Too Much and Too Little is Killing Us – reducing comorbidities

I just got “the call” that my mother who lives on the other side of the country, has tested positive for Covid-19. She has all of the major comorbidities, so prognosis is not good. Following the news, most of us know that age, obesity, hypertension and diabetes are known to significantly increase the risk of requiring hospitalization and death from Covid-19 (you can read more about that here, here and here), yet all but one of these comorbidities can be put into remission.  We can’t change our age, but we CAN reduce our weight, lower our blood pressure and normalize our blood sugar. To improve our quality of life outside of the pandemic, and to have the best chance of fighting it off if (or more likely when) we get it, we need to put our energy into achieving a normal body weight (and waist circumference), blood pressure and blood sugar now.

I am from a family of people that always ‘battled with their weight’.

My dad was tall and very fit when he was younger, a boxer and a ski-jumper but as he aged he accumulated excess weight around his middle. He then developed type 2 diabetes, high blood pressure and heart issues and eventually was diagnosed with Alzheimer’s disease, which is sometimes referred to as ‘type 3 diabetes’ by some clinicians. I wrote this article about that when he was first diagnosed.

My dad died just a few weeks shy of his 91st birthday, which is a ‘ripe old age’ of course, but for the last 40 years of his life, he was not in good health. He took several medications due to multiple metabolic conditions related to his diet and lifestyle. Except for his age, many of these conditions could have been put into remission — or at very least, been much better controlled with a change in diet and lifestyle.

My mom will be turning 85 this fall, and has been overweight since I was little. She too has type 2 diabetes and takes multiple medications for various conditions, many related to diet and lifestyle; conditions which could have been greatly improved, if not put into remission with a change in diet and lifestyle. It wasn’t for lack of trying “diets”. When I was young, she weighed her food, counted points and went to “groups” and at times she lost weight, only to put it all back, and then some. Eventually, she stopped trying. I can’t say that I blame her, given what I now know about the drivers to hunger.

Shared comorbidities

When I became overweight and then obese, and developed type 2 diabetes and high blood pressure, I justified that I was at high risk since both of my parents had the same.  I realize now that the “high risk” was our shared diet and lifestyle, more than genetics. Our shared comorbidities were adopted.

I grew up loving to eat good food and unfortunately considered food as both a reward, and a comfort. When someone was happy, we celebrated with good food. When someone was sad, we consoled with “comfort food”.  Food was “medicine”, but not in a good way. It didn’t heal, but contributed to the underlying hyperinsulinemia that drove the disease process. (I’ve written several articles about this topic, but if you only want to read one, I’d recommend this one.)

Those who have followed me for some time know that 3 years ago I began what I call my “journey”.  It took almost two years to do, but I lost ~60 pounds and a foot off my waist and I put my dangerously high blood pressure and uncontrolled type 2 diabetes into remission, as a result.  I recently posted a summary here, to mark my three year health recovery anniversary; two years of active weight loss and a year of maintenance.

Left: April 2017, Middle: April 2019, Right: April 2020

So why am I writing this post?

Like many people, I am upset by this whole “Covid thing” — not just because of my mom being diagnosed. I’ve been following the news, and realize that the hope for a vaccine any time soon is dim, and effective treatments are still lacking. An article published in the journal The Lancet the other day reported that while ~90% of those who have been hospitalized with severe Covid-19 develop IgG antibodies in the first 2 weeks, in non-hospitalized individuals with milder disease or with no symptoms, under 10% develop specific IgG antibodies to the disease.  That means that except for the sickest people who actually survive being hospitalized for several weeks with Covid-19, more than 90% of people who get Covid-19 and recover outside of hospital don’t develop antibodies to this virus [1]. Since the whole purpose to develop a vaccine is to challenge the body to develop antibodies to the virus — the very fact that most of the time people who don’t get that sick don’t develop antibodies, means that the likelihood of most people developing antibodies to a vaccine may be minimal.  As well, in light of this data herd immunity is also a dim prospect because most people that get this disease don’t produce antibodies, which means they aren’t immune and can probably get this virus again.

With little immediate hope of an effective vaccine or of herd immunity, what CAN we do to lower our risk?

I think that we first need to realize that many experts believe it is simply a matter of time until we are all exposed to the SARS-CoV2 virus and develop Covid-19, so we must look at lowering our risk of having a poor outcome. We can’t change our age, which is the biggest risk factor but we CAN do something to change the high risk comorbidities such as obesity, high blood pressure and diabetes.

Too Much and Too Little is Killing Us

For many of us, having both too much and too little is killing us.

We have diets with way too much refined carbohydrate, usually combined with large amounts of refined fat, and our usual diet is full of these in the form of pizza, pastries, take out foods and snack foods.  We now know from a study that was published almost 2 years ago[2] that this combination of both refined carbs and fat results in huge amounts of the neurotransmitter dopamine being released from the reward centre of our brain — way more than when we eat foods with only carbohydrate, or only fat separately. This huge amount of released dopamine results in us wanting to eat these foods, and craving these foods, and being willing to pay more for these foods than foods with only carbs or only fat [2]. Dopamine makes us feel good, and is the same neurotransmitter that is released during sex and that is involved in the addictive “runner’s high” familiar to athletes. This is one powerful neurotransmitter! It is this dopamine that is driving why so many people on “lock-down” have turned to baking bread and pastries for comfort, and buying snack foods with this same combination once they finally get through a long line to get into a grocery store! 

Too much of these refined “foods” is contributing to 1/3 of Americans and 1/4 of Canadians being obese, and another 1/3 in both countries being overweight. These foods are driving the hyperinsulinemia that underlies many metabolic conditions, including type 2 diabetes and hypertension.  These diseases were killing a great many of us before Covid-19, but knowing that these comorbidities increase our risk of hospitalization and death when we get the virus, why don’t we consider limiting these? I think it is because eating these foods make us feel good and so we self-medicate our stressful lives with something that is socially acceptable. High carbohydrate and fat foods are much more socially acceptable but what will it take for us to see that this for what it is and to consider that we need to change how we eat. If we aren’t willing to admit that our obesity, high blood sugar and high blood pressure are a problem, then maybe we are simply in denial. I certainly was, and wrote about this in “A Dietitian’s Journey”, the account of my own health recovery.

No, I am NOT saying that “all carbs are evil” and I’ve written about this previously, but we need to differentiate between what most of us eat as “carbs” and whole, real food that have carbs in them. I believe we need to eat significantly less of the refined foods that are contributing to our collective weight problem and metabolic health issues, and eat more of the real, whole foods that have gone by the wayside in our diet. I’ve written about the science behind this type of dietary change in many previous articles, and that eating this way is both safe and effective. What I can’t do is motivate people to want to change.

It is my hope that by presenting the evidence, as I have in several recent articles posted on this website that comorbidities such as obesity, hypertension and diabetes are significant risk factors to requiring hospitalization or of dying of Covid-19, that it may motivate some people to consider making some changes. If not now, when — especially given that the hope of a vaccine and/or herd immunity is likely a long way off.

I wish each of you good health and a long life.

If I can help, please let me know.

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd
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Copyright ©2020 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only. The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything you have read or heard in our content.

Reference

  1. Altmann DM, Douek D, Boyton RJ, What policy makers need to know about COVID-19 protective immunity, The Lancet, April 27, 2020, DOI:https://doi.org/10.1016/S0140-6736(20)30985-5
  2. Di Feliceantonio et al., 2018, Supra-Additive Effects of Combining
    Fat and Carbohydrate on Food Reward, Cell Metabolism 28, 1–12

 

 

My Three Year Health Recovery Anniversary – a Dietitian’s Journey

I delayed posting this update to due to the current Covid 19 pandemic, but thought by now we could all use with a little distraction. I hope that this post about my health and weight recovery serves as encouragement as to what is possible simply by eating real, whole food, and sticking with it.

Me – April 2017, 2019 and 2020

Three years ago, on March 5th, 2017 I was sitting at my desk in my office and I didn’t feel well. I didn’t even know what kind of “unwell” I felt.  I decided to take my blood pressure to see if that would give me a clue.  I was alarmed with the results and decided to lie down and take it again. That didn’t help. Not only was my blood pressure high, it dangerously high.  I was having what is known as a “hypertensive emergency”.  While I hadn’t done so in way too long, I also decided to take my blood sugar. The result was 13.2 mmol/L (238 mg/dl) only a half an hour after I ate, which was way too high — even for someone who had been diagnosed with type 2 diabetes five years earlier.  Here I was, an obese Dietitian with a body mass index (BMI) well over 30, dangerously high blood pressure and blood sugar that clearly showed my type 2 diabetes was not well controlled and I knew that all of these factors put me at significant risk of having a stroke or heart attack. I was scared. Actually I was terrified.

As I’ve said on every podcast I’ve been a guest on, and have written about many times, what I should have done at that point was to have gone straight to my doctor’s office;  even knowing that he would have sent me directly to the hospital by ambulance or taxi due to my dangerously high blood pressure.  I should have gone, let them treat me to get my blood pressure down, including taking the medications they prescribed. Then, with my doctor’s oversight I could have begun a well-designed therapeutic diet to lower all of these significant metabolic markers and in time had my doctor gradually de-prescribed the various medications I would have been given, as my weight, blood pressure and blood sugars normalized.

I didn’t. It was foolish. What I did instead was to immediately change my diet and lifestyle and while I fully acknowledge that this was not a wise choice, that’s what I did.

I was so scared.

In the preceding 6 months, I had two girlfriends die within 3 months of each other; one of a massive heart attack, and the other of a stroke. Both worked in healthcare their entire lives and both had become overweight and had developed some of the same metabolic issues I had. I was terrified because I realized that if I didn’t change, I could be next.

April 2017

That day, I printed off my last set of blood test results, and took all my body measurements as if I were a client. I then designed a Meal Plan for myself as I do for others and from that day on, implemented it “as if my life depended on it”, because quite literally, it did.

There’s been no looking back! March 5, 2017 was the beginning of my health and weight recovery journey; A Dietitian’s Journey.

April 2018

In the first year, I lost 32 pounds and 8 inches off my waist, and my glycated hemoglobin (HbA1C) no longer met the criteria for Type 2 Diabetes (i.e. was ≤ 6.0 %), and my blood pressure ranged between normal and pre-hypertension. Updated lab work indicated that my triglycerides and cholesterol levels were optimal, however my updated measurements showed that my waist circumference was still not half my height, which is what it needed to be (you can read more about the reason for that here). In addition, my fasting blood sugar remained higher than it should be. I still had work to do. I was in recovery, but not recovered yet.

After consulting with two physician colleagues, I made the decision to lower my carbohydrate intake, and continued to monitor my blood pressure daily and blood sugar several times per day.  I also began doing some resistance training exercises with equipment I had on hand (and that had been collecting dust for years).

April 2017 & April 2019 (same outfit)

After 2 years on my recovery journey, I had lost a total of 55 pounds and 12 inches off my waist but since my blood pressure remained between the pre-hypertensive and hypertensive range, and in discussion with my doctor’s colleague, I decided to go on a “baby dose” of Ramipril to protect my kidney function. Even though my blood sugar was good and my HbA1C was below the cut-off for type 2 diabetes, my endocrinologist started me on Metformin as a result of my father’s recent diagnosis of Alzheimer’s disease.

I didn’t look at starting on either of those medications as “failure”, as I probably would have been prescribed those at much higher doses from the beginning had I gone to see my doctor March 5, 2017. It was part of my recovery process. My goal however was to make changes so that blood pressure medication would no longer be necessary, but I didn’t know what other changes I could make to have it to come down to a normal level, and for my fasting blood glucose to continue improve as well. After much reading in the scientific literature about circadian rhythms , I realized that to be successful I needed to change when I ate (and didn’t eat) as well as when I was exposed to bright light in order to get my body working according to its natural circadian (24-hour) cycles. I made the changes documented in the literature and began to sleep much better (falling asleep and staying asleep, when I had previously had poor sleep for years). A few months of home monitoring indicated my blood pressure was normal or slightly below and I was getting fasting blood glucose numbers I hadn’t seen before (4.7mmol/L – 5-2 mmol/L). I hadn’t “arrived” but my recovery phase was definitely approaching the end.

A visit to my doctor’s office just before Covid 19 began indicated I had blood pressure that was just below the normal cutoff of 120/70 for someone who is not diabetic, so my doctor de-prescribed the blood pressure medication and recent lab test results indicated that I have completely normal fasting blood sugar [5.2 mmol/L (94 mg/dl)]. Over the past year without trying, I lost another 5 pounds and a little less than an inch off my waist and I am guessing this was probably the result of continued loss of fat balanced by increased weight from added muscle I gained as a result of the intermittent resistance training I was doing.

April 2020

I am now a normal body weight. I have an optimal waist circumference (slightly less than half my height). I am in remission of type two diabetes; both as assessed by fasting blood glucose and HbA1C, and my high blood pressure is in remission. I went from taking 12 different medications three years ago, to leaving my doctor’s office a few weeks ago with one prescription for something non-metabolically related, and a prescription for glucose test strips.

I feel good about myself, about my health and how I look — so much so that in September of this past year I decided to stop straightening my hair and now wear it the way it grows out of my head.  I am “comfortable in my own skin” (and hair) for the first time in almost 3 decades. I didn’t lose weight quickly but it took me many years to become THAT metabolically unhealthy that I gave myself the time I needed to get well and am staying well, without any added effort. The process wasn’t at all difficult to accomplish, or difficult to maintain. All it took was eating real, whole food and reducing the amount of carbohydrate-based foods I ate.  What is nice is that after 3 years on a therapeutic diet, I am now able to add in small amounts of higher carbohydrate-based whole foods into my diet, and tolerate them very well.

While there are many studies showing many others have accomplished similar clinical results as I have eating the same way, doing it myself enables me to encourage my clients because I have “been” there, and I came back!

More Info?

If you would like more information about how I can help you lose weight and keep it off or improve blood pressure, blood sugar or cholesterol please reach out to me. All my services are now provided via Distance Consultation but I already have more than a decade of experience providing virtual nutrition support, so this is nothing new for me. I am licensed as a Dietitian in every province in Canada except PEI and can also provide nutrition education services to those in the US and elsewhere.

You can find more about the details of the different packages I offer by looking under the Services tab or in the Shop. If you have any service-related questions please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd
Fipboard: http://flip.it/ynX-aq

Copyright ©2020 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only. The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything you have read or heard in our content.

 

Five Pounds or Fifty Pounds of Fat – in very real terms

Whether one loses 5 pounds of fat or 50 pounds of fat, I think it is very helpful to visualize just how much that is. Yes, five pounds of fat is much larger than most people realize!

This past week, I purchased a life-sized model of 5 pounds of fat from a well-known nutrition supplier; the same supplier I have purchased life-sized food models from, which I used to use a lot in my practice.  When I received it, I was quite surprised how much room it took up and just how heavy it was.

Here is a photo of the life-sized model 5 pounds of fat on a scale, with my left hand for a size reference:

5 pounds of fat on a scale, with adult hand as reference – © BBDNutrition

Here is a photo of it on an ordinary steno chair:

5 pounds of fat on a steno chair – © BBDNutrition

…and here is 5 pounds of fat being held in my hand:

5 pounds of fat in adult hand – © BBDNutrition

Finally, here is 5 pounds of fat being carried as one would carry an infant:

holding 5 pound of fat – © BBDNutrition

Five pounds of fat is a lot! Sure there is the initial water-loss at the beginning of weight loss, but here I’m talking about fat.

Fat takes up a fair amount of room around one’s waist, or worse inside one’s abdomen or organs. If someone has 20 pounds of fat to lose, that is four of those fat models distributed over their body; legs, belly, arms, neck, back and face and perhaps some in their liver.

I had 55 pounds of excess fat before beginning my journey.

Comparing these two full length photos, it is easy to see how I had the equivalent of one of those fat models over the length of each leg, one distributed between each arm, one distributed over my neck and face and 2 spread out around my waist and hips and some no doubt, in my liver and pancreas. But still, I can’t actually imagine where I was carrying 11 of those, all told!

The fat in my abdomen must have been more than I imagined, as it was wreaking metabolic havoc on my body.  I had very high blood pressure and had type 2 diabetes for 8 years.  You can read the entire story (including lab test results) under “A Dietitian’s Journey” on my affiliate low carb web site by clicking here. Keep in mind that I chose to follow a therapeutic low carbohydrate diet, but there is no one-sized-fits-all diet that is right for everyone.  

Whether you have 5 or 10 pounds of fat to lose, or like me ⁠— a whole lot more, it is really only done a pound or so at a time.  If you have significant amount of weight to lose,  I can not only help you do that, but since I’ve been through it myself, I can encourage you and coach you through it. I provide services across Canada (except PEI) via HIPAA-compliant video conferencing, and most extended benefits providers reimburse for licensed Dietitian services.

More Info?

If you would like more information about the services I offer, please have a look under the Services tab or in the Shop for more information. If you have service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd
Fipboard: http://flip.it/ynX-aq

Copyright ©2020  BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

A Little Black Dress – a personal health and weight loss update

Yesterday I had an occasion to wear a new little black dress that I had bought, and remembered the last time I wore one. Ironically, it was for my Master’s convocation just over 11 years ago, and the dress was a size 16. My degree was in Human Nutrition, yet I was very overweight and had pre-diabetes.

May 25, 2008

The degrees on the wall did not help me understand why ⁠— despite my best efforts to “exercise more and eat less”, I was still overweight.  Despite my research related to the neurotransmitter dopamine, it was not known at the time how dopamine is involved in the potent joint reward system of eating foods that are a combination of both carbohydrate and fat (you can read more about that here). 

I did not understand why following the advice of my physician didn’t help.  I ate according to the (then) Canadian Diabetes Association (now called Diabetes Canada)’s recommendation to eat 65 g of carbohydrate at each meal and 25-45 g of carbs at each snack ⁠— along with lean protein and monounsaturated and polyunsaturated fat and participated in exercise several days each week. I ate “plenty of healthy whole grains” and “lots of fruit and vegetables“, along with low fat dairy,  yet a year later progressed to Type 2 Diabetes; what I was told was a “progressive, chronic disease”.

My studies didn’t help me understand the impact of high levels of circulating insulin on obesity and the effect of the after-meal and after-snack rise in insulin and then it’s drop shortly later on hunger. The reality was, the advice we were taught to “eat less and move more” did nothing to address the underlying issue of being hungry every few hours.  In fact, the detrimental effects of high circulating levels of insulin weren’t taught; only the effects of high blood sugar.

My studies didn’t help me understand that “plenty of healthy whole grains” for someone who is already insulin resistant, with high levels of circulating insulin isn’t helpful.  I didn’t understand how eating plenty of fruit was further contributing to my problems;  both because of it’s high carbohydrate load, as well as it being a high source of fructose. I drank 3 glasses of low-fat milk daily, but didn’t understand the effect of all of those extra carbohydrates on my blood sugar, as well as underlying insulin response.  It was not part of what I studied ⁠— either in my undergraduate degree or Master’s studies, because it simply was not well known.

It is only recently (April 18, 2019) that the American Diabetes Association (ADA) issued their Consensus Report which indicated that “reducing carbohydrate intake has the most evidence for improving blood sugar” (you can read more about that here). In fact, the ADA now includes both a low carbohydrate eating pattern and a very low carbohydrate (keto) eating pattern as Medical Nutrition Therapy for the treatment of those with pre-diabetes, as well as adults with Type 1 or Type 2 Diabetes.

While these are not currently part of Diabetes Canada‘s options, they are recommendations available to those in the United States. In fact, the European Association for the Study of Diabetes (EASD) also classifies low carb diets as Medical Nutrition Therapy and Diabetes Australia released their own updated position paper for people diagnosed with Diabetes who want to adopt a low carbohydrate eating plan. 

Many studies already demonstrate that a well-designed low carbohydrate diet is both safe and effective for the treatment of obesity and Diabetes (see the Physician and Allied Health Provider tab on my affiliate low carbohydrate web site for more information) but much of this has only come to light in the years since I graduated with my Master’s degree.

In the last 4+ years since I first learned about the therapeutic use of a low carbohydrate diet, I have read scores of studies in an effort to become well-informed and continue to do so in order to stay current with the emerging evidence.

April 2017 – April 2019

On March 5, 2017 I began what I have called “A Dietitian’s Journey”. Over the subsequent two years, I put my Type 2 Diabetes into remission, lowered my dangerously high blood pressure and achieved a normal body weight and optimal waist circumference.

You can read my story under A Dietitian’s Journey on my affiliate site.

June 15 2019

I have been in maintenance mode for more than three months and have been able to maintain my weight loss and health gains with little effort.

This photo was taken of me yesterday in my new “little black dress”.

 

The bulk of my Dietetic practice in the past focused on food allergy and food sensitivity (including Celiac disease, Irritable Bowel Syndrome, Inflammatory Bowel Disease), but I am now able to provide a range of options for weight loss and improvement in many metabolic conditions, including Type 2 Diabetes, hypertension and abnormal cholesterol that I was unable to offer a few years ago. I offer variety of evidence-based approaches, including a Mediterranean Diet, a plant-based whole foods approach (vegetarian or including meat, fish and poultry), as well as a low carbohydrate approach (which is what I follow).

If you would like to learn how I can help you, you can learn more about my services under the Services tab or in the Shop.

If you have questions, please feel free to send me a note using the Contact Me form above and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd

Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

 

Green Tea Should not be like Buckley’s®

Recently, I came across a social media post about someone that wanted to drink green tea for it’s health benefits, but just couldn’t get over it’s “bad taste”.  I followed the origin of the thread to Reddit, where people guessed whether green tea’s “off taste” for that person may be genetic, like the taste of cilantro. While that can be the case (i.e. genetic sensitivity to a compound called 6-n-propylthiouracil which is found in some flavonoids), others touched on whether it was because the person was making tea using supermarket green tea bags rather than loose tea, whereas a few people hit on the complexity of the issue.  In this post I will discuss some of the factors that affects whether your green tea has a pleasant or “off taste”,  because after all green tea should be something you actually enjoy and not only drink for it’s health benefits.

NOTE: The first part of this article are some personal details of my experience learning to prepare multi-ethnic food and beverages and the second part of the article is specifically about the preparation of green tea and its health benefits.


Once a Foodie, Always a Foodie

I have been adventurous in trying different kinds of food and beverages since I’m little and I remember my parents taking me to an authentic Japanese restaurant even as a kid.  As a teen, I enjoyed cooking multi-ethnic food and learned authentic Cantonese cooking in the 1970s when my mom took a course in Chinatown. In the 1980’s, I learned authentic Thai cooking from the friend of a family business associate who was from Thailand and in those days one couldn’t buy pre-made Thai curry pastes that are available everywhere now, so I sourced the raw ingredients in Lao-Thai groceries and hand-pounded them myself in a mortar and pestle (that I still own and use!). I still have the recipe books sent to me from Thailand.

It didn’t matter whether it was Asian, Middle Eastern or Jamaican, I was a bit of a purist; wanting the ingredients and cooking method to be as authentic as possible. For me, the best way to find out how to make something was to ask someone from that culture that loved to cook.

What was true about food was also true for beverages.

I couldn’t just enjoy a cup of coffee or glass of wine without knowing more. Whether it was the origin of the coffee beans, the length of time the beans were roasted, or how long the water is in contact with the beans — I needed to know, and I was interested in such things when it was not popular either.

Before “West Coast coffee” was a thing and before there ever was Starbucks® or Peet’s, there was a place called La Vieille Europe on St. Laurent Blvd in Montreal which was where I got my single origin, whole bean coffee. As I found out years later, the son of the roaster that owned that store taught the original roaster from Peet’s in the US how to roast beans. Small world.

When I lived in wine country (Sonoma county) of California for a few years in the early 2000s, I was determined to educate my palate to distinguish between different types of wine, which I did. I knew what I liked — which turned out to be an expensive habit when I returned to Canada after 9/11.  At the beginning I explored the wines of Australia and found some I really liked, but missed the delicious and inexpensive  wines of Sonoma and Napa.

Once again, my palate returned to coffee, but finding a decently roasted coffee in Vancouver BC was harder than I thought. Given that this was the “West Coast”, I was discouraged how difficult it was to find good quality Arabica beans that weren’t over roasted. I stumbled across a few small roasters that did an excellent job, but in time they modified their roasts for “local tastes”, so once again, I was back looking for a new roaster. On a few occasions, I ordered from La Vieille Europe in Montreal because in the 40 or 50 years they have been in business, they never lost their passion for properly roasted, single origin coffee.

Over the 20 years I have lived in Vancouver, I discovered the world of quality tea that is largely unknown to most non-Asian born Chinese. There was one excellent tea importer in the Chinatown that I knew of and one that is still in the Richmond Public market that have single origin estate teas that rival the diversity of the best coffee roaster. Over the past 20 years, I’ve explored different types of tea from China and  have come to like a few; my favourite of which is a fermented tea known as Pu-ehr.

A number of years ago, I stumbled across matcha tea in a specialty Japanese store before it was a “thing”.  Knowing nothing about it, I have since found out that I had been using ‘culinary matcha‘ (designed for making Japanese sweets) for drinking.  No wonder it tasted bitter and I needed to blend it with other ingredients to make it palatable. Thankfully, when fresh it had the same health benefits, which I wrote about in 2013 in this article about the Role of Green Tea Powder (Matcha) in Weight and Abdominal Fat Loss. As you’ll read below, I have since learned about making and enjoying real ceremonial-grade matcha, which is intended for drinking from large matcha bowls.

Learning about Japanese Green Tea

At the beginning of this year, I began to explore green teas from Japan when I discovered Hibiki-An, an online tea importer from Uji region of Kyoto. My culinary world expanded once again.

Unable to decide between the many different types and grades of tea that they carry, I order a sampler of 3 types of green teas (Sencha, Gyokuro Superior and Sencha Fukamushi).  They came in 4 oz individual bags — the quantity that can be reasonably be used up within 3 months, when it is fresh.  All 3 teas were all of “superior” grade, which is not the best quality (as my palate is not developed yet) but is a high grade tea.

When the tea arrived, it came with very specific brewing instructions (a summary of the much more detailed instructions on their web page). I’ve since learned that different types of green tea require different water temperatures and different lengths of brewing time.

Wow, who knew?

For the purpose of “cooling” the water to just the right temperature, there is a yuzamashi — which is a small ceramic cup with a spout that the boiled water gets poured into to cool momentarily before being poured into the kyuzu; a special tea pot with a single handle, built in mesh filter and large opening for the water (see photo, above).

You don’t need the get fancy, though.  I had these things for years from my days exploring different regional teas, but one can use an ordinary bowl to cool the water and any plain ceramic tea pot to brew the tea in!

Tea to Water Ratio, Water Temperature and Steeping Time

Each type of green tea has a very specific ratio of green tea leaves to water, and very specific water temperatures and steeping time.

For example, of the three teas in my sample set, Sencha is brewed at 80° Celsius (176 ° Fahrenheit) for one minute, Gyokuro is brewed at 60-70 ° Celicus (140-158° Fahrenheit) for 1 -1/2 to 2 minutes and Sencha Fukamushi is brewed at the same temperature as regular Sencha, but for only 40-45 seconds.

I’ve discovered that following these guidelines using good quality, fresh tea leaves makes a cup of tea that is like nothing I’ve tasted anywhere before. It is not simply snobbery, but the science of what makes for a good cup of tea.

Note: I downloaded several studies that have researched the difference in brewing time, water to tea leaf ratio and water temperature but have decided against boring anyone with the details.

Recently, I became ready to move onto “realmatcha tea and ordered some from the same supplier in Japan.

It came in tiny cans (quantities that should be used up in a 3 week period).

The colour was a bright jade green and the taste had no hint of bitterness whatsoever!

It tastes amazing!

My teas ordered from Japan are my “weekend teas” and during the week I used run-of-the-mill Sencha purchased locally at a Japanese store.

I drink them because I like them and for the health benefits.

Health Benefits of Green Tea

The health benefits of green tea are many. Several large-scale population studies have linked increased green tea consumption with significant reductions in the symptoms of metabolic syndrome; a cluster of clinical symptoms which include insulin resistance and hyperinsulinemia (high levels of circulating insulin), Type 2 Diabetes, high blood pressure, and cardiovascular disease including coronary heart disease and atherosclerosis.

Catechins make up ~ 30% of green tea’s dry weight, of which 60–80% are catechins. Oolong and black tea which are produced from partially fermented or completely fermented tea leaves contains approximately half the catechin content of green tea

It is believed that epigallocatechin gallate (EGCG) which is the most abundant catechin in green tea actually mimics the action of insulin, which has positive health effects for people with insulin resistance or Type 2 Diabetes [Kao et al].

EGCG also lowers blood pressure almost as effectively as the ACE-inhibitor drug, Enalapril, having significant implications for people with hypertension (high blood pressure) and cardiovascular disease [Kim et al].

Green tea catechins also have benefit for weight loss. A 2009 meta-analysis of 11 green tea catechin studies found that subjects consuming between 270 to 1200 mg green tea catechins / day (1 – 4 tsp of matcha powder per day) lost an average of 1.31 kg (~ 3 lbs) over 12 weeks with no other dietary or activity changes [Hursel].

Drinking 8-10 cups of green tea per day is enough to increase blood levels of EGCG into a measurably significant range [Kim et al], but matcha contains  137 times greater concentration of EGCG compared to green tip tea [Weiss et al].

WARNING TO PREGNANT WOMEN While EGCG has also been found to be similar in its effect to etoposide anddoxorubicin, a potent anti-cancer drug used in chemotherapy [Bandele et al], high intake of polyphenolic compounds during pregnancy is suspected to increase risk of neonatal leukemia. Bioflavonoid supplements (including green tea catechins) should not be used by pregnant women [Paolini et al].

Green Tea Shouldn’t Taste Bad!

The reason someone would find green tea has an “off flavor” was because the tea was either not fresh, not of a half-decent quality, was brewed at the wrong temperature or for the wrong length of time. Think about it this way; it all a person ever drank was cheap pre-ground coffee, they might think coffee tasted bad, too.

The fact is, one doesn’t need to order tea from Japan to enjoy a decent cup of green tea! I found the green teas below at a local Japanese grocery store and when brewed properly they are great as everyday tea.

If you aren’t adventurous to explore ethnic markets or time is limited, I can highly recommend the online supplier I mentioned above as having excellent price for the quality of green tea, very good explanations on their web page and quick delivery.

For everyday use, I have a little water cooler (yuzamashi) bowl and small single handed tea pot (kyuzu) so brewing a decent quality sencha green tea (my daily tea of choice) has become second nature, but as I mentioned above, one doesn’t need special equipment to make a decent cup of green tea!  All you need is the  right amount of fresh, good quality tea leaves steeped for the right length of time in hot water that’s at the right temperature. The only thing to keep in mind is that once the package of tea is opened, it needs to be stored in a sealed, airtight, light-proof container and used up within 3 months or sooner.

Making a good cup of green tea is not really much different than brewing a good cup of coffee. To make a good cup of coffee, one needs to consider the country / countries of origin of the beans, the bean roasting time and temperature, the brewing method involved (drip, espresso, French press, etc), the required water temperatures needed for that method, and the different grind of beans and a specific water-to-ground-bean ratio required for that brewing method. It sound’s complicated, but if you a few types of coffee regularly, it’s not hard.

It’s the same with green tea.

In one sense, there is a lot to learn at first to make a good cup of green tea but on the other hand, once you know a few basics and find a green tea or two you really enjoy, the rest is easy!

Tea has amazing health benefits, but unlike the cough medicine Buckley’s®, there is no need to drink tea that “tastes terrible, but it works”!

If you would like to know more about what I do as a Dietitian and how I can help you with weight loss or to seek to reverse the symptoms of metabolic syndrome, including Type 2 Diabetes, high blood pressure and other related markers, please send me a note using the Contact Me form on this web page.

If you would like to learn more about the services I offer and their costs, please click on the Service tab or have a look in the Shop.

To your good health!

Joy

You can follow me at:

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Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

References

Gayathri Devi A, Henderson SA, Drewnowski A. Sensory acceptance of Japanese green tea and soy products is linked to genetic sensitivity to 6-n-propylthiouracil. Nutr Cancer. 1997;29(2):146-51

Hursel R, Viechtbauer W, Westerterp-Plantenga MS. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obes (Lond) 2009;33:956–61.

Paolini, M, Sapone, A, Valgimigli, L, “Avoidance of bioflavonoid supplements during pregnancy: a pathway to infant leukemia?”. Mutat Res 527 (1–2): 99–101. (Jun 2003)

Kao YH, Chang MJ, Chen CL, Tea, Obesity, and Diabetes, Molecular Nutrition & Food Research, 50 (2): 188–210, February 2006

Kim JA, Formoso G, Li Y, Potenza MA, Marasciulo FL, Montagnani M, Quon MJ., Epigallocatechin gallate, a green tea polyphenol, mediates NO-dependent vasodilation using signaling pathways in vascular endothelium requiring reactive oxygen species and Fyn, J Biol Chem. 2007 May 4;282(18):13736-45. Epub 2007 Mar 15.

Weiss, DJ, Anderton CR, Determination of catechins in matcha green tea by micellar electrokinetic chromatography, Journal of Chromatography A, Vol 1011(1–2):173-180, September 2003

Why I Posted My “Before” Pictures When I was Still Obese

INTRODUCTION: It is not uncommon for people to post their “before” pictures after they’ve reached their goal weight to show how much they’ve accomplished, but why on earth did I post pictures of myself when I was still obese and metabolically unwell? That’s a good question.

There’s a saying that “it is not the healthy who need a physician, but the sick” and while people will consult with Dietitian for many different reasons, those who are significantly overweight find it very difficult to take that first step when it is weight loss they’re seeking. Why?

People feel ashamed of being overweight or obese.

Oftentimes, overweight people feel that they are assumed to be undisciplined or lazy — that their condition is their own fault. They have heard over and over again that;

“If only they would eat less and move more they wouldn’t be so fat!”

or

“If only they ate ‘real food’ instead of ‘junk food’ they would be so much slimmer!”

Really?

If it were that simple, why would 1 in 4 Canadians (and 1 in 3 Americans) be obese?

Because it’s not that simple.

It’s been my experience that many overweight people and obese people often eat what has traditionally been thought of as a “healthy diet”; plenty of fruit and vegetables, low fat dairy products and only brown bread, rice and pasta and they feel frustrated and ashamed of being what is perceived as “a failure”.

Some have told me that sometimes their own healthcare providers have given them the impression that they must be being untruthful about what they’ve been eating because surely if they were eating the way they say, they would have been losing weight. In other words, they are not believed, or in stronger words, they are thought to be lying or at least incapable of accurately assessing how much they are ‘really’ eating.

Why would an overweight or obese person seek help in losing weight from a healthcare professional that views them as undisciplined, lazy or unrealistic about what they are eating?

They don’t.

Often people will try various diets that they read about online because no one will see them try and more importantly no one will see when they give up, feeling once again that they are ‘failures’.

I don’t think that overweight and obese people are failures. I believe many are doing what they’ve been told is the “right thing” but for different reasons. it is not working for them.  My role as a Dietitian is to help people understand what isn’t working and to enable them to be successful — without judgement.

It is for just such people that I posted my “fat” pictures before I ever started to lose weight!

I wanted people to see me as no different and certainly no better than they are, because I’m not. Sure, I have an undergraduate and graduate degree in nutrition, but I don’t get any “free passes” when it comes to losing weight and turning around my own metabolic health. I needed to do it just like everybody else.

I’ve lived each step of my weight loss and metabolic health recovery journey in public because I wanted people to experience in “real time” my frustrations and my victories. I wanted people to see that the path is not linear; that there are twists and turns and stalls, but yes it is possible to be successful. It just takes time and some dedicated work to get well and achieve a healthy body weight.

I look at it this way;

If it took me 20 years to become metabolically unhealthy and obese, what’s a couple of years to become metabolically healthy and normal weight?

Everyone’s weight loss and health restoration journey will be different.

There are no “magic bullets” or “super diets”— but there are different dietary and lifestyle options that can be pursued for success.

I can help.

 

If you would like to learn more about how I can help you or a family member achieve and maintain a healthy body weight and metabolic health, please send me a note using the Contact Me form located on the tab above.

To our good health!

Joy

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Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

Middle-Eastern Style Lentil Soup – whole food plant based

The new Canada Food Guide encourages a whole food plant-based diet which is a good option for those who are metabolically healthy — especially those who are insulin sensitive. The challenge is that I was diagnosed with Type 2 Diabetes 10 years ago and while I am in partial remission now as a result of dietary changes I implemented 23 months ago, on a cold winter day like yesterday I really wanted a bowl of my favourite homemade lentil soup.

I knew from testing my blood sugar in response to different foods that I was beginning to tolerate a small amount of whole, unground legumes such as chickpeas that had been soaked from the dried ones, then cooked. I also knew that leaving the lentils whole rather than pureeing them would reduce the blood sugar response and by adding additional non-starchy vegetables such as spinach and fresh green herbs would also help lower the glycemic response, so in the interest of science (of course) I decided to make the lentil soup and test my response two hours afterwards and the next morning.

The only significant source of carbohydrates that I ate yesterday was the soup which was ~20 g of carbs per bowl.  I was pleased and encouraged that after 23 months of changing how I ate that my blood glucose two hours after eating it was only 5.5 mmol/L (100 mg/dl), which was normal. This morning my fasting blood glucose was 6.3 mmol/L (114 mg/dl) which was significantly higher than what it has been the last few months eating a low carbohydrate diet, but considering the amount of slowly digestible carbohydrate in the soup, it was somewhat understandable.  To more accurately assess my glycemic response to the soup, I should have tested my blood sugar before I ate it, after 30 minutes, 60 minutes and 2 hours after eating it, as I did with my chickpea “experiment” as the 2 hour snapshot after 2 hours doesn’t provide any information as to what was happening to my blood glucose at 30 minutes and 60 minutes, which may have included a spike.

The soup was a nice treat and it was encouraging to me to continue to discover that as time goes on, I can reintroduce small amounts of whole-food carbohydrate sources without unduly impacting my blood sugars. Of course, being in remission from Type 2 Diabetes is not Diabetes  reversal, so I am by no means “cured”, but I am doing much better than 23 months ago.

As I know from several studies, including a 2015 study from Israel (Zeevi D, Korem T, Zmora N, et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015 Nov 19;163(5):1079-1094), everyone’s glucose response to individual foods is different and the only way to know how each person will respond (whether Diabetic or non-diabetic / insulin resistant) is to test individual response to a specific amount of the food, which is what I did. While legumes are not something I would eat on a regular basis as it would negatively impact my glycated hemoglobin (HbA1C) level, it is certainly nice to be able to have it sometimes.

Of course, for those who are insulin sensitive, this is a delicious whole-food, largely plant based meal.

Below is the recipe for the soup. I included a piece of beef shank, but it can as easily be made without any meat for those that don’t eat it.

NOTE: This recipe is posted as a courtesy for those following a variety of different types of eating styles and not necessarily as part of a Meal Plan designed by me. This recipe may or may not be appropriate for you.

Middle Eastern Lentil Soup

Ingredients

1 medium yellow onion, chopped finely
1 medium carrot, diced
4 cloves fresh garlic, minced finely
2 tbsp olive oil
1 slice of beef shank, optional
2 cups small brown lentils, rinsed well
2 tsp coriander powder
1 tsp cumin powder
1/2 tsp freshly ground black pepper
kosher salt, to taste
1 cup fresh cilantro leaves (coriander greens), chopped
1 cup fresh parsley (flat leaf or curly), chopped
2 300 g packages of frozen chopped spinach, defrosted and squeezed dry
4 liters cold water

Herb Topping (optional)

3 green onions, minced finely
2 cloves fresh garlic, minced finely
1/2 cup fresh parsley, minced finely
1/2 cup fresh cilantro, minced finely
1 tbsp olive oil

Saute the green onions in the olive oil over a medium heat until wilted, but not browned, add the garlic and saute a minute or two then add the chopped parsley and cilantro and continue sauteing until the greens are slightly cooked.  Set aside to top each bowl of soup with, just before serving.

Method

  1. Saute the chopped onion in the olive oil until lightly browned
  2. Add the chopped carrot and saute until partially cooked
  3. Add the beef shank, if using and brown on both sides
  4. Add the minced garlic and saute (being careful not to let it brown as it would become bitter)
  5. Add the coriander and cumin powder, and keep stirring
  6. Toss in the rinsed brown lentils
  7. Season with salt and freshly ground black pepper
  8. Add cold water and stir to dislodge anything that may have stuck to the bottom
  9. Over a medium-low heat, bring to a simmer, skimming off any foam that accumulates from the meat protein
  10. Cook at medium-low for several hours, until the lentils are cooked but not too soft
  11. Twenty minutes before serving, add in the well-squeezed spinach, fresh parsley and fresh cilantro (coriander greens)
  12. Prepare the herb topping and set aside to top individual bowls of soupd when serving
  13. Enjoy!
Middle Eastern Style Lentil Soup

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Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

 

 

Finally Reaching Normal Body Weight – a Dietitian’s Journey

Me – May 2015

Today I reached “normal body weight” according to Body Mass Index (BMI) classification  no longer obese and not even overweight. Normal. It seems surreal.

When I began my health and weight loss journey on March 5, 2017 (19 1/2 months ago) I was obese. My weight bordered between Class I and Class II Obesity and I had multiple metabolic health issues. I was diagnosed with Type 2 Diabetes 10 years earlier, had elevated blood pressure and abnormal lipids (cholesterol).  Most significantly, I was in denial as to just how ill I really was. The undergraduate and post graduate degrees on my wall did not inform reality. The mirror did.

I didn’t feel well that day and took my blood pressure. It was dangerously high— classified as a hypertensive emergency. I decided to take my blood sugar too and it was way too high. I sat and considered the numbers of both and considered my options. At the time, I only saw two choices; I could go see my doctor who would have immediately put me on multiple medications or I could change my lifestyle. In hindsight the safest option would have been to do both, but I chose instead to begin to “practice what I teach”.

You see, I had two girlfriends suddenly die of natural causes within 3 months of each other just previous to that day; one of them I had known since high school and the other since university. They were both my age, both chose careers in healthcare, just like I did, and both died from preventable causes. They spent their lives helping others get well, yet unable to accomplish the same for themselves.  It was not for lack of trying, but for not having found a solution before death ended both of their lives. March 5, 2017, I realized that if I didn’t change I would likely die of heart attack or stroke, too. Their deaths may have saved my life.

I began a low carbohydrate diet immediately. I cut refined foods, ate whole unprocessed foods, didn’t avoid the fat that came with whole foods but didn’t add tons of fat either. While it helped a great deal, after several months I realized that I needed to lower my carbohydrates further in order to achieve the remission from Type 2 Diabetes that I sought.  I didn’t simply want to lose weight — I wanted to get healthy!

I consulted the experts and continued to make dietary modifications that got me closer to my goal. The first significant improvement was in blood pressure followed by blood sugar. I lost weight and more significantly lost inches off my waist.  While I hadn’t been formerly diagnosed with non-alcoholic fatty liver disease based on my lab work I more than likely had it. I tweaked and adjusted my Meal Plan many times over the last 19 1/2 months — each time moving myself closer and closer to my goal. Ten days ago I was within an inch of my waist circumference being half my height and now I am within 3/4 of an inch of it. It’s happening!

Body Mass Index (BMI) October 17 2018

Two days ago, I got on the scale and saw a series of digits that I had not seen since my twins were born 26 years ago tomorrow. I decided to crank some numbers.  I did a happy dance. I was almost there.  The photo on the left is weight category.

 

I am not one of those people that the press often writes about that pursued a low carbohydrate or ketogenic diet for “quick weight loss”.  I wanted to get well.  I chose a low carbohydrate diet for therapeutic reasons because it was my underlying high insulin levels which drove my high blood glucose and high blood pressure. To get well, I needed to address the cause, not the symptoms.

So here I am, having reached normal body weight!

Did I think at the beginning that I would actually get to this point? I wasn’t sure. I knew it was possible because I had helped others achieve it, but had never tried myself, so I didn’t know.

For health reasons, I no longer had the option of doing nothing!

At first, I set my preliminary goal as “no longer being obese“. Then I revised it to “being less overweight“.

I found some old photos recently of what I looked like as a young adult and realized what the weight was where I felt and looked my best then reset my goal weight once again. I knew it was entirely doable!

I am almost there!

Then the hard work begins.

Losing weight has been challenging, but not difficult.  Sure, I needed to determine what was holding things up at various stages of my journey and make dietary adjustments just as I do for my clients, but it’s much easier to do that for someone else than for oneself. The “hard work” will be finding out how to eat where I don’t lose any more weight, while maintaining my blood sugar and blood pressure at the best possible level.

If possible, I want to achieve full remission from Type 2 Diabetes and if not, I will learn how to maintain full reversal of symptoms.

I’ve documented the entire process throughout “A Dietitian’s Journey”, including “fat pictures” and lab test results to demonstrate the therapeutic benefit of a low carbohydrate diet and that this lifestyle is both practical and  sustainable.

Perhaps you would like to find out how I can help you achieve your own health and nutrition goals?

Please send me a note using the form on the Contact Me tab above and I’ll be happy to reply.

To your good health!

Joy

you can follow me at:

 https://twitter.com/lchfRD

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Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

My Approach to Eating Low Carb and Links to Popular Recipes

Some people think there is only one type of “low carb” diet; one that includes lots of meat and lots of fat, but that’s not the case.  There are low carb diets that are higher in fat than protein, higher in protein than fat and those that are somewhat of a hybrid. The same thing is true when it comes to “ketogenic” or “keto” diets as it depends what it is being used for. A keto diet for epilepsy or as an adjunct treatment for Alzheimer’s disease or certain kinds of cancer will look very different than one used therapeutically to reverse metabolic conditions like Type 2 Diabetes. There isn’t a “one-size-fits-all” low carb or ketogenic (keto) diet.

As well, there aren’t any “one-size-fits-all” people! Some folks have higher protein needs because of their age or stage of life or the sports they engage and for people seeking weight loss those who have 15 or 20 pounds to lose won’t necessarily need to eat the same way as those with a great deal of weight to lose.

In addition, low carb diets often change over time. For example, those with a lot of weight to lose will often eat differently at the beginning of their weight-loss journey than they do towards the end of their weight loss because their body adapts and changes. As a result, these folks need to have their Meal Plan adjusted over time, whereas someone with a smaller amount of weight to lose may do fine with the same Meal Plan all the way through. Everybody’s different.

How I Approach It

My own meals usually center around some kind of grilled, roasted or stir-fried protein along with a generous serving of fresh low carb veggies plus some added healthy fat such as cold-pressed extra virgin olive oil or a touch of butter just to make things tasty. I don’t hesitate to sprinkle salads with pumpkin seeds or a few nuts, some berries and even a bit of crumbled goat cheese and drizzle it with olive or macadamia nut oil because this way I’m happy to eat a large bowl of it and it keeps me satisfied for hours. For those whose of my clients whose dietary needs are similar, I encourage them to do the same; switching up the type of nuts or seeds they use and changing the type of cold pressed oil they use, as each tastes very different. Even changing the type of vinaigrette from vinegar-based to lemon-based or using different types of vinegar or herbs adds more variety. There are so many kinds of meat, fish, poultry and vegetables that can be eaten and each can be prepared lots of different ways, so there’s no need to get bored eating the same thing.

Reversing Type 2 Diabetes

In a little over a year I’ve lost almost 40 pounds- first eating a low carb diet and then necessarily because of significant hyperinsulinemia (high levels of circulating insulin) and insulin resistance, a ketogenic diet. I’ve put my Type 2 Diabetes into remission while reversing my high cholesterol and high blood pressure and while I’ve not yet arrived at the point where my waist circumference is half my height (lowest risk) I am getting close.

Because I was Diabetic for 10 years and obese for longer than that, I tend to limit my own intake of low carb baked goods (muffins, pancakes and breads) that are often made from ground nuts or seeds and cheese as these are very  energy dense. I still have some of my own excess fat stores to lose as well as continuing to lose fat from places it should never have been in the first place (including very likely my liver) so eating extra dietary fat outside of those found naturally in whole, unprocessed foods (meat, fish, poultry, cheese, egg) doesn’t make much sense.

I do better with a low carb lower fat cauliflower crust pizza  (recipe below) or a low carb zucchini pizza crust (recipe coming soon!) over the very popular “fathead pizza” (based on almond flour and lots of fat from different kinds of cheese) or even my own Crisp Keto Pizza (recipe below) which is high in protein and fat but low in carbs. That’s why there are a few kinds of pizza recipes, so there’s a choice – not just for me, but my clients and visitors to my site. One can’t have too many healthy, tasty ways to eat pizza, right?

Most Popular Recipes

Below are a few of my most popular low carb recipes grouped by type of low carb diet. Please remember, not all recipes will be suitable for your specific health conditions or weight loss goals, so if in doubt please check with your Dietitian or physician. I hope you enjoy them.

Higher Fat Low Carb Recipes

For those that follow a high fat low carb lifestyle, below are a few of my most popular recipes. For me (and quite a few of my clients who are also in the weight loss phase) these are “sometimes foods” and not “everyday foods”.

Low Carb Beer-Batter Fish (seriously amazing)
Quiche Lorraine
Crisp Keto Pizza

Desserts in this category include my  Low Carb New York Cheesecake (amazingly good!) and Low Carb / Keto Ice Cream .

Low Carb Moderately High Fat

Recipes more suited to daily fare for me and those who are in the weight-loss phase of a low carb diet are posted here.  Some of the most popular are;
Crispy Cauliflower Pizza (lower in fat than the Crisp Keto Pizza above)
Low Carb Chow Mein
Low Carb Thai Green Curry
Spaghetti Zoodles with Bolognese Sauce
Low Carb Kaiser Buns great with sliced meat or cheese and lettuce (or used as a hamburger bun!).

This Low Carb Chocolate Chip Pancake recipe was recently posted but I’m pretty sure it will become a favourite, too. It is around my house!

Great everyday side dishes that can accompany a wide variety of poultry, fish, meat and veggies whether for the family or company are;
Low carb high protein broad noodles
Keto Yeast Rolls
Low Carb Roti (Indian flatbread)

Higher Fat Convenience Food Recipes

I have created and posted several recipes for higher fat protein bars if you need an easy, tasty and cost-efficient substitute for expensive low carb convenience bars on the market. These are;

Chocolate Orange Low Carb Protein Bars
Chocolate Mint Low Carb Protein Bars
Low Carb High Fat (Keto) Protein Bars

I even have a Low Carb Green Tea Matcha Smoothie that can be used to target abdominal fat in those following a higher fat low carb eating plan.

If you have questions about how I can help you to lose weight, reverse Type 2 Diabetes, high blood pressure or high cholesterol or to adopt a low-carb lifestyle for its other health benefits, please feel free to send me a note using the Contact Me form on this web page. I provide both in-person services in my Coquitlam (British Columbia) office, as well as services via Distance Consultation (phone or Skype) to those living elsewhere.

I hope you enjoy these recipes and please feel free to send me a message on social media (Facebook or Twitter, links below) if you have questions about any of the recipes or to post pictures when you make them.

To our good health!

Joy


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Copyright ©2018  BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

Symptoms of Type 2 Diabetes ARE reversible – a Dietitian’s Journey

For the last 16-months my goal has been to put my Type 2 Diabetes into remission and to no longer meet the criteria for Metabolic Syndrome. Towards that end, last year on July 11, 2017 I had complete lab work done, including fasting insulin, cholesterol, fasting blood glucose and glycated hemoglobin (HbA1C) and planned to redo the same tests at the same time this July to see how much progress I was making.

The day I had been waiting for arrived!

So, how did I do?

Let’s see where I started from in July 2017;

fasting insulin July 11, 2017

Last year, my fasting insulin was 54 pmol/L which converts to 7.8 μU/ml — well above the ideal insulin sensitive range of 2-6 μU/ml. I was insulin resistant, which was no surprise given I had Type 2 Diabetes for more than 10 years.

What about yesterday – 16 months after starting a low carbohydrate lifestyle?

fasting insulin, July 10, 2018

I went from 54 pmol/L (7.8 μU/ml) to 33 pmol/L (4.8 μU/ml). I no longer have high insulin; in fact, my insulin was now in the ideal range, between 2-6 μU/ml. Very cool!

But then what explains why my fasting blood sugar is still so high?

fasting blood glucose July 11, 2017

I mean, it has dropped a lot from 8.0 mmol/L  (144 mg/dL) last year to 6.9 mmol/L (124 mg/dl) this year, but this was still a huge disappointment.  Yes, many days my fasting blood sugar is in the low 5’s mmol/L (94-95 mg/dl) but not this time. It was at the high end of what it goes to!

Why?

fasting blood glucose July 10, 2018

In the last several months, I’ve been losing a lot of fat from my abdomen (2.5 more inches since the beginning of March, on top of the 8 inches I lost in the first year) and the end result of the action of hormone sensitive lipase on fat cells (adipocytes) is the release of free fatty acids and glycerol. The liver cells (hepatocytes) take the glycerol and turn it into glucose in a process called gluconeogenesis (literally “making new glucose”).  It is this glucose that is produced by my liver from my broken down fat stores that is raising my fasting blood sugar.

The good part is that my fat cells are emptying out.  The bad part is that my liver is making glucose out of it…and what complicates the matter is that I have what’s called “peripheral insulin resistance” from often eating only once a day (time-restricted-eating) and that causes my body to “save” the glucose for necessary processes.  As a result, my body cells don’t take in the excess glucose made by my liver and it hangs around in my blood until I get moving.  Then it will dissipate (provided I eat some breakfast).

What about my glycated hemoglobin (that is effectively the three month average of my blood sugar)?

glycated hemoglobin (HbA1C) July 11, 2017

A year ago, my HbA1C  was 7.5% which is well above the cutoffs of 7% which is set for those with Type 2 Diabetes.

glycated hemoglobin (HbA1C) July 10, 2018

This year it was 6.3% which is below the cutoffs for Type 2 Diabetes of 6.5% and lower than what it was 3 months ago, which was 6.4%. Naturally, it is higher than I would like because it includes all the glucose my liver is making from the fat cells it is breaking down, but sooner or later it is going to run out of that!  Soon my waist circumference WILL be half my height and around that point, my fasting blood glucose should be dropping.  My goal is to see my HbA1C below 5.5 mmol/L (100 mg/dl) and be in full remission from Type 2 Diabetes, not only partial remission which is what I have now.

But celebrating the victory, I am in partial remission of Type 2 Diabetes!!

So how have my lipids changed this last year, with the butter, coconut oil and coconut milk and full fat cream that I have been eating, as well as much more meat than I used to?

Last year, four months into my following a low-carbohydrate diet, this is what they looked like:

Lipid panel, July 11, 2017

 

…and this year?

 

Lipid panel, July 10, 2018

My LDL is down (2.60 to 2.47 mmol/L) , my HDL is up significantly (1.97 to 2.44 mmol/L), my non-HDL cholesterol (chylomicrons and VLDL) is down (2.45 to 2.11 mmol/L) and my already low triglycerides went even LOWER (0.64 to 0.52 mmol/L).

In July 2017 my TG:HDL ratio was 0.35, which is well below 0.87 and this year my TG:HDL ratio was 0.21! This means that of my LDL cholesterol, most are the large fluffy kind (the ‘good’ LDL), and not the small dense kind (the ones that put us at cardiovascular health risk).

I no longer meet the criteria for Metabolic Syndrome which is having 3 or more of the following 5 symptoms:

Criteria for Metabolic Syndrome – from Merck Manual

My waist circumference is significantly <35″

My blood pressure is well below 130/85 (usually around 120/70)

My triglycerides are well below 1.7 mmol/L (150 mg/dl) at 0.52 mmol/L

My HDL is well above 1.29 (it’s 2.44 mmol/L!!)

…but yes, my fasting blood glucose is still > 5.6 mmol/L (100 mg/dl).

So, I’m not “done” yet.

While I didn’t get “perfect” blood work, it’s pretty good for someone that 16 months ago was obese, had been Type 2 Diabetic for 10 years, had been diagnosed 3 years earlier with mast cell disease (which elevates blood sugar and insulin), had extremely high blood pressure and abnormal cholesterol.

Not bad at all.

…and all this by simply reducing my carbohydrate intake and eating whole, real food, including fruit, dairy, meat, lots of veggies and healthy fats from a variety of sources.

Of course, these are only my results. Everyone is different, but at a year, my results closely mirrored the results Virta Health’s study published at one- year study, with 218 subjects that had been eating the same as I have. So, it is certainly not unusual for people following a well-designed low carbohydrate diet to get these kinds of results.

NOTE: There is no “one-size-fits-all” low carbohydrate diet and what works for me may not be what is best for you. Before undertaking a major change in diet, please discuss your plans with your doctor.

Perhaps you wonder what adopting this type of eating style would look like for you, or have questions about how Distance Consultation services work compared with in-person services, and the cost involved. Please send me a note using the “Contact Me” form above and I’ll reply shortly.

Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

References

  1. Merck Manual – Metabolic Syndrome (Syndrome X; Insulin Resistance Syndrome), https://www.merckmanuals.com/en-ca/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/metabolic-syndrome

 

Update on My Own Weight Loss Journey

It’s 16 months since I began my own weight loss journey and I thought it would be a good time to do updated “before” and “now” photos, as well as some measurements.

The photo on the left was me “before”.

Not only was I very overweight, but I had Type 2 Diabetes, high blood pressure and high cholesterol and was in denial about how very metabolically ill I was.

I was in denial partly because I believed that I was eating a healthy diet for someone with Type 2 Diabetes. I dutifully followed the recommended diet from the time I was pre-diabetic until I was diagnosed as having Type 2 Diabetes and continued on it because that is what was recommended to control my blood sugar. I deliberately avoided missing meals or fasting, to keep my blood sugar stable.

As per the recommendations for Diabetics (covered in an article I wrote here), I ate 193 – 259 g of carbs per day, plus sufficient daily protein for my age and a little essential fat.  Keep in mind that only the recommended amount of daily carbs adds up to ~800 – 1000 calories per day — and with sufficient protein for my age was another ~4oo calories, plus another ~150 calories or so in olive oil and a few nuts or seeds on my salad. With intake of 1400 – 1500+ calories per day, how was I supposed to lose weight?

If “eating less” wasn’t an option for me then of course, I was expected to “move more”.  If I didn’t move enough to burn off the excess carbohydrates that I was expected to eat as someone with Type 2 Diabetes, then this was my fault. This is why I was fat, right?

Really?

My diet was “healthy” by most people’s understanding — certainly as defined by the Dietary Guidelines (Canada’s Food Guide) as well as the Clinical Practice Guidelines for Diabetes. My bread was whole grain and so was my pasta and I ate brown or red cargo rice (with the husk). Lunch and dinner and my 2 snacks per day were comprised of lots of fruit and vegetables of all kinds along with some lean protein; 3-4 oz at each meal and an ounce of cheese at snacks.  I barbecued meat, fish and chicken all year round and if I did pan-fry something, I always poured off the ‘excess fat’. The quantities I ate were recommended by the guidelines and as evidenced by the fact that I neither gained, nor lost any weight.

Eating 65 g of carbs at each meal along with protein and 45 g of carbs at each of 2 snacks each day along with a bit of protein however didn’t help me avoid getting Type 2 Diabetes — so what was I expecting to accomplish eating this way after I was diagnosed?* It was supposed to help me manage my blood glucose levels, but unfortunately after a few years of eating that way, I ended up getting high blood pressure and then abnormal cholesterol as well, which is common.

*I believe that some people with Type 2 Diabetes do well eating according to the standard recommendations of the Clinical Practice Guidelines and others by following a whole foods, Mediterranean-style Diet. There is also strong research evidence that still others achieve excellent clinical results following a therapeutic low carb or a well-formulated ketogenic diet for a period of time. There is no one-size-fits-all diet for everybody and it is for this reason that I offer people choices.

When I saw my Endocrinologist 2 1/2 years ago, she said that if I kept eating as I had been, that in 2 years I would be on medication for Diabetes, hypertension and high cholesterol — and within 5 years, I would be on insulin. At that time, I discussed with her my intention to eat a low carb diet and how low in carbohydrate I was willing to go, if I needed to. I was expecting a great deal of resistance from her, given some doctors consider a low carb diet unconventional. Her response surprised me. She told me that me that eating very low carb was the best chance that I had to avoid the scenario she outlined above as well as the complications of Diabetes, including blindness and lost limbs. In fact, she recommended less grams of carbs per day than I was intending.

Unfortunately, it took another 2 years before I became metabolically unwell enough to actually implement the dietary change, but with my Endocrinologist’s approval and encouragement, as well as my GP monitoring my health, March 5, 2017 I began changing how I was eating and I’ve never looked back.

Me – July 2 2018 (16 months later)

The photo on the left is of me on the Canada Day stat (July 2nd), which was Monday.

As of today, 16 months along I’ve lost;

  • 39 pounds (18 kg)
  • 10.5 inches off my waist (27 cm)
  • 2.5 inches off my chest (6.5 cm)
  • 3 inches off my neck (8 cm)
  • 1.5 inches off each arm (4 cm)
  • 1.5 inches off each thigh (4 cm)
  • Both my HbA1C and FBG are in the non-diabetic range
  • My blood pressure is normal for someone without Type 2 Diabetes
  • My lipids (cholesterol and triglycerides) are considered ideal.

I still have an inch and a half to lose off my waist to get to where my waist circumference is half my height and I’m guessing that will take me losing another 18 lbs but who knows? Whatever it is, it is. I had a foot to lose from my waist when I started — so what’s an inch and a half more?

Now, “moving more” is possible! Yesterday, as I do most weekends, I walked for 2 hours and wasn’t tired at all. I work out each week doing slow High Intensity Training and love it and am thinking about joining a dance class in September.  “Moving more” is the result, not the solution.

Keep in mind that my results are only relevant to me, as I am “a sample-set of one” (n=1). As well, my doctor’s recommendations to me may not be the same as your doctor’s recommendations to you. Everyone’s results following a low carb diet will differ, because each person’s Meal Plan will be based on their own medical history, any metabolic conditions they may have, medications they are taking, their family risk factors, starting weight and lifestyle factors. What my journey and yours will have in common if you’re working with me is that it will begin as a moderately low carb intake, where you’ll be eating whole foods from all food categories, with your doctor monitoring your labs and the dosage of any medication that you may be taking.  I’ll gradually lower the amount of carbohydrate you’re eating only as necessary to achieve the clinical outcome(s) that you’re seeking, and with you doctor monitoring the dosage of any medications you’re taking. This often has to occur quite soon after lowering the amount of carbohydrates and in time they may be discontinued entirely.

Some “low carb diets” available on the internet or in popular books promote unlimited amounts of meat, cream, butter and eggs and others promote (or promise) “rapid weight loss”.  I don’t do either. But if you are looking for a Dietitian to support your desire to eat a low carb diet in order to lose weight and lower metabolic markers of Type 2 Diabetes, high blood pressure or abnormal cholesterol, then I’d be glad to be part of your healthcare team.

I have almost a decade of experience providing services via Distance Consultation (Skype and long telephone) and for those living in the Lower Mainland of British Columbia you can see me in-person in my Coquitlam office.

Perhaps you have questions about how I might be able to help you?

Please send me a note using the “Contact Me” form above and I will reply shortly.

To your good health,

Joy


Note: I am a "sample-set of 1" - meaning that my results may or may not be like any others who follow a similar lifestyle. If you are considering eating "low carb" and are taking medication to control your blood sugar or blood pressure, please discuss it with your doctor, first.

Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.