Diet

Eating Some Carbs, and Moderate Protein

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A few months ago, I wrote about some of the changes I was making towards my carbohydrate intake, and I think it’s time for a bit of a follow up.

I’m quite a spontaneous eater. For a long time, I’ve struggled with trying to curb my snacking and be diligent inbetween meals. I would have weeks where I would be super diligent, have excellent blood sugars, but was super hungry and fidgety. Those good spells rarely lasted beyond a week or two, and I would eventually end up rebounding with more carbs.

I was also eating a lot of fast acting carbohydrates and empty foods that left me hungry soon after. Some days I would snack mindlessly in the afternoons, and I never felt great or super energetic at the end of the day.

I knew all of this, but never resolved to do anything about it until recently. In my mind, I never set out on this with the intention of going extreme low carb. Life is too short not to eat cake or drink coffee. For me, this was more of a way to try and improve my eating habits, incorporate more sustaining energy sources into my diet, and to feel better overall. Maybe, just maybe, that would be the key to making my glucose levels a little more manageable.

I now try to have at least one protein source with either breakfast or lunch. For breakfast, I’ve thrown eggs on toast into my rotation alongside Oats or Weetbix and Banana. For lunch, I’ve thrown steak sandwiches and tuna sandwiches into my rotation, rather than having toasted ham and cheese every day. Dinner is usually a cooked meal, and would likely include a protein source at least 4 times a week.

Significant protein meals do need a bolus. I’m still experimenting with this, but I’m finding that setting an extended bolus for 50% of the protein over 2 hours is too much. I would like to give this theory a go, where I would bolus for 100% of the protein amount over 20g.

On good days, I try to keep my snacks inbetween meals very low carb. I usually snack on nuts and cheese, and often have a milky coffee with it, which is about 8g of carbs.

There are still plenty of moments where I indulge. But it doesn’t necessarily happen every day like it used to. Treating myself is more of my choice now, not simply because I’m feeling empty and craving something sweet. If I’m guessing for a piece of cake, I do try to look at it and think about the carb count. It really does make all the difference. The Calorie King app on my iPhone is also really handy for finding carb counts on the go.

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I don’t have a strict number of carbs that I hold myself to each day. As a ballpark figure, I would say that I would eat an average of 30g per meal. But it really does depend on the meal. A low day might be 70-80g of carbs. A high day might be 120g. I think I would rarely go near 150g in a day.

What’s surprising me the most is how much I have unconsciously reduced the amount of carbs I have eaten. For instance, there are days where I glance at my pump and realise that I’ve only eaten something like 75g without even noticing. My blood sugars are more manageable, in part because I have reduced my carb intake, but moreso because I don’t have that urge to snack mindlessly anymore. There is definitely more of a variety and satisfaction in my diet, which translates to less of a desire for junk food. I think I have brought my lunch once in the last month, as opposed to every Friday. Unless you count coffee.

I definitely don’t view carbs as the enemy, so long as I go about them sensibly, carb count and pre bolus insulin appropriately. Carbohydrates that I do eat regularly include nutritious lower carb bread, such as Baker’s Delight Cape Seed loaf or Burgen varieties. Greek style vanilla yoghurt, fruit, vegetables, milk and oats. I eat pasta and rice in moderation if they are a part of the evening meal. I also have a block of chocolate handy for a treat if I’m craving something sweet. 

I often receive e-mails and messages asking me if I would consider going on a genuine low carb high fat, or ketogenic diet. For me, what I am doing at the moment is realistic. That 30g per meal is a number that doesn’t send me rebounding on more carbohydrates. Super high fat or greasy meals don’t particularly appeal to me, either. And to be honest, I’m never going to be the kind of person who converts to low carb as a way of life.

As always, diet is a very individual choice, and I have come across a variety of different perspectives in the DOC. There’s no right or wrong approach. In my mind, the right diet is the one that is realistic, that you can sustain, and that will make you happy.

At the moment, I’m confident that this is the approach that I want to continue with going forward, and the one that will send me toward the a1c I am aiming for. 

To Carb, or Not to Carb?

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I’ve read so many articles about low carb eating lately, that it’s left me wondering if there are any people with diabetes out there who still eat them. I’m not about to start telling you what’s right or what’s wrong, because I believe that diabetes management is a very individual issue. But I would like to weigh in with my own perspective on the age old question. I stress, these are my personal opinions only.

Quite honestly, I’ve never been a fan of low carb. The mere sound of the word makes me cringe, simply because it makes me think of restriction. I also think that eating low carb requires a greater level of commitment in the kitchen all through the day, rather than having just one cooked meal in the evening as I do.

The main reason I do not like low carb eating is because the trade off is usually foods that are higher in fat. Foods that are higher in fat tend to produce spikes in blood sugar levels several hours after a meal. I find that protein and fat spikes are very hard to bolus for, and high blood sugar levels are very resilient to insulin corrections. Personally, I do not like chasing highs several hours after meals and would much rather bolus my insulin just once. If there are any low carb people reading this, I’d be interested to hear how you work your way around this.

I am happy to put the work into the carbohydrates I eat. As I wrote last week, pre-bolussing for meals helps me to avoid the post meal spikes. Carbohydrate counting does work when I’ve got my ratios and basal rates right.

That being said, I definitely have changed my thinking around the way I approach carbohydrate foods. Over time I have slowly made gradual changes to the carbohydrates I eat.

I definitely try not to overload on the carbs at mealtimes. On the weekend, we had Turkish bread rolls for lunch, which were 70g. I cut mine in half, simply because I consider 70g way too much to be eating in one sitting. Ditto for the thick slice Cafe-style raisin toast that I have as an afternoon treat sometimes. I also make sure to weigh out my portions when I have foods like rice and pasta, to make sure I don’t overload on the carbs.

I only eat bread as either toast or sandwiches now, and not as a side or appetiser for my dinner plate. I always opt for lower carb, seeded bread, which also tends to carry greater nutritional value with it. Burgen Pumpkin Seed is a real winner for me, with just 11g carbs per slice. Baker’s Delight Cape Seed loaf is another good one.

I have also cut out a lot of the high sugar foods in my diet. Over one very painful year, I gradually cut the two sugars out of my coffee and tea completely. I no longer eat breakfast cereals, because even some of the better ones are still loaded with at least 20g of sugar per 100g. Ditto for muesli bars, which have been replaced by bananas. I often have microwaveable Oats sachets for breakfast, and I have recently switched from the sugar laden fruit flavours to Original.

My approach to eating has definitely centred around eliminating the carbs that I deem unnecessary or unenjoyable. I would much rather put these carbs saved towards foods that I do want to eat. For instance, those yoghurt pots with the stir through fruit jelly? I would much rather have that sugar in a plate of ice cream instead.

When I look at my Dad, who eats bread with anything and everything, I definitely feel that I eat far fewer carbohydrates than I once did. Would I identify myself as a low carbohydrate eater? I still eat the foods that I want to eat. I don’t feel as though I am depriving myself of anything. I’m simply eating a diet with far more balance compared to life prior to diabetes.

With lots of coffee, and the occasional cannoli or cake thrown in.

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Healthy Eating on World Diabetes Day

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Tomorrow, November 14, is World Diabetes Day. This year’s theme centres around healthy eating as a management tool for both types of diabetes, and as a way to prevent some cases of type 2 diabetes.

Eating well has always been a core part of my diabetes management, particularly since I’m not a big “exercise” person.

I’ve learnt a lot about my food, over the years. When I first started out, I thought that brown bread was automatically better for my blood sugar levels. I religiously stuck to low fat foods, overlooking the other nutritional content that was good or otherwise. And, there was a lot of frustrating times spent writing things down and trying to look for patterns.

Today, I do my best to adopt a diet of low glycemic index (GI) staple foods. A low GI diet ensures that my blood sugar levels rise slowly and steadily after eating, rather than spiking rapidly and then crashing. This includes Burgen bread, Weet Bix, Plain Oats, fresh fruit, crackers that are rich in wholegrains, eggs, nuts and fruit free muesli bars during the day. And home cooked meals with salad or veggies at night time. I’ve also invested in a copy of The Low GI Diet Shopper’s Guide, which is my GI bible.

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I’ve also become extra cautious of the hidden sugars in my foods this year, particularly after watching That Sugar Film. Generally, I look for something with less than 10-15g of sugar per 100g, which is 10-15% total sugar in a product. Muesli bars with choc tops, berries and yoghurt drizzle are generally a no go. Fruit free and nut bars are generally my pick, but there’s very few decent choices on the supermarket shelves here in Australia.

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Ditto for yoghurt. I can’t stomach natural yoghurt no matter how good it is for me, so I usually opt for a plain vanilla. The biggest craze at the moment seems to be those colourful, sugar laden berry glazes on the bottom of the tub that you stir through when you go to eat it for the “visual” effect. I’d be better off having a block of chocolate or bowl of ice cream instead.

Then there’s the sugar in my coffee and tea. Prior to watching That Sugar Film, I had my coffee and tea with two sugars, in the form of artificial sweeteners. Today, I’m down to half a sugar in my coffee at home, and I drink my tea straight. How did I manage this? Commitment. First cutting down to one and a half spoons, and getting used to the taste. Then cutting down to one. And then down to half. And finally, none. Even if that meant chopping my Equal tablets into halves at home, I’m so glad that I did. And I now have more of a receptor to sweetness in the other foods and beverages that I consume.

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So, that’s not to say that I’m perfect. I still eat junk food sometimes. Potato chips, ice cream, lollies, chocolate and other deserts. I buy my lunch most Fridays. I buy coffees 2-3 times a week. I still go overboard sometimes, and I have to adjust my insulin to accommodate those times where I eat more than normal. Like this one time that I won the Easter egg raffle at work (I did share it, though!).

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But a healthy diet is a big part of my diabetes management. And hopefully it’s a part of yours, too.

You can read more about World Diabetes Day on the International Diabetes Federation website here.

There will be a 15 hour Twitter chat for World Diabetes Day tomorrow starting at 7am US Eastern Time (that’s 8pm Saturday in Western Australia, and 11pm in Eastern Australia). I will be moderating the 6-7pm hour of the chat. Follow the hashtag #WDDChat15 on Twitter to join in when you can!

“Really? But You’re So Slim and Fit!”

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I briefly checked into a bit of an impromtu #DSMA chat yesterday morning (thanks to the end of daylight saving time in the US, the chat now happens to coincide with my morning tea break at work and I can check in!).

The question that was being discussed at the time was one of the simplest, yet mind blanking questions. How would I define diabetes? Would I be type specific? Broken pancreas, insulin injections? Or would I go for a blanket definition? Regulating blood glucose levels, healthy lifestyle? Would I say something witty? It kind of stumped me a little.

I recalled a chat over the phone with a work colleague on Wednesday. Coincidentally, we were discussing the issue of a diabetes related appointment during work hours. I casually mentioned that I had diabetes, and her response kind of suprised me.

“Really? But you’re so slim and fit!” 

I wasn’t suprised by her response. Nor did it upset me. What I was suprised at, however, was the way in which she responded. That it was a big deal. I guess for me, I’ve gotten to the point now where bringing up diabetes in real life is not a big deal.

Which brings me to my own interpretation of that #DSMA question. I would like people to know that diabetes is not something that I inflicted onto myself. And I’m not saying this as a selfish person with type 1 who is completely and utterly offended. I’m saying it for people with all types of diabetes.

I’m a bit sick of the media associating diabetes with all of those “lifestyle” factors. Yes, obesity is an issue. Yes, inactivity is an issue. Yes, they’re epidemics, along with diabetes. Yes, in some cases they can be prevented. And yes, we need to work to halt them.

And we can. Independently of each other.

Why can’t we promote healthy diets and active lifestyles, without bringing the words “causes diabetes” into the mix? Wouldn’t it lead to the same outcome? We’d be working towards haulting those epidemics, without stigmatising the people who are already living with chronic conditions.

People living with diabetes would feel motivated and empowered to manage their condition through a healthy lifestyle. And at the same time we’d be encouraging people at risk of developing these conditions to adopt healthier lifestyles.

The only difference?

People already living with diabetes wouldn’t be stigmatised. They wouldn’t have to hear demoralising messages that blame and shame them. They would be able to look forward, instead of being continually dragged backwards into the pit of could ofs, would ofs and should ofs.

Truth be told, nobody chooses ANY type of diabetes. Except for the health care providers, researchers, advocates and donors who are trying to make sense of, and solve it. Each and every single day. And it’s time that we, the patients, are encouraged to look forward rather than backward.

Everything in Moderation Will NOT Cause Diabetes

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Okay, so I was sucked into part 2 of Sunday Night’s report on the Paleo diet again last night. If you’ve been living under a rock, reporter Mike Willessee undertook the Paleo diet for 10 weeks with the help of My Kitchen Rules judge and chef Pete Evans (I’ll call him Paleo Pete from here on in).

Admittedly watching the program last night, I was able to learn a little more about this diet. Basically, there are two sources of energy that the human body can use for fuel: carbohydrates and fat. I hear from a lot of people with diabetes who live and advocate for a Low Carb, High Fat (LHCF) diet. I completely respect that, and I’m sure that your body could be fuelled by fat. I myself have seen some merits in reducing “unnecessary” carbs and sugars in my diet, such as bread on my dinner plate and high sugar snacks such as muesli bars or breakfast cereals. But I do still eat carbs. I don’t feel that I could realistically cut them out completely and still be a happy man. But I completely respect those that do make that choice.

I just can’t fathom how Paleo Pete was quick to dismiss healthy, nutritious foods such as Dairy, Legumes and Grains. I also didn’t appreciate the way he referred to all of these carbohydrates as sugar, which is NOT true. And I can’t fathom how you could expect a human being to live without coffee!.

He went as far as suggesting that a diet of “everything in moderation” would cause type 2 diabetes among a string of other threatening diseases. Paleo Pete, you know absolutely NOTHING about diabetes. Don’t make an empty threat on the base of a common stigma. As my Twitter friend Lala brought to my attention, he even suggested that people who follow the Paleo diet are all exclusively healthy.

Paleo Pete is a chef. He is not qualified to provide nutrition or dietary advice. As one Twitter user commented, being around food doesn’t qualify you to provide nutritional advice. It would be like having a passenger fly an aeroplane. The Dieticians Association of Australia is qualified. LISTEN to them.

Paleo Pete also makes a lot of money off of Paleo. He has a series of cookbooks and other money making products that I don’t really care about. It’s a bit hard to take his claims of “speaking the truth” and “never feeling better” seriously.

As I said last week, Paleo Pete also works for the television network that aired this story. He is a judge on cooking show My Kitchen Rules. So is this story just a convenient case of networks keeping their talent happy?

At the end of his 10 week challenge, reporter Mike Willessee said that Paleo had opened his eyes to some of the his food choices. I feel exactly the same way, particularly after watching the similarly themed That Sugar Film earlier this year. What Mike Willessee neglected to mention was whether he’d stick with Paleo or not. I suspect his view would be similar to mine. There are some aspects that I’d take away from Paleo, but I won’t be rushing to clear out the cupboards and fridges of anything even remotely delicious.

I’m finally on Facebook, and I’d really appreciate it if you would like my page: facebook.com/type1writes.