PHD: note to self

The design of a Perfect Health Diet  meal is found in the body of the apple. Assuming two meals a day, the recipe is to combine:

• A safe starch (roughly 230 grams, which translates to 150 to 300 carb calories);
• A meat, fish, or egg (110-230 grams);
• A sauce made up of fats and acids such as lemon juice or vinegar;
• Vegetables, preferably including fermented vegetables with their healthy acids;
• (Optionally) some dairy or a glass of wine.

This is precisely the recipe which science has found minimizes the elevation of blood glucose after meals.

It seems reasonable to expect that a meal designed in this fashion will have a glycemic index around 30. The odds of 200 carb calories with a glycemic index of 30 generating blood sugar levels that are dangerous – 140 mg/dl (7.7 mmol) or higher – in healthy people is very low. Even in diabetics, it may be uncommon.

So, yes, Virginia. There is a Santa Claus, and you can eat safe starches and avoid hyperglycemia too!

Is it 'safe'? Starch my innards.

Over most of last year I shifted my diet away from low carbohydrate high fat  to lowish carbohydrate high fat + safe starches.

The notion of 'safe' starch may seem weird unless you have been steeped in low carb Paleo diet lore. 

Therein lies a debate...

...which I don't want to get into.

Nor am I going to bring you up to speed. You can Google 'safe starches' yourself.

But I will give you my anecdotal 2 bob's worth:

1. Much of this Paleo thing misrepresents the eating habits of 'ancestral' peoples -- ye olde hunter gatherers.To presume that 'their' diet was overwhelmingly low carb etcetera is not correct. Traditional diets certainly varied between environments but they were not exclusively as the Paleo-ists argue.
2. That said there are some problem foods in the transition out of hunter gatherer-dom -- foods like milk and grains (and more recently -- sugar and vegetable oils). As Vanessa Haynes points out:"The idea behind it is that our DNA profile determines that we should live in that way because for 190,000 years we were hunter gatherers. .... The modern diet, especially in the United States, is not probably the healthiest and probably not in Australia either. So educating children about eating naturally, I have no problem with that. Whether it should be the paleo diet, I think we have to be careful of that because we have had 10,000 years of adaptation to agriculture. Have we adapted to grains? Because the true hunter gatherer can't eat grains either. They have not adapted to drinking milk. But yet most Europeans have adapted to drinking milk. So we've got to take these adaptations into consideration."
3. While eating low carb (under 100 grams/day) I found that on those occasions I didn't (ie: ate more) my blood sugar spiked. You may think that's to be expected and while that may be presumed, the fact that the whole insulin response system wasn't being challenged meant that when it was it tended to over-react.So more carbs routinely rather than much less is probably a good thing -- for me anyway.
4. Because I was routinely taking blood glucose readings after meals I discovered that I could tolerate some carbs more than others...and the ones I'm tolerating the most are -- that's right -- the ones often referred to as 'safe' starches. I'm a bit touchy with rice but potatoes, sweet potatoes and the like come in under blood sugar budget. That is, so long as I don't pig out.
5. So I'm back eating these starches. Potatoes. Sweet potatoes. Yams. Oca (New Zealand Yam).  Rice ...and any  other, often exotic, starchy vegetable I can find and tolerate. But no bread. No sugar. No wheat. No pasta. No dried legumes. Since I can grow a lot of these veg, I'm on a great culinary and horticultural journey.
6. But the trick is in the mix. Starches plus....vinegar or yogurt or fats or pickles or some other acid or oil. No vegetable oils. A few nuts. Any other veg. I don't eat much fruit -- more from habit rather than preference.
7. And it's all good. I have more energy. I put on weight initially but now it is coming off. My gut is happier and my gastronomical universe has expanded.I'm eating about 400-500 grams of  these starches each day.My menu planning is easier and I've learnt to respect the nutritional value of these starchy foods -- not so much white rice, but the tubers are nutritionally rich.
8. I eat other veg of course -- especially colourful root vegetables, cucurbits, greens and herbs -- and meat (mainly lamb as it's my passion), fish and eggs. Steamed or boiled chicken. A little bit of pork. 
9. Blood sugars: doing fine. Occasionally pass my target threshold of 6.7 mmol one hour after meals but well within acceptable frequencies for a person with Type II Diabetes.
10. So all good...and I love these starches! It's like I've broken a fast. When you move away from a dependence on wheat flours and corn ... and base your meals on these other starches the menu is very different.
11. My regret is that I've drifted some way from my preferred Arab and Mediterranean culinary preferences as I'm now locating my menu hunting in the great tuber growing cultures of the world. But there are adaptions. The Koreans, for instance, make an awesome noodle out of sweet potato starch -- dangmyeon. And then there is the big wide world of rice noodles....
12. You can do a lot with tubers....
13. I don't drink much pure milk -- except a dash in tea -- but yogurt I indulge in.Yogurt is the primary solution to 'adapting' to milk...that and cheeses. 

Getting my mojo back...with both hands.

When last we jawed  about dietary matters  I discussed 'safe' starches

See: Adventure in food combining

and noted that I was experimenting with upping my carbohydrate intake by consuming a few foods that were previously frowned upon in the LCHF (low carb/high fat) menu. My major interest was chomping on potatoes -- both sweet and white -- and experimenting with other starches like Taro, Yams and white rice.

No grains -- aside from rice: no bread, for instance, no pastry -- at all. 

That was my project.

Starching up

The first consequence -- albeit a subjective one -- is that I have more energy. I wouldn't be alone in that. Those who have been eating  ketogenic -- low carb, say below 100 grams/day -- do note more verve when they up their carbohydrate intake.  I appreciate the change.  

However, my blood sugar has bounced around a bit post meals. I had been living at around 6.7 mmol -- an hour after eating (and points below) -- as a sort of blood glucose formatted lifestyle. This was well within 'normal' range despite my diabetes.

Since consuming the spuds and such my blood readings have gone up post cibum (pc) maybe something like 1 mmol. The problem is:

• that if I eat a lot of starches my blood glucose goes up even more -- say if I pig out on roasted potatoes; and
• that I respond to rice more sharply than I do to the tubers. 

The takeaway message is, of course, that while I can eat this stuff, I need to watch my serving sizes. 

Nonetheless, I haven't put on weight, my gut feels better and fuller; and my menu options have expanded greatly while I explore the wonderful world of vegetables that grow under the earth. 

I've still got more work to do combining foods. I try to cut my meals with an acid like vinegar (as in pickles or salad) or yogurt. I also try to to eat with a reasonable fat quotient on the plate. These are strategies that have been proven to reduce the blood glucose peaks by impacting on a meal's Glycemic Load.

I'm also taking a tablespoon or so of Potato Starch each day...in a glass of water -- as a rich source of Resistant Starch . While Resistant Starches impact on gut health by altering intestinal flora more in favour of the good guys, they also moderate blood glucose. Indeed, I find my blood sugar levels to be more stable and predictable and my gut more settled than it has ever been. 

All very benign, really.

Kosher.

In fact once I've practiced these changes a bit more I suspect that my 'diabetes episode' is over. I'm not saying I'm 'cured' but that I have engineered habits of daily living that keep my hormonal Islets of Langerhans  pathology in place.

Nonetheless my blood pressure is still in the hypertensive range -- perhaps on average 10  mmHg higher than I'd like. Indeed while I have bought my Systolic BP down by 10 mmHg I am still short of the 'sweet zone' --esp with Diabetes hanging over me. 

On this matter I'm out of creative options for the moment. Lose weight? Exercise more? I suspect that my blood pressure gets elevated like it does by sleep issues. So we're talking overnight apnoea. But I'm not sleeping with one of those horrible CPAP machines strapped to my face!

I guess you can't get everything you wish for...

Exercise and dancing

As part of these changes I've altered my exercise regime.This didn't happen consciously or to any plan. I'd been so ill over the past year that I found it hard to sustain my previous kickbike, dog walking and HIIT weight lifting habits.

What I did sustain, and what sustained me, was the dancing.

See “Those who dance are considered insane by those who cannot hear the music.” ― George Carlin

So today that's the centrepiece. No threat. Creative. A very easy routine. I still love the kickbiking and the dog walking (now with funky music in my ear)...but the HIIT has gone off the agenda and I'm waiting for the chutzpah to start canoeing again. 

It's not that I've suddenly upped my dancing time. I suspect I've become a better dancer so each session offers me more as my body adapts to the funkier me. In fact, my body 'feels' the best it has felt for years in terms of mobility and movement awareness. I'm more flexible (when I'm not stiff and sore).

After all that kettlebell and dumbbell lifting , all that gritted teeth exertion and grunting, the somatic zone offered by dance has had a greater impact on my existence than all that other sweat. It's like Tai Chi Chuan to music. I guess what they waffle on about 'the core' is for real. It's just that you have to find your own way there.

For me its via dance and kickbiking.

Now that I walk with music in my ear my pace has picked up because of the push off and drive offered by the funky vibes I'm listening to. It's strutting'. I'm more sprightly despite my usual episodes of crippling stiffness and pain. (I gotta have my quotient of those!)

And I try to be active throughout the day. In that regard I'm working in the garden every day, just as I've trained myself not to spend long sessions on the computer without a stand up and walkaround break.

Regrettably my concentration is shallow.I suspect this is the lingering consequence of the past year's ill health angst. It spent me a bit. I've paid a price.

I'll know I've moved on when I get back to cartooning and making comics. There's a tragedy in the fact that I was cartooning so well (or so I thought)  -- and so routinely -- before I lost my mojo. 

But now I'm getting it back...with both hands.

I guess you can't get everything you wish for... You just gotta be patient, right?

Adventure in food combining

The PHD 

It is probably a very human trait to obsess over our food.

We are diet snobs. If not for religious purposes we'll format our menu on ethical or health grounds.

I'm no different -- but since I'm diabetic, 'diet' becomes a bigger issue for me as I want to keep my  blood glucose levels in control.

But being diabetic also means I can eat something and an hour or so later, test my blood to see how the food is impacting on my body.

I get to measure my own pathology.

Aside from some key very generic health symptoms,  blood glucose readings will decide if you are diabetic and how much of a diabetic you are.

After 3-4 years of eating a low carbohydrate diet (actually LCHF: Low carb/high fat) my blood glucose picture is such that I now usually fall within the 'normal range' :

 However, shortly after eating, the blood glucose level may rise, in non-diabetics, temporarily up to 7.8 mmol/L (140 mg/dL) or slightly more. For people with diabetes maintaining 'tight diabetes control', the American Diabetes Association recommends a post-meal glucose level of less than 10 mmol/L (180 mg/dL) and a fasting plasma glucose of 3.9 to 7.2 mmol/L (70–130 mg/dL).

Even after a meal my blood glucose seldom goes above 6.3-6.7 mmol, and breaching 7 mmol is, for me, rarer still.

So eating low carb works...for me.

However, over these years I've experimented with some dense carbs like sweet potatoes and white rice. Despite this indulgence -- my occasional splurge seldom led to major spikes in my blood sugar.

Why not? Aren't they as cabohydratey as a loaf of bread or a jar of honey?Am I not diabetic?

In short: no. Some carbs are kosher and they're called  safe starches. Not every gram of carbohydrate is equal.

Part of the background story relates to the question of Resistant Starch. Resistant Starch (RS) is starch and starch degradation products that escape from digestion in the small intestine of healthy individuals. It is resistant to digestion.

But there is more to the story too when you look at these safe starches.

• they are tubers, white rice and the like 
• they are not grains (ie: grass seeds, except for the rice)  

The key question is what these starches break down to.Therein lies a scientific debate which I won't go into. You'll have to do your own Googling.

But the 'concept' begins to explain my easy response to the carb dense foods I occasionally indulged in : white rice and sweet potatoes. These happen to be core 'safe starches'.

But that's  not the full story. It's also a question of how these foods are eaten and with what. And therein lies a fascinating story that relates to some challenging  anthropology.

Examples: Kitava, Okinawans, Tukisenta all eat very high carb and are all free from modern inflammatory diseases.

The whole rationale for the low carb menu -- and its buddy, the paleo diet  --  suffers from the complication that many societies survived and thrived on high carbohydrate foods without the western diet type consequences of  massive incidences of obesity, heart disease and diabetes.

How is that possible if eating low carb tucker was supposedly the best of all possible dietary regimes god for all peeps?

That conundrum is where some of the online low carbers are trying to deal with and probably the best synthesis of that to register so far is the work of  Paul Jaminet and Shou-Ching Shih Jaminet.

Of course there is a lot of spin and rhetoric in the mix. But I can garner  enough  to register my own takeaways.

1. safe starches are kosher: go ahead, you  can eat them so long as you recognise that people are different  and responses will vary.
2. but make sure you eat your safe starches with fats, acids (like pickles, vinegar or yogurt) at the same meal along with your surfeit of meat, fish and eggs. The mix changes the digestive process esp as regards glycemic load.

Simple.

Of course I can't go chomping through starches willy nilly -- even 'safe' ones -- because I'm still diabetic so I need to take care as to quantities I put in my mouth. But that's something I need to experiment with. But with my trusty blood test kit at my elbow  I'm set up as my own laboratory..

LCHF weight loss? Plateau frustration.

Because my Summer was a tough one I put on 3-4 kgm -- and it ain't coming off in a hurry.

In the scheme of things maybe that's not a big deal, but if adipose tissue is granted an inch it may take you out a mile.

I'm still carrying a  lot more weight than the official body image data recommends. Despite what I eat/despite what I do.

I suspect that after a certain age losing weight becomes much more difficult. But then a lot of what I carry around is the denser, heavier muscle meat rather than fat because I do exercise one helluva lot. Unfortunately I carry my obesity about in the worse place for a bloke: in my abdomen.

Nonetheless, give or take a couple of kilograms, I have lost 10 kgms over the past couple of years by pursuing a low carbohydrate regime. And, until last Summer, I maintained that weight loss effortlessly. The genesis of the weight gain wasn't what I ate but that I was less active because of pain and stiffness due to Fibromyalgia festering in the Summer humidity.

I'm sure I can get back to where I recently came from....and therein hangs a challenge.

Metformin

I eat well and in the main I do indeed eat low down the carbohydratic totem pole. I suspect I consume around or under 100 grams of carbohydrate per day.  I know that that is the case because my blood sugars register between 4.2 and 6.2 mmol but usually I'm flagging fives, despite my low dose (500 mgm) of  Metformin.

So my diabetes is being 'controlled' -- sort of -- by diet. (You can't/I can't  cure it.) Therefore, thought I, since I have been such a good boy  maybe I could stop taking the drug.

So that's what I did: stopped taking Metformin. Gone cold turkey.

The main reason I did this is simple: Metformin' s primary side effect (experienced by up to 50% of its users) is diarrhoea, and I was suffering from that big time. In fact  that condition was worsening.

So far so good. There has been no major change in my blood sugar readings. If there is, I'll need to shave back my carb intake and fiddle with my exercise regime  some more.

Weight loss

That still leaves the chronic problem of  me being overweight. When you know you can lose weight and you know  that taking off x number of kilograms will mean that is x number of kilograms you won't have to drag around all day/every day ... the quest is like a chimera.

If only....

I'd like to lose another 5 kgm at least...making my total weight loss 15 kgm. That's a good result by 'diet industry'  standards and should be feasible without me getting all angsty or depressed if I don't attain that figure.

It also gives me something to do: an in-house project.

The question is: how am I gonna get there? What are my options?

1. LCHF. The diet regime I pursue is Low Carb High Fat so I'm tweaking that some more. I know it works. I eat very well indeed. It's sustainable long term. Suits me fine.  I just have to shave back my carb intake some more, at least for a while...and eat more fat (like coconut oil, which isnt my favorite)!
2. More exercise? I do plenty already and am master of my activities, but to my High Intensity Interval Training regime I've added rope skipping. That I have to lift my heavy frame so many times into the air per minute against the  forces of gravity must amount to lift offs of some significance. That a person my age skips surely must add more bounce to my ageing ounce. I used to rope skip/jump and I love it. It was a personal goal and I get a lot of satisfaction skipping as relentlessly as I can like a boxer training for a  fight.
3. Activity. My habit has been to often lie down during the day. I carry so much fatigue, stiffness and pain around that a good lie down -- a siesta -- has sustained me for years. The problem is that resting routinely like that drags down my metabolism and switches off a range of somatic challenges. So I've engineered more stand up into my day. I'm less sedentary. I no longer sit longer than 25 minutes at a time. I move around more and don't lie down during the day. I will nap after my evening meal for an hour or a couple of hours...and that will get me through each 24 hour period.  But in daylight I'm active and upright. My approach here has been fostered by the notions explored in Sitting Kills, Moving Heals: How Everyday Movement Will Prevent Pain, Illness, and Early Death  and Exercise Alone Won't by Joan Vernikos but the approach promoted by N.E.A.T is in the same parameter.

For now that's the limit of my imagination and creativity....

[The Weight Loss? graphic figures above are avatar mock ups of what I may look like now with my current weight and what I could look like if I took off some more.]

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Blood Sugar Adventures : three years on with diabetes

"Getting" diabetes ( albeit the Number Two kind)  was a terrible blow for me. Not only did I get to take on a range of yucky symptoms with potentially bad endings   but the diagnosis was a big shock to  my psyche.

Since I already had chronic ill  health what I didn't need in life was another layer of malady.

But three  years on, after due attention to tweaking my diet and lifestyle I can confidently say that I've 'dealt' with it.

While I  wish it would go away and never come back -- that's not gonna happen. It's in the fam gene pool, unfortunately, and I did well to starve it off or as long as I did.

I coulda done better if I knew what I now know.

But then, that's life, right?

Hindsight is a brutal bugger. Always right but never around when you need it most.

The good news is that I've just cut my diabetes meds in half. I do that and my blood sugar readings are still at fours and fives. That's sorta 'normal'...remarkably normal.

I've been able to do that because...well that's  the inspiring part:

• Because I tweaked my exercise regime to improve my insulin sensitivity. In that regard I dips my lid to High Intensity Interval Training (HIIT) and lifting weights. I do, however, do a lot of exercise.
• Because I embraced a low carbohydrate diet -- and more recently  with greater success -- a Low Carbohydrate High Fat (LCHF) diet. Diabetics have to obsess about what they put in their mouths and in my case I'm eating low on the carb hierarchy:maybe 50-70 grams/day -- usually under 100 grams each day.

To do all this I more or less ignored my doctors. Not that they were telling me wrong but that they are constrained by a certain old school  and very generic point of view. (Diabetic diets is still a hot potato issue).

I still have a problem  with blood pressure which is a diabetic's  dead hand but if I can get that down further I'm sweet. 

Elevated BP is a family curse -- but , of course, as chance would have it, not from the side that passes on the diabetes!

Just on the doctor thing...Before I became a  client at a local indigenous health centre (and I'm not indigenous but they let me attend as a Migloo) local GPs treated my worsening blood sugar picture almost with fatalistic disdain.

"You're pre-diabetic (6-7 mmol/L), Mr Riley. (How about that...) Ok -- piss off."

Among Murris and Torress Strait Islanders, diabetes is a plague so the centre is geared to actively intervene and diagnose. Every visit included blood pressure and blood sugar monitoring. 

I owe so much of my  better health today to the team there...even if I do now customise my treatment regime.

I try to tell people -- if you are on a short list for diabetes (ie: you're over weight, sedentary and/or have a family history of diabetes) do stuff now so that you hold off crossing the nasty blood sugar threshold. If your blood sugar is OK, work to keep it that way. If it's 'pre-diabetic' work even harder.

If it is not being tested (and you are over 50) -- demand that it should be at every opportunity.

You don't want diabetes...at all. It's a bummer all round.

 That you could prevent it -- or at least slow its onset -- has to be a wonderful option.

In my case, a range of symptoms kicked in  and the friggin quacks never thought of seriously monitoring  my blood sugar levels...and when they rose: "Umph!"

That's "general practice" for you in the context of massive increases in the incidence of diabetes across all local populations.

4%  of Australians have diabetes. That's around 898,000 people.
This rate has risen from 1.5% in 1989.

So now I'm diabetes paranoid. People tell me stries about their bood picture with s casual indifference( over 12 mmol/L for one family member) and I think: what the f...! Do they realize how much damage  is happening to their body every time they put food in their mouths? We're talking major health complications and a greatly shortened life span.

Diabetes is  a real nasty. If you are on the short list for it there is one absolute necessity you have to do: Test. Test. Test.

Without pricking your finger and monitoring your own blood picture with blood glucose test strips you'll remain pig ignorant of what's a'happening. Occasional doctors visits won't suffice. What you eat  has to be ruled by the droplets of blood on your finger tips. 

There is no other option. 

Following a diet -- any 'prescribed' diet -- blind to your blood picture needs the feedback that can only be delivered in mmol/L. 

That's the irony: diabetes is the most democratic of diseases. Only you have the power  to treat it.

           

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What I eat...if you REALLY want to know

I am not in this book .

This post is sure to bore the pants off most of humanity. Who gives a stuff about what I (of all people) put in my mouth?

Quick response: I do.

But I wanted to follow up on my last meditation on food because if I knew back whenever what I know now I'd be a lot better off inside  my innards today.

So for want of any access to fanfare and ado I will simply proceed:

Breakfast

A Italian style sausage (x1) and sauerkraut with a short black coffee.

Love it! Love it! Makes getting up worthwhile.

Lunch

A can of sardines

or

Two hard boiled eggs

or

A PawPaw or Berry Yogurt Smoothie 

or

A Green salad with olives or avocado

or

A  vegetable soup.

Tea

I'm a DIY gastronome so I gastrite. Recipe discovery and experiment is my hobby -- that is, within low carb parameters. One course meals and preferably 'one pot'. Plenty of stews and the like. Usually Middle Eastern or  Mediterranean  -- occasionally a curry.

Snacks

On the occasion they matter:

Mixed nuts

or

Cheese 

or

Slices of preserved  meats.

I don't eat much but I do eat well.

Criteria of note:

• The 5 fruit and veg a day sentence is rejected. 5 fruit and veg -- that's a myth. There's no strong evidence to support a magic number
• I'm not frightened of fats. In fact I prefer to get my calories from fats rather than upping my proteins. I go for the good oils if I can...but I don't trim the supposed bad bits off what I cook. Why waste it?
• I pursue an elevated intake of  brassilicas and fermented products (esp sauerkraut and yogurt). Preserved meats are a naughty indulgence now and then. 
• White tea or black coffee; red wine spritzers and chilled green tea are my libations.
• I don't eat grains or legumes...nor spuds (except  sweet potatoes once or so each week). And no fruits except berries and Paw Paw. (Although I'll eat passionfruit because I grow so much of the stuff.) So no pastries...and no pasta or pizza.
• Despite whatever, I do allow myself to indulge occasionally and I will consume what I don't eat: especially a meat pie. (The local meat pie is too delicious to not partake of ever.)

But here's the down side: when you seek to eat as I do, finding something to eat while out and about is a real pain as all the cafe and take away food  culture is either  carbohydrate dense (esp bread, batter and rice) or with massive additions of sugar (eg:sushi). Unlike my daughter I aren't celiac intolerant but I have to empathize as not only is 'wheat' embedded in what you assume it's in but it is in  a lot of other things beside -- such as beer, soya sauce, soups...

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A simple chicken curry served with mashed cauliflower is a low carb lesson

For those who eat low carb one of the great discoveries is how versatile cauliflower is. 

Since you are unlikely to be eating  neither bread nor rice nor potatoes -- as they all are all  dense in carbohydrate -- the humble caulie with around 16 grams of Carbohydrate in a whole head is a great filler-outer-er with some very useful nutritional properties. (That's equivalent to the carbs in one slice of bread).

This simple chicken curry (pictured left) -- I like  to add cloves, plenty of cumin seeds and a good dash of fennel seeds -- was delicious. The spices and a good thick coconut creaming kicked in nicely indeed. The fill out is the mashed cauliflower.

My guess -- as pictured -- 10 grams of  carbohydrate in the serve. (After a time you get skilled at estimating what goes into your mouth.)

When you do your homework nice things begin to happen and after three years of eating low carb I find the regimen easy to follow, the recipe experience both exciting and delicious; and the physiological consequences very pleasing indeed.

The one indulgence I allow myself is some sweet potato once per week. Sweet spuds aren't massively high in carbs but they are outside my preferred comfort range .  Sweet potatoes are nonetheless touted as the "low carb wonder food" because a normal sweet potato contains about 28 grams carbohydrate.

But I tell you: if the prospect of a Diabetes II diagnosis is threatening, this is the way to go. Low Carb is also great for weight loss and may impact on IBS symptoms.

My joke is that I tell my family, "I can eat anything. I just choose not to eat some things." The point being that if I increase my carbohydrate intake with one food, I can trade off that increment by eating some other food low in carbs so that my daily intake stays at a manageable level.

My current management preference is  somewhere under  50 grams of carbohydrate per day. You, on the other hand, may be consuming over 200 grams/day on a 'normal' Western diet.

Example:There are 47 grams of Carbohydrate in a Big Mac alone -- and that's without considering the Coke or the Fries...

I eat plenty. I don't restrict the quantity of what I eat at all. The collateral advantage with a low carb diet is also that you aren't hungry (or you are less hungry) so this may encourage you to eat less in way of caloric intake because you are more easily satiated...and this may be a big reason  why  low carb diets work  for weight loss.

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Underneath all that bulk is Adonis being opportunistic

'Tis amazing that I carry so much weight for my level of activity.

[If I may say so myself: that's my imponderable. ]

How about them genes, eh? I've never been located at a happy BMI. 

The irony is that I'm very fit. Despite my chronic illness  my capacity to do stuff,  to exert myself -- at least when I'm 'well' -- is very good for someone my age. But that extra weight is hard to lose.

This conundrum is explained by the fact that exercise is not in itself a good way to lose weight. It is very good for you because of this  or that reason, but the body compensates for all your exertions to stay at steady state bulk. 

Only by dieting can you begin to shift the kilograms -- but exercise , however, will help you keep them, like some bad smell, away. 

But dieting can feed the problem and yo-yo dieting doesn't work. If you are gonna diet you need to diet for life. 

So I figured that if you have to go without food big time for ever and ever just so you can slim down I'm not signing up to that option. 

I like my tucker.

But after I started a low carbohydrate diet I lost weight. It was effortless and impressive that in a very short space of time I lost 10 kgm. 

Then the weight loss stopped.

This is not an unusual occurrence on low carb diets. Plateauing will often kick in. 

But since shifting from a generic  'low carbohydrate'  format to a Low Carbohydrate High Fat approach I'm back shrinking. 

I'm losing it...

I'm in no hurry and I love the food. 

I'd like to lose another 10 kgm if I could. I don't want any hassles or dramas.  I want  the old bod to shed the grams quietly as I go about my daily business of living.

 The irony is that  because of my current exercise regime and the concurrent loss of adipose tissue,  I'm discovering musculature I didn't know existed. While I'm still fat, underneath all that bulk is Adonis. 

I can feel him. He wants to do the Full Monty.

And just think: each kilogram you lose is less weight you have to carry around every day. 

I have a series of kettlebells that I lift skyward and I appreciate how much they weigh. 8 kgm. 12kgm. 20kgm.

They are all heavy. But that's the sort of extra weight I've been dragging through life--since the mid eighties, when I first fell ill. 

I  have put on 10 kilograms each decade since. 

That's a normal ageing process, that's genetics...It was illness and medication for illness. It was bouts of inactivity. A vicious cycle. 

So if we go back ten years, say, there's Dave walking with a cane and having to go to bed every day during the day so he can make the 24 hours duty roster. 

When I took up scootering -- the kickbike -- I was imagining it as a substitute for one of those electric mobility scooters.

That's true: I was  becoming an invalid rather than someone who was just chronically ill. 

But when I started to consciously work on my exercising I began to roll back the debilitating symptoms of Fibromyalgia and the toll it had taken on  my body.

Of course the art is -- and it is an art -- to challenge yourself without exerting yourself such that you enter relapse. Stress does that and exercise is designed as stress.

The other knack is to pursue a routine of exercise despite your intermittent ill health which will often undermine your capacity to even walk.

Rule of thumb: Know thyself moment to moment and be opportunistic. 

I didn't say 'optimistic'. I said 'opportunistic'. 

That's the rub. Work hard when you get a window.

Anyway, I'm hoping that by continuing with this LCHF regime I can lift more of the heavy burden offa me. I don't have to be religious about it. LCHF is  tasty dining.

I  can't be sure what will happen -- that I will continue to lose weight or not -- but every little bit shedded is gonna be a thrill.

YONI FREEDHOFF (a beriatric physician) contemplates some novel criteria for judging any weight loss program. I'm with Yoni.  My score estimate for LCHF out of 10 for each item is in brackets.

Hunger [10]
Cravings [8]
Feelings of fullness/satisfaction [10]
Need to cook special meals for other family members [8]
Ability to still eat out with friends and family [9]
Energy levels and feelings of general well-being [7]
Complexity of dietary requirements [7]
Dietary flexibility vs. monotony [8]
Rigidity of dietary requirements (ie forbidden foods/food groups and impact on quality of life) [8]
Expense/cost of dietary requirements (ie expensive foods, supplements, etc.)[7]

That's 83 points out of 100

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A day in the life of a LCHF eater

Following on from my recent comments on LCHF -- Low Carbohydrate High Fat -- food eating I thought I'd share with you the stuff I put in my mouth.

Don't worry I'm not regurgitating it or offering it to you via the back end.

This is what I've eaten today. It is depicted in the image.

Click on it for an enlarged view. 

I am a reasonable and creative cook so I get to experiment with the ingredients through all the meal options -- breakfast, lunch and tea...

That's a lot of fun.

I like the food and I do not suffer for my dietary choices. 

I'm still losing  weight, keeping my blood sugars down and fueling everything I actively do...

Works for me.

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Going LCHF -- navigating the low carb transition

One of my closest and dearest relatives is now trying to follow a low carb diet.

(A convert! Wow!)

Since I've been low carb for almost three years now I've put in the hard yards and skilled up by negotiating the challenge of parring back the carbohydrates.

So I'd like to pass on a few tips, drawing on my own experience,  about how you could possibly do it too.

But first some  discourse:

 RELATIVE: Breakfast is hard because I need something really quick, this morning I have yoghurt but I'm just worried whether this will have the energy I need. For lunch I use to have tuna and rice but now I have tuna with biscuits which are still carbohydrates but a lot less that tuna. I need to get a bit more inventive with lunches but it's hard at work when I only have a half hour time slot. Dinners are pretty easy, I usually have stir fry but now I just cut out the rice. I've been finding myself being hungry after meals so I think I need to eat more or it's just my body adjusting.

Breakfast is an open wound away from cereal  and toast as grain eating is our after dawn  collective  norm. I usually eat sausages and sauerkraut or an egg or two but I also  often eat yogurt smoothies. My preferred yogurt mix is either Greek yogurt (the  lowest carb yogurt) with frozen berries or paw paw or yogurt blended with paw paw and avocado. If time is a factor -- and even  cooking eggs aren't an option, maybe boil them up the night before? There's also cheese options. If you have time to fry: then fry up snags, eggs or bacon. An omelet would be even quicker.

As for lunch -- the body has to shift over to metabolising stuff other than easy carbs so there is a transitions phrase which may be a bit rough on the body.  I will often eat a can of sardines for lunch or have a salad ( with cheese or nuts or some sort of meat) or  a soup. 

If out and about eating lunch is a big problem  such as at any shopping centre. I look for the fried stuff  like chicken wings without batter or a Chinese meal minus rice or a sate stick and hopefully without sugar added. Instead of sushi maybe sashimi.

The main challenge, I reckon, is to keep what you eat at all three meals -- breakfast, lunch and tea --  in your head so that you can balance out what you may need to make up or desist from. Do I need more veg or less protein...? What's my carbohydrate intake for the day so far?

This brings me to a few precepts that I adhere to.

1. Know how many carbs are in the food you put in your mouth. This means you have to do  some research on what you eat and always read the labels on the food you buy. My initial rule of thumb was to eat foods that were less than 15-16 grams of carbohydrate per serve. This enabled me to persist with a slice of bread each day and a small serving of Basmati rice weekly  or so in the form of a risotto ( stretching it a bit at 19 grams/serve). But that was my rule which served me well and formatted my consumption. Having given up both rice and bread, I now try to stay below 10 grams per serve but it took me over a year to attain that easy focus.
2. Aim for a carbohydrate threshold.If you  know how many carbs are likely to be on your plate you can begin to manipulate your intake with some aim in mind. What do you want to eat? 130 grams of carbohydrate per day? 100 grams? 70 grams? Under 50 grams? Well you have to do your sums and change your diet to suit your preference. Some low carb diets begin with a very low carb induction phrase. I didn't bother with that. I gradually worked my way down instead. I did nonetheless have  the advantage of testing my blood sugars daily to see how  my low carb diet was  impacting on my body (and its diabetes). So I guess you need a working criteria that you can often refer to to judge your progress. So what would that be? Energy levels? Weight loss? Hunger?
3. Understand your food from the diet's perspective. Recognize that if you are cutting back on carbohydrates you need to generate your energy reserves elsewhere -- from either protein or fat sources. That's a fact. You still have to eat to live and work. You do indeed have a choice and how you proceed is up to you. I think the literature suggests that your best option is to eat more fat rather than to drastically increase your protein intake. So we're talking cooking oils, salad oils, cream, cheese, fats on animals, eggs...whatever. The fats will not only fuel you but they will also satiate you so that you will indeed be less hungry and -- here's the rub -- you will  end up eating fewer calories.  So if you eat a fish for lunch -- make sure you eat fish bathed in an oil. In contrast, the literature suggests that an elevated carbohydrate consumption fosters hunger for more of the same. 
4. Recognize that you can eat anything but chose to not eat certain foods. I think this is  important. While there are food intolerances and allergies, low carb eating is not about treating carbohydrates as poisons. You have to make do as best you can. Nonetheless, you can eat a lot of stuff -- a massive range  of vegetables, indeed most vegetables  -- despite your low carb regimen. As for the carb dense ones, if you have to eat them , eat less of them. The guidelines are pretty simple: stay away as much as you can from all grains and legumes(that's lentils, dry beans and such); be  careful of fruits (esp bananas and mangoes!); and don't eat tubers. On this last point I'm flexible as I do like a once a  week dose of sweet potato and I eat carrots because they fall within my 'under 10 grams of carbohydrate' rule.
5. Be aware that there are hidden traps  that may undermine your low carb diet. The biggest trap of all, in my experience, is milk. Most cheeses are good, so too is Greek yogurt and cream -- but milk is a high carb drink. So shift from lattes to something blacker. Other traps are sausages with heaps of 'non gluten' fillings or anything that has been thickened with corn flour. Similarly you may be eating  a lot of sugar  when ordering Asian food dishes. Chinese cuisine especially but Vietnamese less so. Seldom with Indian curries (but watch out for the lentils and chickpeas).
6. Snacks -- if you need them, make em low carb. Most snack foods like crisps are very carbohydrate dense so you need to step away from that. You may need snack foods to get you through some days. I find mixed nuts best preferably with a mix low in peanuts. Peanuts aren't big time carb eating but they are higher in carbs than a lot of other nuts. My  other preference is cheeses and smoked small goods like salami.  These I consume occasionally as tasty morsels. But the nuts are my most relied on option. But then, eating low carb I don't often get hungry.
7. No beer and no sweet drinks. Sorry but low carb grog is different and this has nothing to do with its alcohol content.  Your top shelf low carb preference is wine, red wine esp, followed by spirits. Low carb beers exist if you want to drink the stuff but you gotta check your tipple for its carb hit. When you get to cider and the rest of the alcohol universe you are tippling at over 15 grams per glass.  Do the sums and a few drinks wipes away what you didn't eat at breakfast, lunch and tea.
8. Remember that carbohydrates aren't the same as calories. You need to note the difference and transcend the bogefying of fats as obesity drivers. (See the literature on this - sample) In fact you have to turn nutrition on its head and think differently. You also have to ask the frank questions about what passes as dietary wisdom. Do you need 5 servings of vegetables a day and two fruits  in order to eat well? Who said that? Where is the science that confirms this? While it may seem easier to simply eat more meat it may not be a good idea esp for your kidneys. So while you may indeed be eating five servings of veg per day -- if you want -- all you need to do is make sure that those servings are low carb. You'll also find that if you eat more fat , rather than a high protein diet, you won't suffer from constipation. 

 That's my passing thought: regular bowell habits.

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Low Carb and High Fattery

So how's it been?

Been? You mean since I started a diet based on a low carbohydrate and high fat intake?

Yes that 'been'.

Easy. In fact I'm pretty much over it and forget that I am on "a diet". It's all about style....and habit.

Style?

Yes: I'm eating Swedish. In Sweden the LCHF food regime is so popular that as Denise Minger writes," in 2011 a whopping 25% of Sweden’s population was trying to eat more fat and curb their carbohydrate intake, with 5% of Swedes identifying as hardcore LCHF adherents." Wow! How about them Swedes!

Yeah, I guess, that is some life style I suppose ... But what's with this"more fat"?

That's the wonder. So go read up. I'm too busy not eating stuff to spend time preparing info so you can digest it. However, the main takeaway is that it ain't exotic at all. You eat cheese, cream, olive oil, butter and similar fatty tucker  while cutting back on high carb vegetables  (and fruits). 

That seems easy enough if it would work...

Oh, it does work.I'm losing weight again and I don't bounce around the scales...

That's good.

Sure. But  I pay a price: No cereals. Always I gotta chase the very light-in-carbohydrate foods. I used to aim for foods that had less than 15 grams of carbohydrate  per serve but now I pitch for under 10 grams of carbs for each serve. The complication is that if you cut back on your total carbs you have to make it up somehow in way of caloric intake and I do that not so much by adding more protein ( such as  meat, fish and so) but by upping my fats.

So how does one do that?

'One' does it simply. For breakfast I may have sauerkraut or kimchi with a sausage or an egg or bit of bacon. For lunch I have a soup or sardines or a pawpaw (or pawpaw and avocado) smoothie on Greek yogurt or a salad. Evening meal is culinary open within the LCHF parameters.

And that is  eating the LCHF way?

Indeedy do it is.I have the blood sugars and the gradual weight loss to prove it. Mind you it's all customized. I don't see it as a strict regime as individual results will vary and you have to tweak it. But I guess I'm eating maybe under 50-70 grams of carbohydrates per day when you, eating a 'normal' diet,   are consuming perhaps  over three hundred. And I like the food. I cook, you see, and I appreciate the challenge offered by  such a diet.  And I eat well. It's all delicious stuff.(At least the way I prepare it). For instance, tonight I cooked a Shepherd's Pie but instead of  high carb potatoes I used mashed cauliflower. 

So there are work arounds?

For pasta there isn't. But I can eat  Chinese food or a curry without rice. No noodles unfortunately. For  high carb tubers like potatoes I substitue pumpkin. The only thing I miss is the ready use of thickening agents like corn flour. My  substitutes are Almond Meal or cream. I eat mixed nuts every day as a snack.. and red wine: I drink red wine.  So it's all do-able. No sweat.

But high fat?

I used to wonder about that. I mean it seems so naughty, right, so obscene? When I started this diet I tried to seriously up my fat intake but ultimately what decides how much grease you eat is how much fuel you need. That's because fats are gonna be your energy resource -- maybe more so than from carbohydrates.  The body, you see, changes its preferred method of energy harvesting. But then fats are more satisfying --- more satiating -- than carbohydrates.So over time my body and my preferences adapted. I thought I'd be eating heaps of fat if I cut back further on carbs -- but the actual shift was much less significant. While I eat fat without a conscience -- I'm not obsessed with eating grease and don't have to force feed myself with butter or oil. Low carb eating also means living with less hunger. I eat more cream than I used to and I don't  hold back pouring on the olive oil  nor do  I  trim the fat  from any meat ...  At issue is ('bad') cholesterol, of course, but I dont have the path results to share...yet.

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Tragedy may be easy but weight loss, like the comedy it is, is hard.

The Truth About Low Carb Diets  is a very useful handbook for those who have spent some time on low carbohydrate diets  and want to both understand the physiology in play and seek to tweak their own regime. 

A lot of the discussion is dense academic stuff that explores the logic of low carb eating -- albeit very pragmatically.

There is both good and bad with low carb diets and it pays to get a handle on the processes you unleash inside you when you cut them carbs. Other 'diet books' make it simple and all very partisan. Some promote Paleo lifestylism and hot bods. Jenny Ruhl , on the other hand, brings a sharp clinical eye to the diet and meshes that with her long term personal experience of diabetes and eating low carb as well as her ongoing relationship with so many low carb (and often diabetic) dieters.

Where the research papers run out or fail to deliver affirming evidence one way or the other there is a reasonable smattering of shared anecdotal evidence to draw upon. Handy advice.

So when you stop losing weight on a low carb diet -- or seem to have stopped (as it happens) -- this is a book to run to for assurances and possible tweaks.

Ruhl also tackles the question of the fat:carbohydrate ratio which is a seldom attended to conundrum embedded in the habits fostered by these diets. The LCHF -- Low Carb High Fat -- diet embraces the pairing but, as Ruhl points out, it ain't that simple, especially if you increase your carbohydrate intake while still eating high fat.

Prepare to balloon.

So all in all, this is the handbook low carb dieters need to refer to as required when some issue upsets their menu planning. For diabetics eating low carb -- I'd think this would be an essential resource as it is very empowering to put the means to control so many consequences of your condition by customizing what you place on the end of your fork.

For diabetics, Diet 101: The Truth About Low Carb Diets takes up where the work of Dr Richard Bernstein leaves off ... and carefully humanises his rather strict eating regime by bringing it up to date in line with more recent research and collective experience.

For people who aren't familiar with all of Jenny's good deeds she lives here: Diabetes 101 --  and has blogged about low carb eating and diabetes for years. It is also the best resource on the web for the recently diagnosed.

It's where I started....and I still come back for more good oil from Jenny Ruhl.

My takeaway message was one I've grasped just at a time when I was becoming confused about what  I was eating... and why. While it may be de riguer to say I'm eating  a low carbohydrate diet -- how low should I go? And if I increase my fat intake: by how much fat? If the diet is working and doing me good, how will I know?

Ruhl is keen to argue that what's good for one person may indeed be different for another and that even non-diabetics can utilize glucose monitoring devices if they want to engineer the best result. But for diabetics the commandment, as always, is direct: test, test, test. 

Glucose monitoring widgets are the new empowering  democracy.

Perhaps you are thinking that what the world doesn't really need is another diet book? Perhaps. But the nutrition debate is shifting as the official paradigm of these last 40 years  collapses in  an array of bad health consequences. But when it comes to us -- we individuals -- whatever is the congealed nutritional social milieu that formed us, we still are up against the challenge of not only dieting but engineering a means to do that  that will stay with us for life. And that's not an easy call. 

Most dieters don't succeed long term. Even persisting for a year is a big ask of our bodies.  Despite the fact that any one diet may work -- is eating it the way you want to spend the rest of your life?

Another complication is that, as Ruhl argues, your potential hypothetical weight loss is going to be contained within 10-20% (very usually much less) of your starting/original weight. So do your sums before you start setting goals and recognise that it may take a long time to even par down that far. 

Tragedy may be easy but weight loss, like the comedy it is, is hard.

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LCHF : registering the gains

I've been LCHFing for maybe about 6 weeks now.

You perhaps wonder: what's LCHFing?

Ans: LCHF refers to a  Low Carbohydrate High Fat diet, of which I have commented on before.

Watch my lips: low carb with high fat. If you aren't eating carbohydrates in normative quantities you have to eat something else. And your options are either protein or fats.

Simple, right? Either/or.

I had been eating low carbs anyway (for  two years) but I went lower still and made up my nutritional needs by being free with the fats: cooking oils, salad dressings, creamed sauces, cheese, eggs,  fat in meats and fish. I fatted up my food while also trimming back on the vegetable matter I ate.

That was the knack, the dietary shift -- and being considerate over what fat  you eat.

Rather than eat vegetable matter casually -- albeit low carb vegetable matter --  I parred back to a few low carb selected items each day that I valued and enjoyed. The irony is that by doing this I celebrated the veg more as it was  more  pristine on the plate than it had been in the past.

I reduced my dependence on meat protein by cooking up meat stocks rather than stews.

I'm still tweaking....but it was easy. It was like eating French...Cuisine française -- but then LCHF is a Swedish concoction.

But hey, preliminary results are great.

1. In 6 weeks of eating so I have lost  1.5 kgm- 2kgm of weight and reduced my waist measurement by 3 or 4 cm.
2. My blood glucose readings( I have Diabetes II ) have fallen from an average of 6 mmol to 5.4 mmol. (That's moving within the range of normal.)

It's too early to register changes in blood pressure or cholesterol but the blood glucose  changes in such a short time  are a fantastic response.

Such that the result surprises me.

While I have been consolidating my exercise regime   I have never found that any type of exercise I do to impact on body weight (although my HIIT habits should undermine my insulin resistance which can then lead to falls in blood glucose).

Another variable is that I have parred back my alcohol consumption by half, by spritzing the wine I drink with mineral water. The problem with alcohol (like frank sugars) is that the body prefers to store and convert it to fat  before it gets around to any other stuff  digested. So alcohol consumption can undermine weight lost regardless of a drink's carbohydrate content.

My problem is that I use alcohol -- red wine -- as an analgesia, a very pleasant analgesia, for muscular pain and stiffness. (I have hadFibromyalgia for 27 years).

[And no -- I'll never giving up  my red wine habit as wine works like nothing else.]

So if this trend continues that leaves me with an outstanding challenge of reducing my blood pressure -- a diabetic's standard side effect and a family habituation.

While further weight loss and sundries hopefully should register on the sphygmomanometer I'm hoping that  my indulgence in more consciously cardio  exercise activities -- running and urban soul line dancing -- will also roll back my numbers. 

You want to bring down your blood pressure pro tem? Go for a run. Works every time.

So all up, I'm smugly pleased with myself.

I am on a winner.

• Where I started from : 2 years ago

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LCHF: Lose weight, ask me how.

There are few things as frustrating as gaining weight and not being able to take it off.

You with me on that?

It may be the dead hand of our past fathers and mothers but then of late, these last 30 years, obesity is a western diet plague.

Genotype may matter but  we can do pretty well dining by ourselves without waiting for our  endomorphic preferences to kick in.

Nonetheless, over the past period following a low carbohydrate diet  I've been notching up some big numbers on my weight loss account.

And it was easy...until it all suddenly stopped happening. 

The conundrum was I needed to get rid of more of what I was a carrying on my body if I wanted to impact further on some of my health issues.

What to do. What to do...

I  spent the best part of a year in limbo. No matter how much I exercised -- and I do more than you I'm sure,  unless you are an athlete or gym junkie -- I was still tipping the scales at figures I didn't want to know about.

I needed  a push to get back to my preferred path: my yellow brick road.

Low carbers like me will be told that the way to get past a plateau is to reduce your carbohydrate intake further for a short time so that the body's metabolism is forced to re-negotiate its consumption. This is cellular level stuff aligned to what substance -- fat, carbohydrate or protein -- the body decides to break down first. The diet shift supposedly should move into true ketogenic mode and shock the bod into catching up.

There's a logic in this. The maths has been done. The paradigm is shifting -- even on the question of eating saturated fats.

I have written here before about  the dietary regime of LCHF -- Low Carbohydrate High Fat. But to give you the drum the logic is simple:

LCHF (Low Carb, High Fat) means you eat less carbohydrates with a higher proportion of fat. The most important point is to minimize your intake of sugar and starches. That way you can eat other delicious foods until you are satisfied – and still lose weight.

A number of recent high quality scientific studies show that LCHF makes it easier to lose weight and control your blood sugar. And that may just be the beginning. --  LCHF For Beginners

That's the drill. Simple stuff. You don't have to obsess about your food, just follow a few basic principles.

I was already lowish (average maybe of 70-110 grams/day) on my carbohydrate consumption....so I was in the groove: vulnerable to further suggestions.

So off I went -- to the kitchen -- and started cooking and eating with a heavy hand on the dairy fats and oils  while I cut back further on my vegetable matter . 

I tried taking tablespoon fulls of coconut oil as a supplement but it caused abdominal upsets.

And to cut a long menu short. it worked: I'm losing the weight again. 

I find the turn around quite amazing. After only a couple of weeks I'm much less the man I used to be: already.

The ideological adjustment is a bit hard after a lifetime of being told  to ease up on the fatty foods. But being a naughty boy has proven rewarding and I'm liking the cheese and cream, eggs and bacon. 

Of course there's a point to be made here:

If I am losing weight on  a high fat diet maybe what  we assume  rules weight gain is ass about?  The problem in our diet  may not be the fat we eat (although some much used processed/artificial oils are very problematical: the trans fats) but rests with our carbohydrate choices, especially the high carb density grains, fruits and frank sugars. The point being, that no matter what plant you put in your mouth it is going to end up as so much glucose by the time it gets  put to work...or queued for storage(as fat).

Don't  just nod you head or believe everything I say, go do your own homework like I did.

But for now, I'm laughing... and look forward to the many happy hours carrying less of me around.

I'm not going to make a ruling on what may be the physiological preferred diet for humans a la 'Paleolithic' or 'traditional' perspective. Anthropological research may be interesting but not conclusive -- although people eating a traditional or hunter gatherer diet don't suffer as we do from high rates of obesity, heart disease, arthritis or diabetes. These diets are, nonetheless, often higher in fat and lower in carbohydrate than the standard contemporary Western diet.

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