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A Healthy Diet that works for Diabetes (and others)

I said in this post that I would give you more details about my successful diet, so here we are.
(I’m not a nutritionist, but I did study physiology as part of my University degree, spent time as an athlete, and have had some chats with nutritionists recently).

No diet is going to work effectively without exercise. It’s very important to always remember this, as it is the key to good weight loss. I’ll tell you why.

A little bit of easy science
In principle, all we have to do is to store less energy and use more of our energy stores and we should regain a healthy weight. Sounds easy, but it isn’t because evolution gave us the “greedy gene” and our bodies always want more than they need right now. The body doesn’t realise we will also have food tomorrow, so it wants it all today. Even our stomachs are elastic so we can fit too much in!

You probably already know we have three main food types – protein, carbohydrate, and fats, and they can all be used as energy sources – even protein. Of course there’s other stuff too, but let’s concentrate on these for now. The reason we have too much weight is because we have stored too much energy and not used it up.

Carbohydrates (in the form of glucose sugar) are the body’s primary source of ready, immediate energy. We don’t store them, except for a few in our muscles and blood supply. Eat too many carbs and they turn into fat and are stored for future use.

Carbs come in two forms – slow release starches (complex carbs) and fast release sugars (simple carbs). The fastest release carb is glucose sugar which needs no digesting, only absorbing. Starchy foods have to be digested before their sugars can be released. This takes time so the sugars are released more slowly resulting in fewer sugar spikes.

Because all carb foods have a mixture of simple and complex carbs within them, Dr. David J. Jenkins and colleagues in 1981 at the University of Toronto invented the Glycaemic Index to easily identify fast release and slow release carbs. This index compares how long different foods take to release their sugars into your bloodstream compared to how fast Glucose could be absorbed. Glucose is given a value of 100, and other foods get a number related to this depending on how fast or slow they are. Peanuts have a low value of 18, while white bread is on a higher value of 70. I may write a post about this interesting subject another time.

Fats represent the body’s long term energy store for times of fasting or shortage, but are also essential for nerve function, brain activity, and many other important things. They aren’t normally available short term, so have to be converted into carbs to be useable. Pervesely, this process requires some energy in order to release even more energy so isn’t usually switched on.

Proteins are the primary burner of energy. They are used for many metabolic things as well as for movement, and may be very short lived: some proteins found in the liver only exist for about half an hour before they are destroyed, but they are vital for our bodies to function. They can be used as a ready energy supply though, and this is what happens when we starve: the muscles are reduced before the fat stores can be.

In the laboratory, and in our bodies, studies show that carbs and proteins provide roughly the same amount of energy when burned. Fats on the other hand release a lot more, but need quite a bit of energy to be input to get the conversion process started.

So, when we diet without exercise the body first looks for carbs for its required energy. If these are insufficient, rather than look for fat the body dips into the protein store. This is bad long term because you need your muscles to burn the fats, yet your body is busily protecting the fats by wasting your muscles. This is how constant dieters produce wild swings in body weight, and gain weight over time rather than lose it.

Exercise
The good thing is that exercise reverses the above process, provided our heart rate goes above a certain level (ask your physician what is right for you – it varies with age, medical health and is different for everybody). My physiotherapist said she aims for a pulse of between 120 to 140 beats per minute depending on the person. My Doctor on the other hand said I should maintain a rate of 70% of my maximum heart rate. She said maximum heart rate could be calculated by a rough rule of thumb of 180 minus my age.

There’s lots of ways of getting the exercise: swimming, cycling, stepping, walking up and down stairs at home, walking, running and many others. Get professional help before embarking on a program: even though I know a lot about exercise I still got help before starting as I’d never exercised with diabetes before!

For me the most convenient was walking (and it was possible for me!) so I bought an iPod and the Nike+ shoe sensor which allows me to record how far I walk, how fast, how many calories I burn and so on. It’s a great aid to fitness, and very motivational.

Without a heart rate monitor, I find how heavy my breathing is is a good guide: when I’m breathing quicker than normal, but still only lightly, my heart is working well and without too much stress. If I increase the workload and I start becoming short of breath or am panting, I’m overdoing it. That’s bad as I could injure myself, putting my exercise plans, and my diet, back quite a bit.

To help prevent injury, always do some light stretching exercises before you begin your workout. I find a 5 minute yoga warm up helpful (not a full session). Stand opposite a table or chair, lift one leg up and straighten the knee and stand there for 30 seconds, then do the same with the other leg and repeat again for both. Then stand parallel to the edge of the chair or table and lift your leg up and sraighten the knee again – you might find this a little more difficult as it stretches the muscles on the inside of your thigh which are smaller and usually stiffer (and therefore easier to injure).

Finally, stand away from the table or chair with your arms at your sides so you have freespace around you. Sweep your arms backwards and upwards as if reaching for the ceiling (the arm motion has to be backwards, not forwards) breathing in as you do so. When your arms are pointing directly upwards, bend your whole body from the waist so that you are moving towards touching your toes, expelling your breath as you go.

It doesn’t matter if you reach your toes or not, what is important is that after you have bent forwards you allow gravity to pull you down a bit more, don’t force yourself down using your muscles, or “dip” as footballers do. Relax your neck and let your head drop too (you’ll feel that). Hold that pose for thirty seconds if possible, feeling the backs of your legs stretch a little more, a little more as the muscle fibres gently unwrap and lengthen. Again, repeat once.

Our bodies respond rather better to exercise than you might think, and increasing levels of fitness can be achieved from just two or three half hour stints per week (on different days of course). The body needs some time off in between to rest, when it builds up our muscles and enhances our cardiovascular system. These are good things – remember, we need our muscles to burn our fat!

Next – food

Meals
The main idea behind my new eating habits is to eat a little, a lot, with regular, balanced meals throughout the day with regular exercise on top. This next bit is counter-intuitive. My three (yes, three!) main meals are breakfast, a good lunch, and dinner. In between these I have a snack. Before I go to bed I eat some supper.

That’s six different times my body now eats, compared to my previous three, or even two some days when I skipped lunch completely. I used to eat late, a really big meal with lashings of carbs and second-helpings, plus dessert. You can imagine how my sugar levels fluctuated wildly with that system!

With the new system I always seem to be eating. It’s great! I have two main meals now instead of one, so I get lots of flavours and variety which prevents boredom. In the past I’ve found diets are things where you have to give things up, and then get cravings for those things, but this is the first one that encouraged me to eat more often! I can actually eat whatever I like, just in small quantities. If I eat some chocolate for a snack, I just need to cut out the same amount of carbs and fat the bar contains from other meals. Somehow, the attraction of some junk foods is quite reduced – especially when veggies and some fruits are pretty much unlimited.

To control the diabetes I need to manage my sugar consumption, and to lose weight I need to reduce fat intake.

Breakfast
This is the one I’m least sure about, because I only have a bowl of porridge made from 40g of rolled oats and I’m not sure if I should be eating more than that. Still, oats are a slow-release carb and have beneficial effects on cholesterol levels too. I did have Weetabix but this was giving me too much of a sugar spike in the morning. My sugar levels are much better on the porridge which I can eat hot summer or winter. I might try some Birchermuesli as an alternative in the future (I’ll post some recipes later).

Mid morning snack
Usually, a banana or other fruit. I could also have a piece of wholemeal bread, and so on. I find the banana easiest to fit in with office life as it somes ready packaged (banana skin). I sometimes have a cereal bar instead, but make sure these have oats and low fats and low carbs. I’m trying to have less than 20g carbs at a snack.

Lunch – 4 courses (yes, FOUR!)
Thin, non-creamed soup such as vegetable or beef bouillion.

Second course a side salad – mixed, or tomatoes and cucumber, whatever you fancy that is vegetable matter only (yes, I know tomatoes are technically fruits because of the seeds).

Main course is half a plate of vegetables or salad, one quarter of a plate of carbs (potatoes, rice, pasta etc) and one quarter of a plate of protein (meat, fish etc). My nutritionist suggested I think of my dinner plate as a clockface. From 6 o’clock to 12 o’clock it’s vegetables, from 12 o’clock to 3 o’clock it’s carbs, and from 3 o’clock to 6 o’clock it’s protein.

All main courses should use this clockface analogy (which is why I am going to query my breakfast arrangements – I may have to increase what I eat!). I could also have a simple sandwich (eg Ham on thin wholemeal bread) instead of the carbs and meat. If I did that I’d swap the veggies for a second helping of salad (which I really enjoy).

Dessert is a low fat, low sugar yoghurt, ice cream, flan, or cold custard from a pot, or a fruit salad (I can eat as much fruit and vegetables as I like).

Mid-afternoon snack
This is much like the morning snack but I try to make sure I don’t repeat the same thing I had in the morning.

Evening Meal
Pretty much the same pattern as lunchtime, but varying in menu.

Supper
Just after measuring my blood sugar I have a low fat, low sugar yoghurt with some wholemeal crackers. A piece of wholemeal Ryvita would be ideal. The fibre in the cracker and the fat in the yoghurt slow down the absorption rate by your gut of the sugars in the yoghurt, so my blood sugar’s are much more stable through the night.

Results
It’s early days yet, I’ve only been out of hospital for just over 2 weeks, but already there are some positive effects.

  1. My belt buckle fixing has gone down two holes ie my waist measurement has reduced.
  2. My face looks thinner – I can see my cheekbones in the mirror and my feet below me again.
  3. The Doctors expected me to put on 8Kg by now, and I’ve actually lost 1Kg, meaning my programme is responsible for a “net” loss of 9Kg. Special circumstances apply here though, so you may not see the same effect.For me, the Doctors were predicting the 8Kg loss as my sugar balance reduced from 20 to 30 mmol/L down to the more normal 5 to 7 mmol/L range based on the idea that water would replace the sugars in my blood. If you are already on stable sugar levels you may not see the 8Kg loss, just the 1Kg or perhaps a little more.
  4. Getting up off the floor used to be a major struggle, now it’s a lot easier as my legs have got stronger – I can actually feel muscles there again!

You may not be so impressed with the weight figures, but don’t forget that due to the exercise my muscles are growing in size and increasing my weight, even as I burn off fat to reduce it. The good thing about this is that my body’s capacity to burn off fat will increase as my muscles get bigger. This results in good weight loss that stays off, not bad weight loss you get from fad diets or slimming drinks.

If I lose 10Kg per year for three years I will be quite happy. That level of weight loss is not unhealthy and can be sustained. Once I reach that level I will be able to slightly increase how much I eat, but of course I will monitor things along the way: I don’t want to get into a situation where my fitness is so improved that I start to burn off energy I don’t have stored. That could be dangerous.

I’ll keep you posted with how my weight loss program goes over the next few months. Once I lose enough weight I should be able to get off the medication altogether, and that’s what motivates me. I want my life back!

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7 comments on “A Healthy Diet that works for Diabetes (and others)

  1. Hi,
    I t is an excellant article on “Understanding Diabetes” and controlling the disorder process.

  2. Wow,

    What an in-depth and informative post, thanks for sharing all of this. The GI is definitely a life saver and has helped me so much.

    Many people try to ignore or deny many of these things because they think it is too complex. But really it isn’t and once you get the hang of it things become habit and get really easy.

    I look forward to future posts and following your blog. Take care 🙂

  3. Very informative and a great guide whether diabetic or not. I’ve experienced diabetes by proxy as my brother became an insulin dependent diabetic at aged 7 but has slightly been in denial ever since and now has some quite serious health problems due to being quite laise faire when it came to a sensible management of it.
    Best wishes for the diet and life adjustments.

  4. […] Healthy diet that works for diabetes (and others) via fifthdecade […]

  5. […] Diet , Diabetes , iPod , Sport , Health , Food , Apple A little while ago I wrote my piece on the dietary regime I’ve been following to combat Diabetes. I was diagnosed with the condition on 15th April 2007 and spent a week in hospital. Since then […]

  6. So – how is it going ? I read your article with great interest. My parents are diabetic and this level of structured diet will really help them. Would love to hear more of how you are getting on with it !

  7. So far, I’m ahead of schedule, having lost 15 Kg in total. Holidays are a pain, because it is next to impossible to find food suitable for diabetics. Christmas wasn’t too bad, but the lack of summer fruits in winter is a definite hurdle to overcome. I definitely eat less fruit now, and weight loss has stopped as a result. However, I still do the exercise, and eat reduced carbs so I am not putting weight on either. I am looking forward to summer!

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