Carbs, Starches, & Grains Denial

Here is an update after almost 2 months of cutting out the above mentioned nutrients (?) as I attempted to keep my insulin response under control (remember, no diabetes here) and push my fat cells to deplete their supply. First the hard part, bread and potatoes were sorely missed by my brain. My family continues to shake their collective heads that one can go without eating any type of grain, refuses dishes made with flour, laughs in the face of fresh sourdough (sigh), or can sit and watch them eat fresh cut french fries from In-N-Out Burger. That leads me to the other hard part, eating so radically different from those around me. I am not low-carbing, or doing Atkins, or eating primal (still enjoy some dairy), so folks find it hard to pigeon-hole my plan. Plus, I still count calories since I don’t care how much fat I eat and want my body to chew up its own fat stores, not live off of what I ingest.

Now the easy part. Eating this way is easy. I am never hungry. Variety is limited only by my lack of originality in cooking. Eating out is easy since most restaurants will happily leave off side dishes even if they won’t substitute fruit for potatoes or give me an extra side of veggies. Besides, we rarely eat out except for breakfast and eggs are so on my plan.

So what am I eating and how much of what? Looking back at the last month, my carb intake per day has ranged from 9 grams to 87 grams with an average of 55 grams/day. The highest day came from an intended splurge of a mocha coffee. So much for no sugars, huh? That was my only refined sugar source the entire month. Protein mainly comes from lean sources such as fish and roasted chicken breasts and eggs, although I do eat more red meat now than I did last year when I had this strange aversion to meat sources from animals with eyelashes. The can of whey protein sits languishing in the pantry for a desperation snack when I am too lazy to eat real food and need some calories. I eat no more than 2-3 servings of fruit per day – always berries except for the occasional fresh pineapple. Eggs – I love eggs! I always keep a few hard boiled ones hanging around, again so I know there is acceptable food available. But, I prefer my eggs freshly cooked and usually with some Canadian bacon and maybe a touch of Tillamook extra sharp cheddar cheese and mild green chiles and whatever else I can throw in to spice ’em up. Raw almonds and walnuts are other acceptable food sources as long as I measure them out. Salads, you bet – with oil and balsamic vinegar dressing. One food I have to be careful with is Greek yogurt. I buy non-fat Fage and add my own berries, but sometimes it reminds me too much of ice cream. Plus, the whole question of dairy in one’s diet is still bouncing around in my head. Although, I refuse to give up my 2 tablespoons of half-n-half with my morning coffee and the occasional bit of cheese. Veggies, I need more veggies – working on that.

Exercise… I am still on the very, very slow track of walking because of my statin-induced myopathy. Enough said or I just will start whining.

Supplements: Because of my damn myopathy and overall attempt to lower inflammation (which is unrelated to the myopathy), I am now taking Vitamin D3 5,000 mg/day, fish oil 3 gm/day, L-acetyl carnitine 500 mg/day, some multi-vitamin with a bunch of stuff in it (helpful, right?), and CoEnymeQ10 300mg/day.

I’ll end here with a fun side-effect of CoQ10 that few people experience – photosensitivity. I never, ever sunburn. But in Hawaii after 2 hours in the sun I developed a blistering burn on my chest that lasted for 3 weeks and a lovely spotted reaction on my arms and legs (where the skin wasn’t so virginal).

Oh, yeah – I lost 10 pounds.

sunburn

CoQ10 Photosensitivy Reaction

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Eating in Paradise

How does a gal cope being away from home and kitchen and living a low(er) carb, no sugar, starch, grain life style while in Hawaii? Besides sipping 100% Kona coffee on the lanai, this has been a challenge.

Who wants to cook every meal while on vaca? Sure, eggs for breakfast are fine and go great with whale watching from the comfort of the deck chairs. I have been skipping lunch, although our trip to the local Walmart (a must for buying the cheapest tee shirts and aloha shirts for friends and family) has the cupboard stocked with tuna and sardines. The condo complex has an amazing barbecue setup, which we plan to use with some fresh fish from the local fishermen, if we ever manage to get our butts out to the harbor. The local KTA supposedly sells decent fresh fish, too. Costco, a favorite of everyone here, does not sell local fish.

We ate out yesterday after a glorious whale watching excursion. I didn’t care for the fresh catch of the day and went with a burger, no bread. Why do all plates comes with some sort of starch and more starch? Asking to substitute fruit and veggies is like asking for the moon. The portions were HUGE! And, since when did it become so hard just to offer oil and vinegar as a dressing? Can you tell why I don’t eat out much?

All is not lost. Fresh pineapple is waiting to be cut. Almonds are sitting around when the need for a quick snack hits. Found a Subway using the app AroundMe to grab a quick salad on the way to a distant favorite beach for boogie boarding. And, that fresh fish WILL be on the grill tonight.

Whew, thanks for letting me vent. I think my inability to exercise to any degree is messing with my brain chemistry. Yes, I am still holding a grudge against the manufacturers of all statin medications.

Perhaps I need to go meditate on the lava rocks below. My Mom would have loved being here. Life is too short to bitch this much.

USDA Dietary Guidelines – BAH

I must say I had a good laugh when these were announced 1/31 – then I got frustrated. The message is simple and supposedly evidence-based. The guidelines were written by lipophobes and the calories in/calories out believers.

Here is the summary for consumers (a new food pyramid will emerge soon, oh joy):

• Enjoy your food, but eat less.
• Avoid oversized portions.
• Make half your plate fruits and vegetables.
• Switch to fat-free or low-fat (1%) milk.
• Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.
• Drink water instead of sugary drinks.

Yay, eat less. Who doesn’t know that and why has it taken so long for the USDA and HHS to come right out and suggest it? So why didn’t the guidelines address the food industrial complex that forces supersize portions on us? Yes, the entire guidelines are directed at the individual, as if we each live in a vacuum.

Look deeper at the executive summary, which will be translated into consumer messages, and these are some examples of what you will read:

•Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.
•Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
•Consume less than 300 mg per day of dietary cholesterol.
•Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
•Reduce the intake of calories from solid fats and added sugars.

How is the average American going to calculate their daily intake of sodium and saturated fat? Well, except the low percentage of us already trying to be good doobies and are using food tracking software. Is there really strong evidence for limiting dietary cholesterol when most of our cholesterol comes from internal production and the link between total cholesterol and heart disease not that strong.  (Answer: NO) Won’t people see the mixed messages about limiting cholesterol yet using eggs and shrimp as “good food”? (And they are good foods.)

Who is least served by these new guidelines ? 1) The poor, who already have difficulty finding affordable lean protein; when more affordable food is higher in salt and sugar; who are assaulted by the fast food industry (Micky D’s anyone?) and are not be reached easily by generic guideline messages. 2) The obese who don’t lose weight on the “one-size-fits-all” diet of limiting calories. 3) Medical professionals looking for something to tell their patients/clients other besides “eat less, enjoy it more”.

I will be interested to see the new food pyramid, how the guidelines are translated in public health messages, and how the specific messages about what to consume are disseminated to those most at risk, i.e., the poor, the obese, those who do not trust the government.

My overall reaction is that was a colossal waste of government money and until Big Food industry is targeted, as well individuals, the country will not be served well by the USDA.

End of rant.

Diet Revolution

To be precise, I should say that over the year my diet way of eating (the dieter’s PC phrase) has gradually evolved. While I remain committed focusing on behaviors around health (eating, physical activity, paying attention to my body, etc.), over the last 3 months what I eat has shifted. Time to revise my behavioral goals around food to reflect what I have learned as I went through a prolonged plateau, a battle with severe side effect from a statin medication that left me inactive for weeks, and a reconsideration of the role of cholesterol as a risk factor for me individually.

Going back to January 8, 2010 here were my behavioral goals:

  • restricting my calories to 1500kcal/day on average in a week
  • aiming for a balance between protein, fat and carbs
  • spreading out my food intake throughout the day, which means eating breakfast
  • no food after 7pm
  • no red meat
  • no ice cream (the ultimate trigger food for my binging)
  • minimal refined grains and grain products
  • adding at least 3 fresh fruits/vegetables per day
  • shopping only for fresh produce
  • limiting what is in the cupboard/frig to what is acceptable to eat
  • no artificial sweeteners or drinks with artificial sweeteners – sweet stimulates me to eat more sweets
  • monitoring everything calorie that goes into my mouth (I use the Livestrong.com site)
  • charting my weight twice a week
  • being physically active 30 minutes a day, beyond job and household activities

I believe that insulin is the big drive behind fat – getting fat and staying fat. There is much scientific evidence for support, and as a physician who believes in evidence-based medicine* I am not one to follow fads. My personal experience over the years has shown how sensitive my hunger, eating, and ultimately my weight are to foods (starch, sugar) that increase insulin. I cannot change my genetics, but I can change my food intake so fat is able to get out of my body easier and stay out forever. Also, I want to choose foods that decrease inflammation (because of family history of heart disease and because fat tissue produces inflammatory molecules); and I probably need nutritional supplements with vitamins given that I will still count calories.

Why count calories and not just low carb it? Theoretically one could just eat fat and eat little to no carbs, but eventually their body would stop drawing from fat reserves and use just what is provided in their diet. So calories do count when trying to lose weight  – it is the quality of calories that count for mobilizing fat and maintaining fat loss.

Given all of the above and more information circling in my brain, here are my revised behaviors in an attempt to change the regulation of my fat tissue:

  • No wheat, sugar (except that in natural foods), starch, or grains
  • Emphasize quality protein
  • Aim for ratio of 50:30:20 protein:fat:carbs in 1200 calories
  • Limit fruits to 2 servings a day – mostly berries
  • Veggies are unlimited (potatoes are not a veggie)
  • Monitor all intake daily using software to account for above and review macronutrient intake every week
  • Eat breakfast, ALWAYS
  • Ice cream will always be off-limits, and the only off-limit food
  • Eat if I am hungry – and figure out why I let myself get hungry
  • Have acceptable snack foods available
  • Weigh no more than once a week
  • Engage in fun, physical activity at least 30 minutes/day
  • Supplement with vitamins as needed to reduce inflammation
  • Review the above list every week after weighing

Sound restricted? Yes, it is now because I have another 50 or so pounds to lose. Will I occasionally eat cake (or potatoes) – you bet, but just a taste and only in celebration. Should I exercise more? This is all I can manage now because of the myopathy from taking statins. My goal is to be able to do whatever I want without restrictions because of my weight and to keep my health optimal.

*Evidence Based Medicine is the integration of the best scientific evidence available with clinical expertise and patient values to reach optimal decisions for individual patients.

Emerging From a Fog

Since last I wrote, or visited the blogging community, or stayed on plan… Well, no excuses. My father’s visit was wonderful but distracting and challenging food-wise. He is a feeder – for real. Despite knowing my food plan and decades of yo-yo’ing, he would put candy (home-made fudge) on my desk, buy ice cream (ICE CREAM!) and continually offer me crap. I found that when we would go out to eat, I could easily stay within my food plan, but at home my stimulus control was gone. His presence just made it worse. We negotiated about putting candy in his bedroom, having him buy ice cream in small cups and hiding it in the freezer where I wouldn’t see it. But our joint grief over Mom (just 4 months fresh), and his need to conjure her through his cooking rituals made it impossible to tell him not to cook. I found the fudge and his midnight snacks irresistible. I wanted to strangle him.

Then a wondrous event occurred over the week of Thanksgiving. Our entire immediate family, one of Sue’s sisters, and Mom’s best friend and her husband gathered at our home for almost an entire week. That time was a warm cloud of love filling the house.  We cooked, ate, played games, sat around fires outside and inside, laughed, told jokes, remembered Mom – and my eating sweets was totally out of control.

Amazing how one year of new habits can be easily overthrown. I am beginning to believe there is a carbohydrate addiction…

My skinny Father now is back in Dallas, exactly 1 pound heavier. Although I “only” gained 4 pounds over the 2+ months, I have felt completely out of control with food and sleep; my mood is low (OK, grief-holidays, I get it); and I have been searching for help. Sue is completely off her food plan also and could care less.

In desperation, I joined Weight Watchers last week after reading about the new points plan based on scientific evidence with more emphasis on protein and fiber. WW is a huge change for me, but I’m trying this for 2 reasons. 1.) I want to get away from the severely restricted foods we have used the past year, and WW seems to have a lot of tools that will help me to (OMG) cook. 2.) I need more social support. I hate groups, but I want to try in-person as well as on-line WW. The monetary commitment is a pain but adds another incentive.

For now, it’s back to daily monitoring of food, walking to resume the modicum of fitness that I had, reconnecting with my blogging buddies, and going back to all of those behaviors around food that I so neatly laid out almost one year ago.

family picture

Thanksgiving Family Portrait

Candy Is Disgusting – Who Knew?

I caved; I freely admit it. After almost one week of exposure to sweets galore, I finally gave in and allowed myself to eat some chocolate (and not the dark 73% cacao type). This turned out to be a sickening experience. The sugar rush was horrid. The taste was overwhelmingly sweet. My pancreas went into overdrive, and I wanted nothing more to do with candy – I hope.

Unlike quitting cigarettes more than 30 years ago and finding that my nicotine receptors were easily stimulated by smells, activities, and certain people, my ultra-sweet receptors(?) seem to be highly offended by exposure to these substances. BUT, I’m afraid that I could quickly become immune to my nauseating response and relapse to eating sweets of all types. I certainly still struggle with starches and keep them out of reach. The slippery slope to eating very high glycemic index substances might be close by…

Until I return home, my solutions are to fall back on the 5 D’s –move my mother’s stash of sweets into her bedroom (distance); distract myself with any number of tasks that need to be tackled in their house; drink, drink, drink water (or iced tea since this is Texas); take calming deep breaths; destroy any sweets I grab for, or at least get them out of my reach.

When will my problems with stimulus control go away?

Vacation Mode /Off

After 9 days away from home (what a grand trip!) and another 5 at home with neither of us working, I now have to face my not-so-daily routine while the spousal-type goes back to her demanding work. The good news, eating becomes more structured. The bad news, I really enjoyed having zero demands except those placed on us by the pets and our own expectation of not being totally worthless to the rest of the world — adios until next vacation.

Here is my reflection so far of how eating out and at home in a less structure manner went during that time:

  • Travel days were the most difficult. While protein bars might work for many folks, they are triggering to my “sweet lobe”. I did resort to using the new Cliffs Builders Bars, which have a higher protein:carb but still experienced cravings that had me throwing bars across the room in our hotel one night.
  • An unexpected long travel day (13 hours instead of 5) left us “stranded” with only airport food. Really poor choices in most airports when trying to keep low calories and balanced protein/carb/fat. That day I totally blew it – probably more from stress of trying to get home and dealing with the airline than lack of appropriate food. God knows I have enough fat stores to let me fast for 13 hours!
  • Eating in NYC without going to restaurants is completely doable, and we did it this time. Our focus this trip was culture and movement. By selecting a hotel in a wonderful neighborhood near a well-known market and having a kitchenette, we were able to choose wisely. I did get one bagel with nova lox and cream cheese – but only one! We shared a piece of cheese cake, but only one. Fruit, low-fat cheese, deli meats, salads made up most of our meals and presented nicely on our hotel room plates.
  • Writing (even a couple of brief blog entries) was a good distraction and zapped me out of some mindless eating one night, even though what I was eating was healthy. Mindless eating remains a major hurdle for me.
  • Walking! We walked everywhere; the subway was our only form of local transportation in NYC besides the limo to and from the airport; my knee was not that much a problem — what’s a little Tylenol and ice pack every night? My favorite walk was a 2-mile stroll from Brooklyn across the bridge back into Manhattan with hundreds of other tourists and locals on their lunch-time runs and bike rides.  I consider eating tied to my eating routine, so it fits here.
  • Once home but still on vacation, we were both reluctant to eat in our usual routine, and for the first 3 days I munched around on almonds, yogurt, salads, but at off hours. This felt a bit out of control. I also did not keep track of my intake – very much out control. Two days ago I snapped back into sleeping and eating in my usual pattern, monitoring my food, and reconnecting on blogs. Routines are VERY IMPORTANT – make that structure.
  • I lost one pound.

I’m still trying to figure out what all of this means for my next trip coming up in June when I have to spend time with my family for 2 weeks during my father’s surgery, recuperation, and caring for my mom and him. Just anticipating that visit makes me cringe because of the perceived threat to my weight loss and eating pattern. Planning ahead…

Times Square candy store

Candy everywhere!

Huge m&m on times square screen
Chocolate follows me to Broadway!