Thursday, 27 October 2016

Effect on Appetite

I have always been hungry. Always seemed to need more to fill me up than most people. Got hungry again sooner after eating. And could continue to eat when already full... especially sweet things.

I always thought this was a moral failing. Well, most of the time. Occasionally, I would think to myself "But I'm hungry! Surely I have to be able to eat enough not to feel hungry all the time?"  But, for the most part, I would think that it was my fault that I kept on eating food I didn't need.

I've already described how I fell into LCHF almost accidentally. And, for me, the most powerful aspect of it is the effect on appetite. That's what makes it possible not to overeat. I eat... I get full... and I stop eating. And I'm satisfied for many hours.

Take today, for example. I did feel slightly hungry when I woke up, which is unusual. But then, I did have more carbs yesterday then usual - we had a curry at the pub and I ate a small amount of rice that got scooped up with my curry, and about 1/4 of a naan bread. But it wasn't a strong hunger, so I ignored it.

Then we want for a walk, starting shortly after 10.30am. We walked for about 4.5 hours. Only in the last hour or so did I start to feel slightly hungry - but it soon passed. By the time we got to the tea shop, all I really wanted was a drink. But I thought eating something would be sensible. Everything on the menu was very bready. I chose rarebit, and scraped the cheese and bacon (which were delicious) off the bread, eating just a couple of mouthfuls of the bread.

Sometime after 7pm, we went for dinner. I had some smoked salmon with avocado mousse, then some lamb loin with green vegetables. And I am satisfied. Won't need to eat again until tomorrow lunchtime/afternoon.

This is not about willpower or morality. This is about the hormonal environment created by what I'm eating. I choose the types of food and allow my body then to choose the quantity and timing.

Monday, 24 October 2016

Away From Home

When you're at home, you're in charge of what you eat. You exercise control when shopping. Only buy things which are on the plan, and you are 80% of the way there.

When you go out it's a bit harder. But most places will have at least something on the menu that can be adapted to be suitable.

What if you go away for a whole week????

We have started our Autumn break. After much debate, we decided to book our hotel room only rather than B&B.  So that means we'll be looking for two suitable meals a day. A reasonable start this evening - the pub next to our hotel was our destination.  I chose the Pinwheel burger from the specials menu - a chorizo rolled into a spiral and served on top of a burger with cheese.... minus the seeded bun, and swapping the chips for a salad. The salad came with a dressing on the side - which I tasted. I caught a distinct hint of mustard (which I don't like) and sweetness - probably honey. So I left that, and added my trusty pot of olive oil from my bag. I don't think that's going to last me the week, though.

I was more than ready to eat, given that I hadn't had much the rest of the day - I had an early afternoon funeral, so just snacked on the remaining olives from the fridge and some macadamia nuts before going up to church.  But the burger AND the chorizo was a bit much, and I couldn't finish it. Then back to the hotel room for a (decaf) coffee - although with those little pots of semi-skimmed milk, rather than the double cream or full fat milk I would normally have.

So - day one done. Let's see what tomorrow brings.  I have brought my glucose meter with me to keep up my daily monitoring - hopefully a reminder to keep me on the straight and narrow and dissuade me from indulging in a piece of cake "because we're on holiday".

Friday, 21 October 2016

Stages on the Journey

I didn't have much of a clue when I started. So I did what most of us do these days - I asked Doctor Google.

I can't remember the exact sequence of events, but within about a week of getting back from my holiday I had found the DietDoctor website and several facebook groups and other forums which support an LCHF way of eating - some specifically for people with diabetes, others more general.

I read. I learned. I asked questions.

They recommended books - I bought some of them and read them avidly.

I read about the science of ketosis, and went from thinking that it wasn't really necessary, and what I would need to do to achieve it was just too restrictive.... to understanding that there are real advantages to being keto-adapted, and that to achieve that you had to stay in ketosis for a number of weeks and months. After that, you could probably afford to come out of ketosis for brief periods without losing all the adaptations - but why would you? Maybe for Christmas.... or a family wedding.... but otherwise? Not so much.

My first attempts at LCHF cooking were a bit clunky. I shopped almost every day because I kept on thinking of new ingredients to try. Avocadoes - I had never bought one before, and it took me a while to learn how to get the stones out and skins off (easy 0 use a dessert spoon).  Coconut oil - to start with I fried EVERYTHING in either that or butter. I sometimes used too much, and the food was much too greasy.  I kept on reading that lard was a really good thing to use, but I couldn't bring myself to try it. And then I did... and if you think bacon fired in butter is delicious (which it is), bacon fried in lard is even better.  I discovered that if cabbage - which has never been my favourite vegetable - is fried in butter with some chopped-up bacon it becomes rather delicious. And that cooked chicken breast added to a salad is really tasty when sprinkled with salt, pepper and olive oil.

My eating definitely went through stages.  At first, I was still snacking quite a bit, but instead of biscuits, crisps, fruit or chocolate it was nuts, cheese or olives.  At first I ate a lot of eggs, bacon and yogurt (not all together, obviously).  I made a nut granola recipe from the Real Meal Revolution book, and ate it with Greek yogurt for breakfast on the days I wasn't eating bacon and egg. I learned to enjoy fried mushrooms.

After a month or so, the snacking started to diminish. I was feeling very satisfied at mealtimes, so ate less in between. I read that cream is preferable to milk in tea and coffee because the carb content is lower. I couldn't stomach the idea of cream in tea, but I started putting it in the two cups of coffee I have most days. And since I had cream in the fridge, I started using it in sauces when I cooked, and putting it on my berries instead of yogurt.  Now I get through an awful lot of cream, and not very much milk or yogurt any more.

I learned - quite early on, actually - that there are many flavours of LCHF, and people can be quite passionate about their particular version. I have learned to sit somewhat light to these discussions. But thanks to observing them, as well as the broad principles of eating low carb, high fat, moderate protein and minimally processed, I also avoid seed oils as much as possible, don't generally eat legumes, and think that leaning towards cream rather than milk and yogurt is probably helpful.

But no doubt next week, that may change!

Wednesday, 19 October 2016

A Fasting Day

Oops, missed a day there. Never mind. Here, as promised, is a report of my fasting day on Monday.

I started fasting after eating tea on Sunday. It was probably about 7pm by the time I'd finished my coffee (with double cream - yum!).  During the evening I drank some water, and later on some cider vinegar diluted in water. Why? Because it has been demonstrated to suppress fasting glucose levels the following morning.

The following day, Monday, I drank only water and alternative teas without milk (e.g. green tea with lemon, redbush etc).  I had a couple of twists of Himalayan pink salt - I've discovered I prefer to just eat it off my hand and chase it with water rather than dissolve it in water. The reason for taking salt is that when fasting, and on a low-carb diet, the kidneys are not forced by high insulin levels to hang on to sodium. That's why blood pressure tends to drop. This means that low-carbers and fasters, rather than moderating their salt intake as is usually recommended, need to take more.

The on Monday evening I had a bit of a wobble. There is a theory that if you are going to interrupt the fast it is better to do so with something very high in fat, since fat produces the least insulin response. I had a handful of macadamia nuts. Then a block of cheese. And then some more nuts, and a decaf coffee with cream, all at around 9.30pm. OK, so not a total fast, then, but I did wait out the rest of the time till lunch on Tuesday without consuming anything else calorific.

Here are my blood glucose and ketone readings over the length of the fast:

Monday - on waking     6.1   1.2
               - 1pm ish        5.8   1.5
               - bedtime        5.1   2.8

Tuesday - on waking     5.0   2.5
                 before lunch  5.0   2.2

As you can see, the general pattern as the fast goes on is for glucose levels to fall, and ketone levels to rise.

Glucose falls because there's no carbohydrate or protein coming in. The liver is capable of manufacturing glucose (from recycled proteins and the glycerol component of fat), and in type 2 diabetes, it does far more of that than it should.  But when there's nothing coming in, the glucose produced by the liver will be used by those body cells which can only use glucose, which is red blood cells, the cortex of the kidneys and a small part of the brain.  So there's less of it left to float around in the blood. And when glucose falls, insulin falls too - which is what I want to achieve.

A blood glucose level of 5.0, by the way, is considered normal. It's in the normal range. However, in someone who is *truly* normal - a fit, healthy active young person - it would probably be lower - especially after fasting.  So, I have a way to go on reversing my insulin resistance.

Ketones rise because, with no carbs or protein coming in, the body turns to fat for fuel. Most body cells can use fat directly, but the brain can't. So the liver makes ketones out of fat, and the brain happily uses them.  This is a process called ketosis, and is a normal part of human metabolism, there to be used when food is scarce. Except in the modern world, it is never scarce - unless we choose to fast.

Because I eat a low-carb diet, I am in ketosis all the time. My ketone levels, outside of fasting, have usually been in the high 1's/low 2's.  By contrast, someone who is having regular meals containing carbs would be unlikely to see more than 0.1

So, how did it feel?  Pretty good, actually. It's normal for me now not to have breakfast, so the only difference on Monday morning was that I had green tea with lemon rather than ordinary tea with milk. It's not a big deal to skip lunch, either. I worked in my study in the afternoon, and apart from one spell when I felt a bit 'spacey' for a short time, I was fine. I had a meeting in the evening, which probably helped keep my mind off things.  But then... oh yes.. there were the macadamia nuts and cheese. Evenings have always been my weak spot when it comes to unscheduled eating. But Tuesday morning - absolutely fine.  I worked, and then about 12.45 I made lunch, and the fast was over.

I intend to do more of this. But maybe not for a little while, as we are on holiday next week. Who wants to go on holiday and fast?  But - in honour of my new LCHF eating plan, we have booked the hotel room only. I'll probably take a couple of packets of macadmia nuts and supply of alternative tea bags, because the milk in the room is likely to be semi-skimmed (which I no longer drink, given the choice) or artificial creamer (containing sugar).  A week of seeking out suitable food choices among the cafes and restaurants of the Cotswolds. Nice!!

Monday, 17 October 2016

Today - Nothing!!

Today I am fasting.

If you want to know why fasting is a good idea - there's a whole load of information starting here. The executive summary, though is that type 2 diabetes is primarily a problem of insulin resistance. I make a shedload of insulin, but my body doesn't listen, so my blood glucose stays too high. That's type 2 diabetes - both insulin levels and glucose levels are higher than normal.  And the higher the insulin gets, the less my body listens to it.

Fasting allows both glucose and insulin levels to fall. AND that actually reduces my degree of insulin resistance. It does loads of other good things as well, but the impact on  insulin resistance is the primary reason why I'm doing it.

Anyhow - all the sciency stuff, and answers to all your worries about fasting - are  here. This is about what it's actually like to fast.

It's heading towards 4pm. I haven't eaten since about 8pm last night. No breakfast. No lunch. No milk in drinks (I have drunk green tea and redbush tea, and water).  How do I feel?

Well, OK, actually. I went for a run this morning. Took a church council meeting. Made a pastoral visit. Came home and, after a cup of (milkless) tea, have been working in my study this afternoon. I am getting on with life as usual.

I have felt hungry intermittently. But it passes. It doesn't build and build and get worse and worse - it comes and it goes.

I do think about the fact that I won't be eating today - in fact, before tomorrow lunchtime. But it's not distressing me that I haven't eaten.

What interests me is what happens to my blood glucose and ketone levels while I fast. I am testing both - first thing, 1pm, again at bedtime, tomorrow morning and then tomorrow before I break my fast at lunchtime.

What I *expect* to see is glucose coming down and settling in the normal range - that's what's happened during previous fasts - and ketone levels climbing.  I'll give you the numbers tomorrow.


Sunday, 16 October 2016

So, What Do You Eat?

If you don't eat bread, potatoes, pasta, rice, any grain products at all (cake, crackers, crispbreads, cereals) and no sugar..... what exactly do you eat?

- Meat, fish and eggs are the main protein sources. I go for less processed ones most of the time, and eat similar serving sizes to anyone else

- Loads and loads of non-starchy veggies and salads. If it grows above the ground, it's probably fine. If it grows underground, it's higher in carbs and I need to go easy

-Fruit - very little, actually. I eat some berries (with double cream) most days, because they are the lowest carb fruits. I steer away from most other fruits.

- Nuts and seeds, full-fat dairy products and healthy (naturally occurring) fats. If it comes from an animal or can be squeezed out of a fruit, and has not been chemically altered, it's fine. The fats I use most for cooking are lard (yes! lard), coconut oil and ghee, with butter, olive and avocado oils to add to/slather over food.

Here's what that actually looks like when you turn it into meals.

Breakfast could be bacon, egg, tomatoes and mushrooms. Fried, not grilled (except I probably prefer my eggs scrambled, so that's how I do them. Streaky bacon, not back. Or it might be half an avocado with a dollop of cream cheese. Or some full-fat Greek yogurt with a home-made nut granola (containing nuts, spices and coconut oil)

Except I seldom eat breakfast any more. I am much less hungry than I used to be.... so I've pretty much stopped eating breakfast.

Lunch is usually my lighter meal of the day. Nine times out of ten it's a salad (salad leaves, peppers, cucumber, baby tomatoes) drizzled with olive or avocado oil, with a bit of protein added. Some cooked chicken or ham. Smoked salmon. Feta cheese, walnuts and avocado.  And whereas I would always have followed my previous lunchtime sandwich with a (sweetened) yogurt and a piece of fruit, I now have a few olives, or a piece of cheese and some macadamia nuts. Or nothing!!

Main meal - well, lots of possibilities. A bolognese sauce (made from fresh ingredients to avoid the sugar in the ready-made) over spiralised courgettes (still working out the best way of cooking those). Baked or pan-fried salmon with a load of veggies (covered in butter) or salad (with olive oil). A shepherd's or cottage pie, but the mash is cauliflower rather than potato, served with veggies.  Rack of lamb, roasted in the oven, with veggies. Home-made curry in a creamy sauce, served with shredded roasted cauliflower instead of rice.

If I'm eating out, there are several options. Anywhere that does an all day breakfast is a good bet - just don't bother with the toast or fried bread.  Steak/gammon/chicken and chips - but swap the chips for extra salad or veg.  I can usually find a soup or a salad to pass muster. And when everyone else is tucking into dessert, I will be sipping an Americano with cream.

This way of eating is causing me to be inventive. The internet is a great resource - there are thousands and thousands of low-carb recipes, and loads of places to find advice about swaps and substitutions. Living low-carb in a high-carb world isn't always easy. But it's nothing like as difficult as you might think.

The best thing for me is the way that hunger and cravings have decreased. A month ago we went to the theatre and I decided to have an icecream during the interval. It was stem ginger - one of my favourite tastes. But with the very first mouthful, I knew it was too sweet. Oh, I ate it alright - sugar is highly addictive. But I didn't really enjoy it. And I resolved there and then not to have it again.  I have some home-made low-carb icecream in the freezer - sweetened with xylitol. But I'm only getting through it very slowly. I don't crave it any more.

To me, that's really quite amazing.

Saturday, 15 October 2016

To Begin at the Beginning

Hello!

This is a new blog to accompany a new phase in my life. Well, not entirely new - it started a few months ago. But as my confidence has been building, I've decided to go a bit more public.

The phase concerns what I eat and when I eat it. I have come to the conclusion that a low-carb, high-fat, moderate-protein diet ketogenic diet composed mainly of natural unprocessed food is the best (i.e. healthiest) way for me to eat. That's a bit of a mouthful - so let's call it LCHF, which is an acronym that Google will tell you lots about.  I've also become convinced that intermittent fasting is a very healthy thing to do.

It's also pretty much the complete opposite of Government's healthy eating guidelines. And flies in the face of advice to people with diabetes. But I think there is good reason to believe those guidelines are not helping people with diabetes, and in fact are making them worse. And probably contributed to them developing diabetes in the first place.

I stumbled on this way of eating almost by accident. When we were on holiday this summer and I was enjoying all the freshly squeezed orange juice and croissants, I had in the back of my mind the vague intention to do something about my weight once we got home.  I've always been overweight. In fact ,for most of my adult life I have been severely obese. From the start of 2012 to the middle of 2013, I had lost 7.5 stone and got off my diabetes medication.  But by the middle of 2016, I had regained 6 stone and was back on medication. And although I don't have the figures to back it up, I was pretty confident that my diabetes was not properly controlled.

So, I had to do something. And it so happened that the only English-language newspaper available in our hotel, the Daily Mail, was starting a series on low-carb eating. Now, I have heard about low-carb to manage diabetes for a long time. But whenever I heard it, I pushed it away. Sure, I can understand that eating sugar isn't a great health choice (actually, it's really damaging), and I know that carbs are mainly what increase blood glucose - especially high glycemic index ones. But, really - can anybody live without bread, pasta, potatoes, rice, cereals, and CAKE!!!

It turns out that you can.  I made a start the day after we got back from holiday - 5th July 2016. It took a few days to get my head round the concepts, and I've adjusted as I've gone along.  But, in summary, in a little over 3 months I have lost over two and a half stone. When I started eating this way, I didn't have any test strips for my blood glucose meter - it is no longer policy to prescribe them for people who are not at risk of hypos. So I bought my own (the one with the cheapest test strips) - and in 6 weeks I have seen my fasting glucose level go from the mid 7's to less than 6. (Normal is under 5.5)

And the best of all is.... I am not hungry!! I don't mean that I never get hungry - of course I do. But much less often, and much less intensely. And that means that I am not constantly wanting to snack and nibble. I am eating delicious. satisfying food, mostly cooked from scratch from fresh ingredients, as much of it as I want,  and I am getting slimmer and healthier with each day that passes.

Not bad, eh?

LCHF eating is controversial. The establishment doesn't approve of it - but (I have come to believe) the establishment's view is based on flawed interpretation of cherry-picked data. It's not saturated fat that causes heart disease - it's inflammation, caused by high levels of insulin and a high intake of sugar and other refined carbohydrates.

Anyhow - the purpose of this blog is not to convince you of the science. I'll link to some of it so you can read up on it if you want to. The purpose of this is to record my experience as I continue this journey of discovery and my body adapts.

See you soon!