Decent article on fasting if you ignore the unsupported semi-vegan dietary recommendation. It’s amazing how one can write an entire article on lowering insulin production through fasting and then ignore that very concept when choosing food to eat. Plants are part of a good dietary plan but most plants are mostly carbohydrates. To lower insulin levels all the time, not just when not eating, you have to lower the carb intake. You can’t build your diet on a non-essential macronutrient and expect to stay healthy.
Several recently published meta-analyses of observational studies and randomised controlled trials (RCTs) have found that total saturated fat is not associated with non-communicable diseases including coronary heart disease, cardiovascular disease, and all cause mortality
Did great yesterday until the end of the day when I succumbed to the siren call of ice cream after a very long day. The breakfast spike was due to my infatuation with blueberries.
Today was a new day though. I had my typical Wednesday breakfast at Nick and J’s Cafe of three eggs over well with bacon and black coffee. Then I met a friend for lunch at Dickies for 1/2lb of brisket. We celebrated his amazing success on his low carb/fasting journey which I hope he’ll share on this blog sometime soon.
This afternoon there was a handful of green grapes running out the door to go do yard work at the office.
After last week’s daily deluge of carbs this week I plan to be much more moderate in my intake.
Today, breakfast was just a few scrambled eggs which had no impact. Lunch was a protein shake I like to make from About Time Protein powder with added MCT oil. Again there was no impact.
Dinner was the only meal that showed any increase in my blood sugar. It consisted of roasted chicken, fresh corn on the cob, steamed carrots, and some Colbyjack cheese. The elevation wasn’t enough to push me over 100mg/dL however.
So the lesson I’d like to impart here is that it only takes one day of change to see an impact on your health. Studies show that by the third meal of a low carb nutrition plan there is measurable improvement in someone’s insulin resistance. The time to change is right now.
I heard a proverb one time that said the best time to plant a tree is 20 years ago. The second best time is right now. Make your next meal the first meal of a new way of life. If you need help, call my office. That’s what I do.
This weekend was my final two days on a high carb, ‘celebration food’, diet. For these days I planned several very high carb meals and they didn’t disappoint in their effect on my body.
On Saturday I worked Trinity’s Walk In Clinic at Fort Sanders West. Usually I bring a breakfast treat for the staff consisting of various low-carb yogurts with fruit and some decently low carb granola options. I decided to try out several of the types of yogurt individually to see their effects.
The first attempt was about 8:30am with Fage’s full fat yogurt. As you can see, one of the individual serving containers had no effect on my blood sugar. Listed as 6gm of carbs the actual amount is much less than that as the process of making yogurt utilizes some of the lactose through fermentation. It might be a good choice in the future for me for a low carb, low impact food.
The second attempt was an hour later with a blackberry Carb Master yogurt from Kroger. At 5gms of carbs and plenty of artificial sweeteners I was hopeful for a small impact. Again, there was no rise to my blood glucose but you can see a dip shortly there after. I’ve come to believe that the artificial sweeteners cause a release of insulin or a failure of glucagon which results in a low to often develop. I’ve seen this in several patients too. I will probably be limiting or avoiding these yogurts down the road. I’d rather have the plain full fat Fage.
Finally I got to the day’s glucose master challenge consisting of two apple fritters which I ate before I headed to Home Depot for some errands. I waited until after clinic was done as I knew it would slow my mental capacity and I didn’t want them to affect my clinical skills. No surprise my glucose spiked and I seriously contemplated laying down in the middle of Home Depot to take a nap. Not wanting to be cited for vagrancy I soldiered on and finished up.
After getting home, I spent several hours working outside in vigorous yard work involving moving rock, shoveling, and digging out a new flower bed. Those bouts of activity were associated with spikes in glucose too. I’ll be interested to see how my glucose responds to exercise when I’m fat adapted later this month. I’ve purposely not exercised in a formal way this past week to keep me as insulin resistance as possible. I’m looking forward to getting back to it.
On my final day, I wanted to go out with a bang so asked the family to go to Mimi’s after church. They were pretty surprised as I never want to go eat there as their low carb selection is very limited. This time that was the point. I had hoped for French Toast but since it contains cream cheese and orange marmalade, two things I really don’t like at all, I decided to try the chicken and waffles. Honestly, I’ve never had this before. I’ve eaten plenty of chicken and plenty of waffles but never on the same plate. I can see the appeal especially after pouring 2 ounces of maple syrup on everything.
The impact was amazing. Again, I felt like taking a nap and found it more difficult to think clearly. The carb count on this meal was incredible. The chicken and waffles is listed as 97 gms of carbs on Mimi’s nutrition website. When the syrup is added it totals 183 gms. Essentially the sugar in 2 oz of maple syrup is the same in all of the chicken and waffles! I couldn’t believe it. The effect lasted hours with multiple spikes. The maximum glucose achieved wasn’t especially high but the duration of effect was over several hours. The area under the curve was very large. That’s when the damage is done.
Later that night, I ate another couple burgers with buns similar to the ones earlier in the week. I wanted to see what affect they would have after such a high sugar load for lunch. Interestingly, it was blunted. Whereas they would typically cause an elevation, it was more restrained.
So as the week has progressed, I’ve learned and experienced many interesting things. I feel more sluggish and less mentally sharp in general and specifically after high carb meals. I’ve gained 3.5lbs of weight (in one week!). I’m more swollen and achy during the day. I don’t think I’m sleeping nearly as well as I usually do.
A single meal has a big impact. That impact is in both directions. A single bad meal causes stress for hours. A single good meal can really help you recover back to normal more quickly. Remember that each day is about each meal. Don’t stress too much ahead of time over the upcoming meals. Fight the battle in front of you and move on. Each day has enough trouble of it’s own.
What’s next? This week will be short as I’m headed out on vacation Saturday but I’ll be turning my attention to a good low carb, whole food recovery plan for the remaining days. I’ll be interested to see how quickly the weight will come off and I start to feel better. After vacation, I’ll use another sensor and document my progression into nutritional ketosis. I’ll be showing my ketone meter readings too.
I’d love to hear feedback from anyone about how this blog series has impacted your decision making process on food or your experiences with blood sugars. Please feel free to email me directly or post a comment publicly as you deem appropriate.
Yesterday was day 5 of my CGM experiment with my FreeStyle Libre. It was pretty boring which was a little by design and a little by accident. Interestingly, this blog series has prompted about a dozen of my patients to contact me and acquire a CGM for themselves. I have heard feed back that the lowest price seems to be about $35 per sensor using a GoodRx coupon. Several folks have found that price at Wal-Mart and Walgreens.
I started out the morning still feeling very full and, as you can see from the graph, my glucose numbers were still bouncing around until about 3 am from all the food on July 4th. So, I fasted for breakfast to try and recover. I had planned to have a very low carb lunch of left over plain hamburgers but walked out of the house with them still sitting on the counter. Doh!
I wasn’t able to leave the office at lunch so only ate a small snack and a protein powder shake. In total, it was about 20gms of carbs. That accounts for the small spike and quick recovery. I didn’t end up getting home until 9pm and decided to have leftovers from the July 4th party. That was a pretty high carb meal. As I’ve come to expect, I spiked and dropped after going to sleep. The roller coaster of numbers continued until this morning. One lesson I’m learning is just how detrimental late night eating is. Next week I’m going to eat some moderate to large size dinners of very low carb food and see how much effect that has while I’m asleep. I’m also going to focus on skipping more late night dinner meals if they aren’t a sit down meal with my family.
Overall, the first part of the day was a recovery period which went well. If I had stuck with that process, you can see how a day of appropriate celebration can be accommodated better when surrounded with a few days of self-control and proper eating. We are built for cycles of fasting and feeding. Celebration with rich food can be very appropriate. We just need to limit our celebrations to those days which are in fact a celebration.
Celebrating Independence Day, like almost every other American holiday, involves lots of food. Yesterday’s rumor of cake was not unfounded and today was a day marked not by one big meal but by multiple opportunities to eat richly.
Breakfast began with my first cake, four of them to be exact. Paleo Pancakes found at Costco are a lower carb (but not low carb) grain free version of traditional pancakes. They are surprisingly filling for their size and generally you don’t want very many.
Interestingly, these pancakes produced in me a phenomenon I see in many other people and regularly talk about. It’s a clear sign of insulin hypersecretion and dysregulation of the body’s glucose balance mechanism. I developed reactive hypoglycemia after my breakfast meal of four 3 inch diameter pancakes with honey and butter, two fried eggs, and blueberries.
When my CGM read low I double checked it with a finger stick. You can see they correlate well. As my glucose rose, so did my insulin level. It effectively moved my blood stream glucose into the cells of the body and brought the level back down to normal. However, when it hit normal, about 85 mg/dL, the body’s compensatory hormones that help balance the effect of insulin likely failed to appropriately be released. Glucagon is the chief counter-regulatory hormone and signals the body to release its stored glucose from the liver. This slow dripping stream of glucose raises the blood glucose levels just as insulin lowers them. The delicate balance between the two allows for a stable number. Failure of glucagon to release allows insulin to work unchecked thereby continuing to move glucose into body cells and lowering the blood level. Many people feel this occur and Snickers has based an entire ad campaign on this phenomenon. “You’re not yourself when your hungry.” Anyone ever been called h-angry?
Many people try to correct these symptoms by having a carb rich snack or drink. If you must, have a small amount of complex carbs possibly with some protein or fat to slow digestion. Something like a couple ounces of nuts or half an apple and avocado. Ultimately the best fix for this scenario is retrain your body to release hormones appropriately by converting to a low carb, moderate protein, quality fat diet as we’ve been discussing. When done correctly this always corrects the issue as a thoroughly fat adapted individual cannot suffer hypoglycemia.
Of note, I think my hemoglobin and hematocrit are low as a result of the retained fluid from my excessive carb intake this week. Hyperinsulinemia results in retained salt and water which dilutes a stable red blood cell mass. I suspect my blood pressure is running higher than normal too although I haven’t checked it. I have noticed more lower leg and ankle swelling at the end of each day.
After breakfast we began getting ready for our family to come over to cook out. As I started the fire and prepared the outdoor space, my wife made an All-American Angel Food Cake. Her offer of the mostly empty frosting bowl and a spoon was not refused and that promptly spiked my glucose around noon.
Lunch was burgers and hot dogs cooked over the open fire using this awesome campfire grill set up from Wimpy’s. Burgers cooked over a real wood fire really are the best you’ll ever have. They were so good I had the leftovers for dinner. Both lunch and dinner were finished with a piece of cake. You’ll note a small peak between those two meals on the CGM graph. I honestly don’t know what to attribute that to. I don’t think it was food related.
Lastly, what’s Independence Day without a little bowl of ice cream? I think I remember from history class that General Washington celebrated each victory with vanilla bean, or maybe that was Captain America. Either way, it’s definitely American.
So like many holidays, at the end of the day I’d swear I’ll never need to eat again but without fail I do. I think this is a challenge for many of us. Our celebrations are defined by food. We celebrate holidays and get togethers and times with friends and families. I’ve celebrated many an afternoon just making it through the work day. We celebrate Saturday mornings and Sunday lunches. We should celebrate all of these times as life is a celebration of God’s grace and love to us. However, we don’t always have to celebrate with massive meals of carb rich food. Remember the 1/2 lb of brisket I ate the other day? It was delicious and never moved by glucose. I truly believe we can celebrate wonderfully without developing insulin resistance or diabetes. Just think of all the extra celebrations we could have if we lived this out well. Too many lives are cut short by diseases resulting from high insulin levels. We can be a generation that adopts a new normal and changes our own destiny.
I don’t know what tomorrow’s going to be like. It’ll be hard to top today but I’m sure there will be something I can try.
Here on my 3rd day of wearing my Freestyle Libre, I moderated my food intake a little and didn’t go overboard on anything in particular.
For breakfast, I ate at Cracker Barrel with my Bible study group and I ordered the Double Meat. Typically I skip the biscuits and gravy before heading to work but have been known to partake on other occasions. This time I chose to eat both biscuits with butter and one strawberry jelly. This was about 70 gms of carbs as calculated through LoseIt.com. Remember that the toast and jam I had on Day 1 was 72 gms. Interesting that I ate more carbs at home than at Cracker Barrel. I admit, I didn’t see that coming.
Breakfast developed a double peak glucose spike again. Pizza showed a similar response last night but you can see that it continued to cause spikes well into the night. It caused 5 spikes all together and then still displayed lots of variability in the normal range until I got up only to disturb it again with breakfast. All told, having eaten the pizza at about 6pm last night my glucose wasn’t stable until about 6am this morning.
After breakfast, my numbers leveled out until lunchtime when I ate a low carb meal of eggs and cheese with a medium sized apple listed at 22 gms of net carbs. It barely got my glucose over 100 mg/dL and then it leveled again.
When I got home from work I ate a small snack of 7 dates at 28 gms of net carbs. They are often one of my whole food snacks when carb count isn’t as critical. As you can see, their effect is not very high and is a smoother curve than breakfast breads have been. Foods in their whole form often are much slower in digestion and absorption than you might expect for the amount of carbs in them. This will show up as lower peaks and a more rounded shape on the monitor.
After eating, I headed outside to keep working on cutting up the fallen and hung up trees from last week’s windstorm. It was strenuous work especially given the heat and humidity. Exercise can mobilize glucose for immediate use which I believe accounts for the second spike after that from the dates.
Lessons learned from today, I think, are real food is better than fake food, the effects of poor choices can last a long time, and more than food can cause glucose to rise and you can’t always control those factors.
Tomorrow I’ll have a couple opportunities at my family’s get together to really test my glucose response. Rumor has it there will be cake!
Tonight I enjoyed my favorite pizza, Little Joe’s ham and mushroom. Having grown up with the owners, I spent many a Saturday night there with my family. The breadsticks are fantastic.
As you can see pizza has a hidden surprise. It’s not just one peak of glucose dumping into the blood stream, it’s two. This delayed phase can be especially tricky for diabetics who live by insulin (type 1).
I decided to follow it up with two mashmallowless S’mores. I calculated the pizza at about 102 grams of carbs and the S’mores at 72gms. That’s a huge sugar load right here before I go to bed. Wonder how I’ll sleep and how long it will take me to recover once I get back to eating well.
Tomorrow I have my weekly Bible study breakfast meeting. Our usual place is closed so we’re headed over to Cracker Barrel. I’m going to see what a couple biscuits and jelly do relative to my toast experiment from earlier this week.
I’m honestly anxious to finish up this process. The data makes it so clear what I should eat and it’s hard not to clean it up. I know that anytime by blood sugar is much above the green area my body is being injured. I can feel my brain not working well. Things are dull and I know I’m slower than I should be. But the experiment must continue.