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Diabetes Update: Tweaking The Diet

October 10, 2012

I’m now well into the second year of major changes to the diet, which I’ve described before, but perhaps could stand a little recap.

In July of 2011, I was diagnosed with diabetes, scoring a solid 10.0 on my HbA1c, a fasting glucose level of 213, and blood pressure in the 160/110 range.  Over the prior six months, I’d lost 25-30 lbs. as my body had begun rejecting more and more of my high-carb diet, ejecting as much excess sugar as possible through my urine.

Ultimately, I rejected my prescribed treatment of Metformin and determined to see if I could fix the problem through diet and excersize….again covered in the above referenced article.  I was quickly – within 1-1/2 weeks – able to regulate my blood sugars and began losing weight at a rate of 2 lbs. per week, bottoming out at 188 lbs within five months.  Along with the diabetes induced weight loss, a total of 77 lbs was lost.  My first post-diagnosis blood panel indicated an HbA1c of 4.9.  By month 7 or so, I was also off the prescribed blood pressure meds, typically producing readings in the range of 115/75.

The diet that I’d followed was, generally speaking, merely low-carb, though I tend to describe it as a paleo-style diet.  But, the low-carb label is a bit more accurate.  For one thing, I do consume dairy products, though very little milk….mostly cheese, half-n-half, heavy cream, and Greek-style yogurt.  As much as possible, however, I seek raw milk and, likewise, tend towards grass-fed or wild meats and fish, and organic eggs.  Naturally, I consume as much vegetables as I can stand and a couple of smallish servings of fruit each day.

This is a high-protein and high-fat diet that, in my experience, has produced excellent results:  high energy, consistent fat burning, and easy satisfaction of hunger.  Though I’ve not followed through with more blood testing (will probably resume again soon), the initial tests indicated significant improvement in my cholesterol….meaning increased HDL, big decline in Triglycerides, and little change to LDL.  Though my total cholesterol wasn’t terrible (by conventional guidelines) it did improve on this diet.

OK, enough recap, on to the “tweaks”.

Issue #1:  As noted above, I “bottomed out” at 188 lbs, around Christmas 2011.  Since that time, I’ve gained approximately 12 lbs over roughly 9 months.  At 188, however, I had estimated my body fat at around 16%, indicating 30 lbs of fat, 158 lbs of lean.  In June 2012 (six months later), I estimated 12% body fat at 196 lbs, indicating 23.5 lbs of fat, 172.5 lbs of lean.  Net change:  +14.5 lbs of lean, -6.5 lbs of fat.  In other words, I’d continued to lose approximately 1 lb of fat per month and gain a little more than 2 lbs of lean.

Of course, some changes had already crept into the diet over the New Year.  For one thing, I was eating more, mostly protein, something that, apparently, made a huge difference,  Yes, my weight loss stopped.  My body, however, was clearly taking that protein and putting it to good use.  All in all, my protein intake had “crept up” to roughly 1 gram or so per Kg (+/-180 grams) per day.

I’ve mentioned this data to a number of fellow-fitness-freaks, some who’ve called me a liar.  So be it.  There’s simply not prepared to believe that a 52-year-old man can add 2 lbs of lean mass per month with fairly light physical training.  My exercise regimen, it should be noted, involves 3-4 hours of light activity per week with, perhaps, 30 minutes of HIIT (high intensity interval training) thrown in….usually some weights and sprints.  Nothing extreme.  I try to take a 30 minute walk or bike ride each day and try to throw in 5-10 minutes of HIIT activities along with it, moving the focus from one muscle group to another, usually skipping a day or two following any weight training.

Working with numbers (as I do), I can extrapolate better than most folks…I just do it out of habit.  Continuing this trend for another six months, I would expect to hit a weight of 210 with body fat in the range of 8% to 9%.  One problem:  I really don’t want to be that bulked up, though I am targeting an eventual body fat in the 8% range.  As a consequence, I’ve started laying off a bit more of the HIIT routine, and tried substituting more low-grade activity in the shop.

Of course, I’m also eating less as a result, most of my rising intake resulting from exercise induced hunger.  So far, the results seem positive, I’ve lost a couple of lbs over the past month, increasing my fat-loss to 2-3 lbs per month, without gaining much new muscle mass…meaning I might get to 8% body fat a little sooner.

Don’t get me wrong, I think muscles are good…I’ve intentionally tried to build new muscles as part of the diabetes treatment…but there is a limit, right?

Issue #2:  As noted by other authors, there is a tendency of low-carb, high-fat diets to induce “physiological insulin resistance“.  On top of that, excess protein can also contribute to rising blood glucose levels.   I’ve experienced both effect, I believe, though it may not be all that problematic.  While during the weight-loss phase of my diet I consistently produced fasting glucose levels in the 85-90 range.  Since the new year, however, levels nearer to 105 have been more common.  Since I haven’t had a recent HbA1c test, I don’t really know what the overall effect has been, but it’s possible that my levels have crept up.

As noted in the above articles, these mechanisms are completely natural and useful, ensuring that:  a) the brain gets enough glucose and b) that excess protein in metabolized.  As my body composition has changed, I’m just discovering some useful parameters to the diet that may need to change with it.

For instance, my initial responses to the rising FBG numbers were to cut more carbs from the diet and to extend the fasting periods of the day…mostly eating dinner earlier and breakfast later.  That hasn’t helped all that much.  At this point, my carb intake has also, sort of naturally, declined to closer to the range of 60-70 grams per day, from my initial target near 100 grams per day.  In some ways, this demonstrates the likelihood that my body is simply ensuring that there is sufficient glucose available for brain function, albeit at a fairly modest level.

I’ve theorized that there would be a point at which I’d very probably need to increase my carb intake, if for no other reason than to halt the weight loss.  I’ve discovered of course, that the body will gain weight with calories from fat and protein, ha, ha.  A number of authors have discussed carb re-feeding, which is something I will probably decide to try in the near future.

Issue #3:  I’ve continued to study issues related to dietary fat and cholesterol and have been persuaded that quite a lot of what passes for conventional wisdom is pure bupkis.  Some, however, is worthy of note, specifically the issue of omega-3 fatty acids.  One of the reasons I don’t fall into the classical “paleo” category is that I (thus far) refuse to give up dairy.  In this regard, that puts me rather squarely into the Weston A. Price Follower (WAPF) camp.  (Note:  I’d provide a link, but their website appears to be suffering some virus issues at the moment.)  In a nutshell, the WAP philosophy focusses on whole, natural foods, including grass-fed meats and raw dairy.

Now, I understand some of the concern and/or criticism of dairy, particularly the form of casein that is prevalent in most American dairy.  Then, too, there are those that have (probably) legitimate issues with lactose.  Still, dairy is a great source of protein and a generally beneficial ratio of omega-6 to omega-3 fatty acids….one that greatly improves with pasture grazing.  In any regard, this remains an area where my diet could stand a little improvement, seeking out more omega-3 rich foods and cutting some of my remaining omega-6 rich foods (like my almonds).  So, more fish, more olives, more walnuts for me.

Another change that has occurred naturally over the past six months has been an increase in my egg consumption.  When possible, I’m eating farm raised eggs, but that hasn’t kept up, since I’m probably consuming close to 2 dozen per week.  We’ve plans to start raising our own chickens, which should help again with the omega-3/omega-6 issue, but (for those who’ve kept up) the old cholesterol issues with eggs – and saturated fat generally speaking – has been sufficiently debunked (IMHO) that I’m reasonably comfortable with this change.

I know this about my diet:  it increases my HDL levels, it reduces my triglycerides, and it increases the likelihood of beneficial (fluffly) LDL.  Either way, more evidence is being produced that amplifies the critically important function of cholesterol in the body and the disastrous consequences of reducing it.  As noted in one of the above-linked articles, if the goal is reducing arterial plaque, reducing cholesterol is not the way to do it, reducing the chronic inflammation that leads to plaque (no matter what it’s made of) is.

Final Comments

All things considered, I think my diet “experiment” is working out rather well.  I’m clearly more fit than ever, though it remains to be seen just how much irreversible damage may have been done to my insulin production and/or sensitivity.  My doctor absolutely refused to approve an insulin test (one reason I’ve been less than enthusiastic about returning) and I’ve been reluctant to request a glucose tolerance test (GTT).  In fact, I’ve very little concern at the moment about these issues since I’ve no real desire to replace the grain/starch components of my “old” diet.  I’m not really missing anything.  In the end, that may be one of the best things about this “new diet”.  After more than one year, I’m still on it and am completely satisfied.

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