I realized yesterday that what we believe is possible has a lot to do with what we achieve.

There are a handful of life goals that I thought I’d never achieve because I didn’t believe they were attainable, but after a few years of using a low carb approach with my clients and seeing their success, I started “practicing what I teach”… and here I am, 10 pounds from the weight I was before I had children. With having had twins and then a singleton within 14 months of each other, that is a lot of weight that was not lost previously by trying to cut calories and exercise more…plus the added weight I gained from eating foods that were a mixture of fat and carbohydrates because they were irresistible.

For the last number of months I have been steadily losing inches off my waist but without losing any weight at all. I knew that as long as I was losing either inches or pounds, I was not at a “plateau”, so I carried on.

Adapt Your Life Vancouver – September 15, 2018

September 15th, a little less than month ago, I had the opportunity to hear Dr. Eric Westman speak in Vancouver on the ketogenic diet that he uses in his own clinical practice.

Dr. Westman is Associate Professor of Medicine at Duke University Health System and the Director of the Duke Lifestyle Medicine Clinic and is an internationally known researcher specializing in low-carbohydrate nutrition. Dr. Westman is currently the Vice-President of the American Society of Bariatric Physicians and a fellow of the Obesity Society and the Society of General Internal Medicine and has co-authored three books to date, including The New Atkins for a New You (co-authored with Dr. Stephen Phinney and Dr. Jeff Volek).

I welcomed the opportunity to learn from someone that has been following a ketogenic lifestyle, researching and publishing about it and teaching it to his patients for many years.

One of things I learned was a very practical way to determine one’s idea body weight. According to Dr. Westman, it’s the adult weight that a person felt and looked their best at. The other thing that I learned was in his approach to following a strict ketogenic diet, there is a need to eliminate fruit and nuts. More on that later…

I began to think about what was the adult weight I felt and looked my best? 

I came up with what that weight was and thought to myself; “What? Really? That’s very…low!” To try to look at it more objectively, I asked myself if that weight was either unrealistic or unattainable.

My ‘best’ adult body weight is 18 pounds more than my lowest adult body weight (where overweight family members were concerned I had an eating disorder!) but is 5 pounds less than the weight I was before I had my children, including multiples. I concluded that this weight seems both attainable and realistic.

When I calculate my Ideal Body Weight, it’s the weight I was at 21 years old when family members worried about me and which was only sustained for a  very short time before my wedding. It was certainly not where my natural set point was when I was physical active and fit. That weight was where I looked and felt my best. Dr. Westman’s method made sense for me.

Calculated Ideal Body Weight

I’ve always found that calculated Ideal Body Weight (IBW) based on established formulas to be a discouraging and unattainable goal for my overweight or obese clients.

Ideal Body Weight (IBW) Formulas

Men: 50 kg + 2.3 kg for each inch over 5 feet
Women: 45.5 kg + 2.3 kg for each inch over 5 feet

Clinically, I’ve tended to use Adjusted Body Weight (ABW) as “ideal” with my overweight and obese clients as it is applicable if a person’s Actual Body Weight (what they currently weigh) is greater than 30% of the calculated Ideal Body Weight (IBW). To most, if not all of my overweight and obese clients, achieving Adjusted Body Weight usually seems like a Technicolor dream.

Adjusted Body Weight Formulas

Men and Women: IBW + 0.4 (actual weight – IBW)

For me, my Adjusted Body Weight is also the adult body weight that I felt and looked my best at so that is my next goal.

Using Dr. Westman’s method of aiming for the adult weight that I felt and looked my best, which is also my Adjusted Body Weight,  I still have ~15 pounds to lose.

The Exercise Factor

Something else I needed to factor in to my weight loss plan is the “exercise factor”. Now that my eating is no longer driven by cravings for carbohydrate, made worse by high insulin levels, I am naturally “eating less and moving more“; which is a natural outcome of eating a low carbohydrate diet, not a means to an end! I am ABLE to move more BECAUSE I am eating less!

For the last 6 weeks, I’ve been doing resistance training 4-5 times per week (using body weight, resistance bands and dumbbells and barbells) and this is resulting in me building and toning muscle.

I expected that my weight loss would be slowed because muscle is heavier, but that’s not actually happening.

Strict Ketogenic Diet – Dr. Eric Westman’s Approach

Since January (i.e. for the last 10 months) I have necessarily been following a ketogenic diet in order to lower my blood sugar to below the Diabetic range, eliminate high blood pressure and to achieve and maintain a waist circumference that is half my height. As I’ve told many of my clients, my level of carbohydrate intake is significantly lower than any Meal Plans that I have designed for others and this is because of the degree of metabolic disruption I had previously caused myself. I had been Type 2 Diabetic for 10 years, was obese and worse, was in complete denial about the health risk to myself until March 5, 2017 when this ‘journey’ began.

Dr. Westman taught at the conference was that in the weight-loss phase of a strictly ketogenic diet he recommends that his patients stick to real protein foods (meat, poultry, fish and shellfish and eggs), salad greens and low carbohydrate vegetables, plus limited quantities of healthy fats and oils, cheese and cream. What isn’t included in this phase of the ketogenic diet he has his patients follow is fruit and nuts, not even on salad.

Since I saw Dr. Westman speak on September 15th, I gave up nuts and fruit and since then, I’ve since lost 2 pounds and another 1/2 inch off my waist.

Effect on Blood Glucose

The effect of giving up fruit on blood glucose is also observable.

September 15-October 10 2018 blood glucose versus previous 2 months

During July and August it was local blueberry and blackberry season and I ate far too many, way too often. I justified that they are good antioxidants, which they are, but they are not ideal foods for someone like myself who’s been Type 2 Diabetic for 10 years…at least not at this stage of my metabolic reversal.

As can be seen in the graph of my own glucometer readings (above) my average blood glucose in July and August was 6.3 mmol/l (114 mg/dl). Since September 15th, I’ve cut out all fruit, not even a few berries on my salad and I no longer reach for nuts as part of a mid-day meal, but a hard boiled egg or hard cheese or fish, instead. My average blood glucose has dropped to 5.1 mmol/L (92 mg/dl).

Based on the literature, about half of this effect is due to the Metfomin that I continue to take (protective measure given the Alzheimer’s diagnosis of my father and family history of cardiovascular disease) and the other half is due to me having stopped eating fruit.

I am currently achieving normal blood sugar levels, which is amazing! Both my endocrinologist and I hope that in time she can withdraw the recently prescribed Metformin and I will be able to sustain my blood glucose with diet alone, once my liver and pancreas have more fully healed. Time will tell. In the meantime, I am doing everything I can do to get well and stay well.

NOTE: Keep in mind, these are my (n=1, sample set of 1) results based on my specific medical history and metabolic conditions. Since everybody’s needs are different, there is no one-size-fits-all “low carb” diet for everyone.

Perhaps you wonder how a carefully-designed low carbohydrate or ketogenic diet could help you improve symptoms of Type 2 Diabetes, lower high blood pressure or simply lose weight? Please send me a note using the “Contact Me” form above to find out more.

Feel free check out the various services that I offer under the Services tab or in the Shop and if you’d like to get started, you’ll find everything you need there.

I provide both in-person in my Coquitlam, British Columbia office or via Distance Consultation on Skype of long distance phone, so please let 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/

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 – a very short video update

This morning I went for a walk at one of my favourite places (Como Lake Park) and decided it was time to post a video update. It’s short (1:36 seconds) and stands in sharp contrast to the video that I made and posted 16 months ago on March 16, 2017 (1:35 seconds) at the very start of my low carbohydrate journey, a Dietitian’s Journey.

Looking at the two videos (posted below) there’s no mistaking how significantly overweight and out of shape I was on March 16, 2017 compared to today – and I’m not done yet.

July 25, 2018 – today’s video

March 16, 2017 – my first video

Looking at freeze-frame photos from both videos one on top of the other (below), the progress I’ve made is unmistakable.

I have 4- 1/2 years experience teaching a low carb lifestyle to my clients, and I have 16 months living it myself, with weight loss and clinical results that are visible and verifiable. You can review my latest lab test results here.

A Dietitian’s Journey – 16 month video update (March 16, 2017 – July 25, 2018)

I am no longer an obese Dietitian with uncontrolled Type 2 Diabetes, high blood pressure, abnormal cholesterol and high insulin levels.  I “practice what I teach”.

If you would like to begin your own “journey” and want the professional support of a knowledgeable Dietitian that’s been there, then please feel free to send me a note using the Contact Me form on this web page or you can send me the completed Intake and Service Option Form if you’d like to get started. I provide services via Distance Consultation using Skype or long distance telephone, as well as in-person in my office. You are welcome to begin with a single visit to get to know me and my teaching style or to take a package which will give you everything you need to get started on your own journey. A complete description of each package is available under the Services tab as well as in the Shop, with a summary on the form.

I greatly look forward to helping you recover your own health, as I’ve been able to recover my own.

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/

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.

Much More than “Eat less and Move More” – a Dietitian’s Journey

I’ve never told anyone that what they needed to do to lose weight was “eat less and move more”, but I know many of my clients have been told this by other clinicians, but who was I to talk? After all, I was an obese Dietitian.

The photo on the left was me before I began what I’ve called “my journey”, a Dietitian’s Journey.

Not only was I very overweight, but I had Type 2 Diabetes, high blood pressure and high cholesterol and was in denial about how very metabolically ill I was.

I was in denial partly because I believed that I was eating a healthy diet for someone with Type 2 Diabetes. I dutifully followed the recommended diet from the time I was pre-diabetic until I was diagnosed as having Type 2 Diabetes and continued on it because that is what was recommended to control my blood sugar. I deliberately avoided missing meals or fasting, to keep my blood sugar stable.

As per the recommendations for Diabetics, I ate 193 – 259 g of carbs per day, plus sufficient daily protein for my age and a little essential fat.  Keep in mind that only the recommended amount of daily carbs adds up to ~800 – 1000 calories per day — and with sufficient protein for my age was another ~4oo calories, plus another ~150 calories or so in olive oil and a few nuts or seeds on my salad. With intake of 1400 – 1500+ calories per day, how was I supposed to lose weight?

If “eating less” was not an option for me then of course, I was expected to “move more”.  If I didn’t move enough to burn off the excess carbohydrates that I was expected to eat as someone with Type 2 Diabetes, then this was my fault. This is why I was fat. Right?

Really?

My diet was “healthy” by most people’s understanding — certainly as defined by the Dietary Guidelines (Canada’s Food Guide) as well as the Clinical Practice Guidelines for Diabetes.  My bread was whole grain and so was my pasta and I ate brown or red cargo rice (with the husk). Lunch and dinner and my 2 snacks per day were comprised of lots of fruit and vegetables of all kinds along with some lean protein; 3-4 oz at each meal and an ounce of cheese at snacks.  I barbecued meat, fish and chicken all year round and if I did pan-fry something, I always poured off the ‘excess fat’. The quantities I ate were recommended by the guidelines and as evidenced by the fact that I neither gained nor lost any weight.

Eating 65 g of carbs at each meal along with protein and 45 g of carbs at each of 2 snacks each day along with a bit of protein however didn’t help me avoid getting Type 2 Diabetes — so what was I expecting to accomplish eating this way after I was diagnosed?* It was supposed to help me “manage my blood glucose levels”, but unfortunately after a few years of eating that way, I ended up getting high blood pressure and then abnormal cholesterol as well, which is common.

*I believe that some people with Type 2 Diabetes do well eating according to the standard recommendations of the Clinical Practice Guidelines and others by following a whole foods, Mediterranean-style Diet. There is also strong research evidence that still others achieve excellent clinical results following a therapeutic low carb or a well-formulated ketogenic diet for a period of time. There is no one-size-fits-all diet for everybody and it is for this reason that I offer people choices.

When I saw my Endocrinologist 2 1/2 years ago, she said that if I kept eating as I had been, that in 2 years I would be on medication for Diabetes, hypertension and high cholesterol and within 5 years, I would be on insulin. At that time, I discussed with her my intention to eat a low carb diet and how low in carbohydrate I was willing to go, if I needed to. I was expecting a great deal of resistance from her, given some doctors consider a low carb diet unconventional. Her response surprised me. She told me that me that eating very low carb was the best chance that I had to avoid the scenario she outlined above as well as the complications of Diabetes, including blindness and lost limbs. In fact, she recommended less grams of carbs per day than I was intending.

Unfortunately, it took another 2 years before I became metabolically unwell enough to actually begin to implement the dietary changes, but with my Endocrinologist’s approval and encouragement, as well as my GP monitoring my health, March 5, 2017 I began changing how I was eating and I’ve never looked back.

Me – July 2 2018 (16 months later)

The photo on the left is of me yesterday.

As of today, 16 months into my journey, I’ve lost;

  • 39 pounds (18 kg)
  • 10.5 inches off my waist (27 cm)
  • 2.5 inches off my chest (6.5 cm)
  • 3 inches off my neck (8 cm)
  • 1.5 inches off each arm (4 cm)
  • 1.5 inches off each thigh (4 cm)
  • Both my HbA1C and FBG are in the non-diabetic range
  • My blood pressure is normal for someone without Type 2 Diabetes
  • My lipids (cholesterol and triglycerides) are considered ideal.

I still have an inch and a half to lose off my waist to get to where my waist circumference is half my height and I’m guessing that will take me losing another 18 lbs but who knows? Whatever it is, it is.

I had a foot to lose from my waist when I started — so what’s an inch and a half more?

Now, “moving more” is possible! Yesterday, as I do most weekends, I walked for 2 hours and wasn’t tired at all. I work out each week doing slow High Intensity Training and love it and am thinking about joining a dance class in September.  “Moving more” is the result, not the solution.

Keep in mind that my results are only relevant to me, as I am “a sample-set of one” (n=1).  As well, my doctor’s recommendations to me may not be the same as your doctor’s recommendations to you. Everyone’s results following a low carb diet will differ, because each person’s Meal Plan will be based on their own medical history, any metabolic conditions they may have, medications they are taking, their family risk factors, starting weight and lifestyle factors. What my journey and yours will have in common if you’re working with me is that it will begin as a moderately low carb intake, where you’ll be eating whole foods from all food categories, with your doctor monitoring your labs and the dosage of any medication that you may be taking.  I’ll gradually lower the amount of carbohydrate you’re eating only as necessary to achieve the clinical outcome(s) that you’re seeking and with you doctor monitoring the dosage of any medications you’re taking. This often has to occur quite soon after lowering the amount of carbohydrate, and in time they may be discontinued entirely.

Some “low carb diets” available on the internet or in popular books promote unlimited amounts of meat, cream, butter and eggs and others promote (or promise) “rapid weight loss”.  I don’t do either. But if you are looking for a Dietitian to support your desire to eat a low carb diet in order to lose weight and lower metabolic markers of Type 2 Diabetes, high blood pressure or abnormal cholesterol, then I’d be glad to be part of your healthcare team.

I have almost a decade of experience providing services via Distance Consultation (Skype and long telephone) and for those living in the Lower Mainland of British Columbia you can see me in-person in my Coquitlam office.

Do you have questions about how I might be able to help you?

Please send me a note using the “Contact Me” form above and I will reply shortly.

To our good health,

Joy

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 ©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 – defeating discouragement

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

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

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

So what happened to the fat?

Here is the Science Made Simple explanation:

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

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

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

So is that why my blood sugar went up?

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

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

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

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

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

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

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

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

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

That is a lot of fat.

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

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

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

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

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

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

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

To our good health,

Joy

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 ©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 – how old would you be?

March 5, 2018, it will be one year that I’ve been following a low carb lifestyle and today I took stock of what I’ve accomplished so far and set goals of what I will accomplish this coming year.

A year ago, I set four goals;

(1) blood sugar in the non-diabetic range

(2) normal blood pressure

(3) normal / ideal cholesterol levels

(4) a waist circumference in the “at or below” recommended values of the Heart and Stroke Foundation

…and I wondered aloud in one of the first blogs in my ‘journey’;

“Will I meet all these goals?  Who knows?! But I won’t know if I don’t try and the alternative of a life of medication for blood sugar, blood pressure and eventually cholesterol too does not appeal to me!”

Well, its a year later and what have I accomplished?

(1) My HbA1C is below the cutoffs for a Diabetes diagnosis and much of the time my fasting blood glucose is as well.

(2) My blood pressure is in the normal range for someone with Type 2 Diabetes and half the time it is in the normal range for someone without it.

(3) I have normal / ideal HDL cholesterol and triglyceride levels and my LDL is in the normal range.

(4) I have a waist circumference that is within the recommended range set by the Heart and Stroke Foundation.

This is good, yes and I am pleased with my progress but I am not content to pat myself on the back, buy a new outfit and rest on my laurels. I have things I still want to accomplish and towards that end, I have set some new goals for the coming year – year two in A Dietitian’s Journey.

I have updated the above goals for this year. I want to have;

(1) HbA1C that is in below the high end of the normal range (i.e. < 5.5 % instead of 6.0%) and to consistently have fasting blood glucose that is also below the high end of the normal range (i.e. ≤ 5.0 mmol/L | 90 mg/dl instead of 5.5 mmol/L | 99 mg/dl),

(2) blood pressure that is in the normal  range for healthy adults without Diabetes,

(3) normal to ideal triglyceride and cholesterol levels – as good, or better than currently,

(4) a waist circumference to be half my height based on research covered in an earlier article,

(5) I want to be fit.

So what is “fit“?

I think that most people think of fitness in terms of what is usual for people of the same age and gender. If that’s the case, I definitely do NOT want that!

I want to be fit enough to shovel the snow off my driveway without needing a break. I want to be fit enough to carry in two 20 kg bags of salt myself – one in each hand.  I want to chop the firewood for my fireplace and stack it myself and I want to be able to change the tire on my car myself, if need be. I can do those things now, but I want to keep being able to do that as the years go on.  I don’t want to be one of those “women of a certain age” that sit in a chair doing “seniors fitness”! I want to be able to manage a resistance or weight training workout of women half my age, when I am in my 60’s and 70’s. Heck I want to live a full and productive life like I do now, when I’m “old”.

My grandmother and I

My grandmother lived until the age of 104 years and was in good health until a few months before she died and like many seniors, it was a ‘fall’ that began the health failure cascade that eventually ended her life.

If I begin strengthening my muscles now, I won’t become one of those frail seniors with spindly little legs. That’s what I mean by “fit”.

With the encouragement of a few doctors that I know that are quite a bit younger that I am, but considerably more knowledgeable in this area, I’ve decided to get fit following two main recommendations;

(1) eat sufficient protein to prevent sarcopenia, the visible loss of muscle mass and strength that is commonly associated with aging

and

(2) to practice high intensity training (HIT) to build up my muscles, so that they are the healthiest they can be for my age.

Something I have learned by listening to the lectures of Dr. Donald Layman (on protein requirement as we age) and to Dr. Doug McGuff (on strength training for health and longevity) is that what is common as people age is not what is normal

It is common in our society to see older adults with muscle loss, however when we look at seniors in other cultures, this is not normal.

Okinawan senior woman, farming

The seniors of Okinawa, Japan for example continue to do manual jobs and practice martial arts well into their 80’s and 90’s and the aborigines of Australia remain lean and fit as seniors.

 

 

Aborigine senior

This is “normal“.

 

 

 

We’ve confused “common” with “normal” and instead of visualizing seniors exercising looking like this;

Okinawan man practicing karate

…all too often, we picture this:

“seniors exercising”
“Weight training in your twilight years” – Global News

An article last year on Global News titled “weight training in your twilight years” had the picture to the left accompanying it – as if all one can reasonably expect from a woman in her 60’s is to be able to lift a 1 pound weight.

No, that is not fitness.

 

…which brings me back to my last goal. I want to be ‘fit’ the way it is normal to be fit – not what is commonly viewed as fitness for “women of a certain age”.

I want to eat optimally and function optimally because anything else is less than what we were created to do and be. This means continuing to eat low carb because as someone who met all the criteria for Metabolic Syndrome, including obesity, Type 2 Diabetes, high blood pressure and high cholesterol, this is what it will take to keep those diseases and disorders in remission. It also means strength training my muscles and eating sufficient protein to accrue new muscle – not to become a body builder, but to be a fit woman.

Final Thoughts…

In the lecture given by Dr. Doug McGuff on strength training for health and longevity that I watched, he told the story of Satchel Paige (1906-1982), considered the best pitcher in baseball history and who began pitching at the age of 42 years.

One of the quotes he is renowned for happens to hang on the wall in my client bathroom and reads;

“How old would you be if you didn’t know how old you are?”

– Satchel Paige

 

My grandmother was often mistaken for a woman 20 years her junior right up until the last year or two of her life because she didn’t “act old”.  She lived in an apartment for seniors and cooked her own porridge each morning and in good weather walked to the local shopping center two blocks away until she was a centenarian.

I want to be that kind of senior!

And so, as I close off the first year of A Dietitian’s Journey, I begin the second with goals having been met and new ones to be achieved.

So let me ask you this, “how old would you be if you didn’t know how old you are?”.

Have questions about how I can help?

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.

A Dietitian’s Journey – competent to counsel

A week or two ago, there was some discussion on a Twitter thread that some “wouldn’t trust a fat Dietitian” and yesterday I was told “once you get in shape then you can dish out advice” – as if my past or current health status makes me less credible or competent to counsel others. Both of these got me thinking, is a ‘slim Dietitian’ really more credible? What is a Dietitian’s credibility and competency based on?

There is no question that there is a ‘fat bias’ and am not arguing whether there should be or shouldn’t be, but what makes any clinician credible is the scientific evidence on which we stand. What makes me credible in teaching others to follow a low carb / keto lifestyle has nothing to do with my body weight; it has to do with the 76 studies with almost 7000 subjects over the past 18 years which provides the scientific basis on which I base my practice. What makes me competent to counsel is my education, as well as my experience in clinical practice.

I have a post graduate degree in Human Nutrition, am a published researcher and have over a decade of experience in private practice and my learning didn’t stop there.  If it had, I would not have made the transition in thinking that I did approximately 3 years ago. It took a huge amount of research and reading and very strong scientific evidence for me to come to the conviction that what constitutes best-practice in helping people address overweight, obesity and insulin resistance, including Type 2 Diabetes is following a low carb / keto lifestyle. I continue to spend most of my free time reading scientific studies in order to more fully understand the strength of the evidence on which my clinical practice is based.

Competence is the ability to achieve a desired result and my ability to help others lose weight and lower their metabolic markers is independent of my body mass. My competence is dependent on the scientific research.

My current body weight does not make me less competent to counsel others. I am a “sample set of one” (n=1) and my personal health and weight-loss journey is just that – personal, anecdotal evidence. It encourages my clients and those that read my articles that I actually understand what is involved in living a low carb / keto lifestyle, and when I say that it can be done fairly easily and over the long-term, I know this first-hand.

Someone pointing out that I am not skinny is not news, as my past and current health status is on my web page and plastered all over the internet in Technicolor, for all the world to see. But, eleven months ago, I was an obese Dietitian with a host of metabolic issues including Type 2 Diabetes, hypertension, dyslipidemia, high visceral adipose, etc.). I was the poster woman for Metabolic Syndrome. I started “practicing what I preach” and the results speak for themselves.

My progress is well documented, I’ve lost 35 pounds, 7½ inches off my waist and have only 2 ½ more inches to lose to achieve an ideal waist to height ratio. I am in partial remission from my Type 2 Diabetes, have almost normal blood pressure and have a lipid profile that is considered ‘ideal’, and no longer take medication for chronic gastroesophageal reflux disease (GERD) – something I have done for years.

If you want to read the technical details of my progress, you can read this article.

…and I have the mirror.

Eleven months ago (March 16 2017), this is what I looked like;

March 16 2017

Today, this is what I look like:

January 28 2018

Sure, I still have 15 pounds to lose to be in the normal weight category and probably closer to 25 pounds to lose to be at my ideal body weight and waist circumference, but eating low carb isn’t a ‘diet’ for me, but a permanent change in lifestyle. It has to be because of the degree to which I have become intolerant to more than a small amount of carbohydrate. I just need to keep doing what I am doing and continued improved health and appearance will come. This is my journey.

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

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 – 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

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/lchfRD/

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 protein, decreasing 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

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 – 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

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