Get Fit So You Don't Croak It Before Your Time

I have been catching up on my reading, and I stumbled on this December 27th post from Mark's Daily Apple, entitled "An Open Letter to Kids and Teens (and Infant Prodigies)".

In this post, Mark  encourages kids to "get healthy while you're still healthy, while you're still unbroken. It's always easier – and more effective – to keep a new knife sharp than to restore a chipped, rusty, neglected old one."


And I totally agree, and wish that I read this earlier, because I would have commented that this is true not just for kids, teens and infant prodigies, but also for those of us who are a bit older.  It is never too late to stop taking care of yourself.

I also would have commented that this advice is especailly relevant to those of us who have parents who are chronically ill, overweight, type 2 diabetic and/or have huge bellies.  We have the same genetic predispositions that our parents do, by and large, and that puts us more at risk for these same health issues than the general population.  It is both a nature and a nurture thing. 

Take me and mine, for instance.

Five years ago, there was no one in my immediate family who weighed less than 200 pounds.  My mother, at 5'1", hovered around 200.  My father, 5'9" and 210.  My sister, who was 22, at 5'4", weighed about 320 pounds and had chronic back issues.  At 26 and 5'6", I weighed 236 pounds.

My father had and has a huge belly.  He is a type 2 diabetic, with a significant medical history of cardiovascular disease.  He has had such major and near 100% arterial occlusions that he has undergone angioplasty and coronary artery bypass graft surgery.  He was 36 at the time of his first angioplasty.  He has suffered numerous strokes, transient ischemic attacks, heart attacks, and several incidents of congestive heart failure.  His diabetes is ill controlled, despite caloric restriction, compliance with the ADA diet, and pharmaceuticals. 

He happens to be in the hospital at this very moment.  Coincidentally, he was admitted on 12/27 - the date that Mark's post was written.

My dad's continuing medical issues have been a major source of inspiration in my efforts to be healthy by adopting a LCHF and mostly primal diet and by exercising.  When I started this WOE last year, I was a 30 year old, 231.5 pound, prediabetic woman with high blood pressure who needed weekend naps to keep up with my then 3 year old. 

One year ago, the week after Christmas 2010, my dad was also admitted to the hospital and nearly died of cardiac complications.  Between that admission and his CABG surgery in February 2011, dad had at least 6 incidents of congestive heart failure. 

Fast forward to today.  He is back in the hospital.  He went in because his daily diuretic meds stopped working, he retained 13 pounds of water over a 4 day period, and he was having difficulty breathing.  Since that admission, he has lost kidney function.  He has needed three dialysis treatments, and two blood transfusions.  He is still gray and swollen.  He is on prednisone as well, and his blood glucose has spiked at 500+.  It is hard to distinguish the cause of his present illness from the symptoms that he suffers.  He has so many comorbities, that when one thing goes wrong, everything goes wrong.

It sucks.  It hurts.  I am afraid for him.  He is sure that this is the year that he dies.

Yesterday, I was at Stew Leonard's - a popular grocery store near my home.  It is the kind of place that gives out samples of food items on Saturday and Sunday mornings and early afternoons.  Oddly enough, the aisles are not your typical grocery aisles, and in fact, resemble a winding path.  As a shopper, you are compelled to wander your way through the entire store, and pass by all of its offerings.  This is a one way path.  It is often the case that on a busy weekend day, you will follow the same families as they shop ahead of you. 


Yesterday, I was behind a family of very fat people.  Mom and Dad were both over 400 pounds, easily, with mom being the larger of the two, and exhibiting a large, tremulous gut, which draped down over her sweatpants-clad thighs.  The two children, a boy and a girl, were between 9-12 years old.  Each one must have weighed around 175 pounds.  The mom could barely walk.  They grazed at each food station set up along the way, often crowding around the stations and eating several individual food samples each.  Each child had entered the store ahead of us, nursing their own 20 oz bottles of Dr. Pepper.  They whined throughout the entire store that they were hungry.

I just wanted to cry.  We had left my dad's hospital room not one hour before arriving at the store.  As I looked at these parents, who were probably my age, I thought to myself:

How much time will they have before something goes seriously wrong with their health, and they die, or become disabled, and can't take care of their children? 

How sick will these children get?  How large will they grow?  Will they begin to exhibit the swollen bellies of their parents?  Do they have diabetes already? 

Life passes by quickly.  It doesn't take long to get to the place where you are so fat and sick that you probably won't survive.  Ten years ago, my dad looked pretty good for his age and moved around well.  Everything started to go downhill after that. 

I sometimes wonder whether, if he had made some changes to his WOE before the downward spiral began, he would be gray and swollen in the hospital today. 

Nope.  It is never to early to start taking care of your health.  I'd like to believe that it is never too late, either.

Pity Party Pig Out - Reflections

Last week was a doosie.  My daughter is in the hospital recovering from a procedure (she’s okay), and I spent the whole weekend there with her.  I came home on Sunday night, leaving my husband there to stay, as I had to go to work on Monday morning and he did not. 

Sunday night, watching football by myself in my jammies, I wanted a snack.  I went to the fridge, and found a mountain of Chinese food leftovers, none of which I should be eating.  I seized on the stress of the weekend as an excuse to pig out on forbidden foods (yes, it was a conscious choice and I knew what I was doing). 

I wish that I could say that I stopped at the cold spareribs and chicken fingers.  I didn’t.  I went back to the fridge, looking for something sweet, thinking to myself, “well, I already blew it with Chinese, what’s a little more junk food going to hurt?” 

I found about 4 ounces of coconut chocolate chip cookie dough in the freezer, and demolished that.  I looked down at my belly, which had already started to rumble at me disagreeably, and felt a bit ashamed.

I justified my bad eating choices, in those moments, by thinking that, with all that I had going on, I deserved a break, and no one would think poorly of me for cheating.

Making excuses for poor behavior to justify continuing down a path that I should not be on is just crazy talk!  Who am I making excuses to?  Me?  Sending excuses from myself to myself?  This is how I got into the rut that I was in – you know, the rut that had me ballooning to 236 pounds on my 5’6” frame, suffering from diabetes, high blood pressure and PCOS. 

I am past this and I am better than this.  Taking personal responsibility for my health at all times means that when life hands me lemons, I do not drink lemonade.  I also do not eat lemon squares or lemon pie, or indulge in lemon chicken.  I calm down, take stock, and decide not to go forth into a feeding frenzy. 

The truth of the matter is that I have this one life, and this one body, and I believe that I can do better for myself and for my family.  No one benefits when I eat crap that can literally send me into a coronary. 

Gifting myself with junk food, sugar and starches is the old Kate, the one who numbed herself with food because she could not face sad things in her life.   

The new Kate is honest with herself, and is getting healthier day by day.  She doesn’t run from problems.  She faces them head-on, and sends them packing.   

Does this familiar to you?  Check out:

Pema Chodron, Getting Unstuck, This is a great CD from Pema Chodron, a buddhist nun.  She's been there.  This CD really helped me understand what I was doing to myself with food.  Its not a CD about food or dieting - its about being in a rut and identifying why you created the rut, and what its done for you lately. 

Dark Chocolate is Good For You…

…and it can fit into your LCHF lifestyle.  Surprise!

I admit that I am a chocolate fanatic.  Always have been and always will be.  When I restarted strict LCHF in early August, I made some promises to myself.  One of those promises was that I would find a way to make regular, decadent chocolate consumption compatible with LCHF. 

Guess what I found out?  30-40 grams of dark chocolate, eaten every day, is ridiculously good for you.  Plus, if you are choosy with your chocolate, you can easily find bars that contain 30-40 gram servings containing 10 or fewer grams of net carbs. 

Let's discuss, shall we?

How Sweet are You?

It may be a pain in the fingers, but I heart my glucometer. 

By teaching me how my body reacts to the things that I eat, this device has given me a new measure of gustatory freedom.  I've learned a lot, and have had a lot of surprises along the way. 

Our sense of taste does not always alert us when our food contains carbohydrate, and we can be lulled into a false sense of security when a meal appears to be heavy on the meat or vegetables.

One of the best uses of a glucometer is to understand whether the food you enjoy at your favorite restaurants or workplace cafeteria, or your aunt's famous [insert name of recipe], is as healthy and appropriate as you think it is for your WOE. 

Diet-Scape Learning Curve

How Did I Get Here?

If you have been reading this blog for a while, you may recall that I started low carb on a whim after reading a discounted diet e-book called Neris & India's Idiot Proof Diet and Cookbook.  I got the book for $2 or something, and loved the book's humor and attitude.  Basically, I read that book through the night, and started my new diet the next day, and ended up very quickly in ketosis.  The ketolysis process was expedited by a stomach bug that decreased my hunger and – because I spent much of a full week retching and wretched – forced me into what was essentially a liquid fast broken up by a few occasional triscuits.  I certainly was ingesting fewer than 20 grams of carbs each day.  By the time I felt better, I was already through the nasty carb-flu symptoms.  In fact, I don't think I even noticed them, as they were completely overshadowed by the stomach bug. 

I lost weight. 

I started to wonder why I was losing weight.  From N&I, and from a previous, half-hearted attempt at Atkins, I knew what carbs were, where to find them (and not find them) in food, and I had a vague understanding that carbs turned into fat by some metabolic process.  However, I didn't really understand digestion and metabolism and hormones, and all of the other things that go into the equation.

So, I began to do research.  I did a lot of internet research in the beginning: haunting PubMed and trolling around the Frontline: Diet Wars webpage to get a feel for what the diet-scape looked like, and what the various diet practices were predicated on.  I watched the movie, Fathead.  I learned about ketogenesis, and that the key to the low carb diets was this ketogenesis.  I learned that ketogenic diets have successfully been used, for decades, by credible physicians at top-level hospitals, to treat epilepsy in children.

This spurred me to read books by some of the diet gurus I had learned about online.  I've read so much:

• The Low-Carb Comfort Food Cookbook (Eades M.D., Mary Dan, Eades M.D., Michael R., Solom, Ursula)
• The New Atkins for a New You (Westman, Dr. Eric C., Phinney, Dr. Stephen D., Jeff S. Volek)
• Dr. Atkins' New Diet Revolution, Revised Edition (Atkins, Robert C.)
• Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats (Fallon, Sally)
• Why We Get Fat: And What to Do About It (Taubes, Gary)
• Protein Power: The High-Protein/Low-Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health--in Just Weeks!  (Eades, Michael R., Eades, Mary Dan)
• The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health and boundless energy (Primal Blueprint Series) (Sisson, Mark)
• Good Calories, Bad Calories (Taubes, Gary)     
• The New Evolution Diet (De Vany PhD., Arthur)
• The Vegetarian Myth (Keith, Lierre)

I started to understand that there was a very long history associated with the diet-scape, and that some of it was pretty darned ugly.  There is compelling evidence that bad politics allowed bad science to be the foundation of our modern-day standard American diet, and that Americans, today, are more obese than they used to be, suffer from more chronic health issues than ever before, and are dying, in higher numbers, from diseases like heart disease and cancer.  Tragically, more and more young children are extremely obese are diagnosed with Type 2 diabetes (that's the reason why T2 is no longer called "adult onset" diabetes).  Our health is imperiled and this terrifying trend starts young.

Although I appreciated the simple rules provided by Atkins and N&I, I started to worry about some of the low carb faux-foods that I was bringing into my diet: fake sugar and oddly processed starches to be precise. 

I had sat down with Nourishing Traditions and much of what the authors discussed made an impression on me.  This was the first time that I learned about the danger of grains and the anti-nutrient properties of some of their components, including phytic acid.  NT convinced me that I needed saturated animal fat to be healthy, and had to avoid certain fats (including certain oils that are produced in pretty horrifying ways).  NT started to get me thinking about the contrast between traditional ways of preparing foods and the food that I purchased from the grocery store on a regular basis.  I wondered about lactofermenting vegetables to preserve them; consuming raw, unprocessed fresh dairy products; and buying organic produce and grass-fed, pastured meat products without nitrates or other additives or preservatives.  I lactofermented my own salsa (it was good and a little fizzy).  I started making and drinking kefir water for its pre- and pro-biotics.  In short, I started to care about eating WHOLE FOODS, and avoiding processed foods as much as possible.

I started learning about theories of Ancestral Health.  In particular, I read about Primal, Paleo and Evolutionary diet and fitness.  I found that primal appeals to me.  It just makes sense on some inner "Aha!" level.  Primal mimics what our Paleolithic ancestors ate and how they exercised.  There has been no evolution since Paleolithic times, and we are born physiologically identical to our Paleolithic ancestors.  Their remains and other significant evidence show that they were vibrantly healthy, had large brains, well-developed musculature, and good teeth.  They ate meat, eggs, vegetables, fruit, nuts and seeds.

I'm not completely Primal, though.  I eat small amounts of products that contain very small amounts of processed sugar, like dark chocolate.  Most significantly, I eat dairy every day (in the form of cream and cheese) and that is decidedly un-Primal. 

So, that begs the question…

What Do I Eat?

• I do not eat grains.
• I eat the highest quality meat and non-starchy vegetables that I can get my hands on. 
• I enjoy eggs that are high in omega 3 fatty acids. 
• I eat some nuts, including almonds, pistachios, macadamias and occasionally cashews, about 3-4 times per week. 
• I cook with organic butter, virgin coconut oil, olive oil and sometimes lard. 
• I do my best to avoid bad fats; I certainly don't keep them in my house. 
• I try to eat avocados and coconut products several times a week for their healthy fats (and because they are tasty). 
• I do not eat legumes. 
• I eat 30 grams of 60% dark chocolate every single day. 
• I rarely eat fruit, and when I do, I eat no more than 1 cup of berries in a given day, and I make sure that I eat them with fat.  I never drink juice.
• With the exception of the sugar that is in the dark chocolate I eat daily, I generally don't eat sweetened foods or drinks. 
• I generally eat foods that are found in the perimeter of the grocery aisle. 
• I usually avoid things that have to be processed by the liver, including caffeine (exception is the chocolate and 1 cup of coffee in the a.m.), fructose, alcohol (I occasionally have a slightly alcoholic drink), and I don't take drugs like Tylenol unless I really need them.  This way, the liver can spend less of its time removing toxins from my body (because I'm not consuming those toxins) and more of its time breaking down my stored lipids into their constituent parts and making me healthier and thinner.
• I drink boatloads of water. 

Intermittent Fasting Helps Psoriasis?

Today is Day #5, which really just means that I've done my two fast days this week, and I can eat like I normally do. 

As a follow-up to yesterday's post, I will confirm that fasting on Day #4 was WAY more manageable than fasting on Day #2.  I really didn't feel terribly hungry, and I definitely didn't have hunger pangs yesterday, the way that I did on Day #2.  I felt completely fine.  Also, I thought to check my blood glucose at the end of yesterday's fast, and confirmed that I had a perfect reading of 103.  Not even close to hypoglycemic (which was one concern that I had). 

Have I realized any benefits of IF yet?  I would say yes. 

1. I haven't weighed myself (there is laundry on top of my scale, and I've been too busy to put it away).  I feel slimmer, and I am wearing a fitted top today of a non-stretchy material, and I can see that it fits more loosely around my middle than it did when I wore the same top last week.
2. I am deeply in ketosis. 
3. On Tuesday, while fasting, I felt like I had an abundance of energy, and felt the desire to exercise.
4. I do have a feeling that it is easier now to avoid evening snacking.  Even on the nights where I could eat as much as I wanted to after 6:30 p.m., I didn't.  The fullness from my dinner really held me through and I did not want to eat. 
5. Dermatological improvement.  I haven't changed anything about my scalp psoriasis treatment, but this week, I am less inflamed and flakey than I have been in recent weeks.  There is a tangible difference.  My skin seems to have cleared up all of a sudden.  I had a zit on my chin that has lingered for weeks.  I woke up today and it was gone.  My skin texture has improved (smoother). 
6. However, on the downside, my BMs were very loose last night.  For months, I have been very regular and comfortable.  Now, I'm not sure what's going on - can it be attributed to the fast, could it have been what I ate (homemade thai red curry with chicken and peppers), or do I have a touch of something? I went this morning, and it was more solid.  I feel fine, otherwise.

We will see what happens on Sunday at weigh in/measurement.  If all goes well, I may incorporate one 24 hour fast per week into my regimen. 

Honestly, I have to say that the dermatological improvements alone would make it worth it, even if I don't lose a lick of weight this week.  I have read anecdotal evidence that IF helps to alleviate the symptoms of autoimmune disorders (that is what psoriasis is).  My scalp psoriasis has been pretty uncomfortable the past few weeks (at its worst - imagine the sensation of your entire scalp burning and itching - like sunburn and chicken pox combined).  Today, I have no flakes and a normal scalp.  I'm still using my meds, but maybe over time I can ratchet them down a little.  Stress can really cause a flare up, and life has been stressful recently.  If IF works and could help clear up my psoriasis over time, that would be amazing.

Diabetes? Type 1, Type 2, or [Type] None?

Last night, I received a phone call from my MD at home.  The results of my fasting glucose and insulin tests from last Friday came in.  My fasting blood glucose was 118 mg/dl, and my fasting insulin was 10.  Apparently, the blood glucose was elevated, but the insulin was well within the normal range (the max normal is 17).  The fasting blood glucose result seemed strange in light of the prior post-prandial glucose test I took at the lab, which resulted in a reading of 95 mg/dl.

But...I expected a higher than normal fasting blood glucose.  I have read a number of blog entries and posts from low-carbers out there who have had the same results:
http://www.livinlowcarbdiscussion.com/showthread.php?tid=1381
http://high-fat-nutrition.blogspot.com/search/label/Physiological%20insulin%20resistance%20%281%29

My doctor is concerned that I may be diabetic.  According to her, I should do a glucose tolerance test, and get my HbA1c tested.  I told her that I was worried about getting a false positive from a GTT because of my low carb diet.  As observed by Dr. Atkins: 

"Note: The GTT results are not considered accurate unless you are consuming at least 150 grams of carbs a day for at least four days before you take the test. Therefore, doing it after you start Atkins would mean you'd have to go back temporarily to eating a high carbohydrate diet (and almost certainly regain some of the pounds you have just successfully lost)."  Dr. Atkins New Diet Revolution, p.113 (2002 ed.). 

This recommendation seems to be pretty mainstream:

"Those taking the OGTT to diagnose diabetes or prediabetes who are not pregnant should eat a normal, balanced diet the week before taking the test. Experts recommend that this diet include at least 150 to 200 grams of carbohydrates per day. Patients must fast for at least 8 to 12 hours before having the test."  http://diabetes.about.com/od/symptomsdiagnosis/a/ogtt.htm; see also, http://www.ehow.com/how_2077817_take-pregnancy-glucose-tolerance-test.html (recommending 150g for 3 days prior to GTT).

I know I'm getting about 20-30 grams of carbs a day, which is confirmed by my carb counting and daily ketosis testing.  I'm leery about guzzling all of that sugary stuff for the GTT, about high-carbing it for 3-4 days prior, and about sticking around a blood lab for 2 hours to get the GTT done (I have to work, people)!! 

So, we're compromising.  I'm going to do another fasting glucose and the HbA1c tomorrow morning before work.  I'm going to start monitoring my blood sugars three times per day with a home glucometer, which I have to pick up this afternoon from the pharmacy (yay, insurance paid for the glucometer and lancets – no copay!).  Then we'll see if we need to do the GTT after those results come in.  Hopefully, the HbA1c will look good enough so that I don't have to do the GTT.

I have read that exercising at night, and eating a good, low carb snack before bed, can help with fasting blood glucose.  Guess that means that yours truly is hittin' the gym tonight.

I hope I'm not diabetic.  Type 1 and Type 2 are both in my family.  Type 2 I can deal with, as it is likely to resolve itself once I've got my health and weight under control.  Type 1 is pretty scary stuff. Shudder.  My maternal grandfather and first cousin once removed have Type 1.  But I make insulin…  and I have PCOS, which is related to insulin resistance (I make too much insulin).  I don't know how you can have symptoms of insulin resistance and have Type 1 diabetes, because having insulin resistance implies that you are producing a lot of insulin and your cells just aren't responding to it.

I'm going to start keeping track of my blood glucose levels on this blog.  Hopefully, it will provide some insight and result in a healthier me.