A Dietitian’s Journey – the road to better health
Two years ago, my Endocrinologist gave me the choice between a low-carb-high-healthy-fat diet with occasional periods of fasting or taking medication for Diabetes, high cholesterol & blood pressure. Two weeks ago, I made my choice.
As a Dietitian, I’ve heard of many different types of diets; some good and others not-so-much and I’ve also heard people tell of their success and failures with each of them. I’ve heard of the pounds lost and amount-and-then-some gained back and the feeling that somewhere along the line these people feel as though have failed. But did they? Was it really a lack of will-power or was something else going on?
In past blogs, I have talked about the changes to Canada’s Food Guide, which paralleled changes to the US Food Pyramid, both which began in 1977. Both countries made dietary recommendations that focused on low-fat, high carb diets; all with the promise of lower rates of heart disease, but what we got instead was what some have called the “Diabetes Epidemic“.
What effect have these dietary recommendations had on obesity statistics?
In 1978, only 15% of children and adolescents in Canada were overweight or obese but by 2007, that rate doubled to 29% ! By 2011, obesity prevalence alone was 15.1% for boys aged 5 to 17 years, and 8.0% for girls of the same age.
What about adults?
In the period of 1970-72, the prevalence of obesity* in Canadian adults increased from 10% to 26% in 2009-11.
Obesity is defined as having a body mass index (BMI) ≥ 30 kg/m 2
Based on waist circumference 37% of adults and 13% of youth are abdominally obese – and this kind of fat, which lies around and between our organs increases risk of heart attack and stroke far more than fat under the skin (sub-cutaneous fat).
As of 2013, there were approximately 7 million obese adults and 600 000 obese school-aged children in Canada! Not just “overweight”, but OBESE!
These statistics and a discussion with a friend who is a physician resulted in me beginning to question whether this dramatic increase in obesity and overweight after 1977 was correlated to the changes in the dietary recommendations of Canada’s Food Guide and the US Food Pyramid toward lower fat, higher carbohydrate diets.
I began to question whether the ‘standard’ three-meals-and-two-or-three snacks per day, with 45-65% of calories coming from carbohydrate really was best. And so began the process of me changing not only what I believed, but what I practiced.
A Dietitian’s Journey – the beginning
I remember back at McGill, when I was doing my undergrad training as a Dietitian, one of my professors saying that most people chose Dietetics because they came from a background of disordered eating or diet-related health issues. True to form, most of my extended family were obese and most had Diabetes, high blood pressure and high cholesterol and were on a whole host of medications for each.
Fast-forward 20 years (and several children later) and despite losing 35 of the 60 pounds I had to lose, I became Diabetic. More recently, I’ve had high blood pressure.
Unable to answer my questions regarding addressing both of these through a low-carb-high-healthy-fat eating plan, my GP referred me to an Endocrinologist. After a thorough physical examination and a whole host of blood work, she asked me about how I planned to address this, given that I am a Dietitian. Hesitantly, I told her that I planned to eat a high healthy-fat diet and low carb diet with a medium amount of protein and use intermittent fasting to lower insulin resistance. She asked me what percent of “net-carbs” (total carbs minus fiber) I was aiming for and what percentage of protein and what my fat sources would be, and I told her. I was waiting for an extremely negative reaction, but instead was completely taken aback by her reply. She said that from she’s been reading in the literature, my plan was not only evidenced-based, but that if I didn’t don’t lose the rest of the weight and eat this way, that I will end up on both medication for my blood sugar, and cholesterol and likely for my blood pressure, too.
I began to implement the dietary and lifestyle changes and was seeing my “numbers” coming down, but like many people, life happened and I didn’t follow through. The weight crept up and presumably so did my blood sugar and pressure, but I had stopped monitoring those ages ago. But it was a problem with my eyes — one whose cause was unrelated to being Diabetic or having high blood pressure that was a game-changer for me. Having these conditions put me at higher risk of losing my vision and this was simply not something I was willing to risk.
Two weeks ago, I arrived at a fork-in-the-road. One direction was the same as most of my family took; with medication for blood sugar, blood pressure and cholesterol. The other was the road that I am taking; the one less traveled, but very well-researched, and with the encouragement of my Endocrinologist – a low-carb-high-healthy-fat way of eating, with days of fasting in the day but eating supper, and periods of days of eating and then not eating.
Not “starving”, but “intermittent fasting”. The difference?
Starving results in the body lowering its metabolism to spare calories and intermittent fasting and alternate-day fasting results in the body raising its metabolism and burning stored fat.
The expected outcome?
The first goal begins with lowering insulin resistance; which is the underlying cause of Type 2 Diabetes, and with lower insulin resistance follows lower blood sugar levels – both fasting blood sugar and A1C (3 month average).
A change in diet and strategic use of fasting, lowers insulin and cortisol levels which in turn, lower triglycerides (TG). TG are largely a byproduct of a high-carb diet (especially affected by fructose), so lowering these results in lower TG and in turn, lower levels of LDL (bad cholesterol) and higher levels of HDL (good cholesterol). Lower insulin and cortisol as well as less abdominal fat, results in lower, more normalized blood pressure.
Will it work? The research seems to indicate it will and over the weeks to come, I will posting the results of some of that research so that the context of what I’m doing can be understood. After all, I am a Dietitian and a scientist — it has to be evidenced-based.
The First Two Weeks – off to a good start
Of course this is an incredibly small period of time to look at, but in the first two weeks since I started my low-carb-high-healthy-fat eating with intermittent- and alternate-day fasting , my blood sugar has decreased substantially even on the days I was eating, provided I was eating very few carbs.
My blood pressure went from 50% Stage 1 hypertension with 1 hypertensive emergency (scary!) and ~30% Stage 2 Hypertension the first week:
…to approximately 80% Stage 1 Hypertension and almost 20% Prehypertension the second week.
That is a significant change!
My weight is only down ~ 4 pounds, but I’ve lost 1 inch off my waist.
I am not hungry on my intermittent-fast days …and keep in mind, I talk about food all day long with my clients. If I am not talking about food, I am working on meal plans and writing about food! If I was hungry, this would be torture, but it’s not. In fact, the last time I ate was last night at supper and I feel fine. I should have had a coffee though (as I get caffeine headaches if I don’t). I’ll make one soon.
I’ve only taken one alternative-day fast so far and it went fine. I drank “bone-broth” (I’ll explain in coming blogs!) and had my morning coffee with a little cream, no milk because of the carbs. I don’t really like cream, but it was okay. Bone broth is interesting — a bit like chicken broth, but different.
One side-bonus that I never expected, is that I am sleeping better than I have in years. Crazy good sleep and waking up rested. What a great added bonus.
I have a long way to go to get to my goals (plural) because I’ve set the bar very high…and why not? If the literature indicates that this works, then I want;
(1) blood sugar in the non-diabetic range
(2) normal blood pressure
(3) normal / ideal cholesterol levels
(4) a waist circumference in the “at or below” recommended values of the Heart and Stroke Foundation
Will I meet all these goals? Who knows?! But I won’t know if I don’t try and the alternative of a life of medication for blood sugar, blood pressure and eventually cholesterol too does not appeal to me!
So join me in my journey – a journey of change, of good health and on a road less traveled.