A Dietitian’s Journey – my personal 2018 year in review

NOTE: This is an excerpt from my "A Dietitian's Journey" diary and is my personal n=1 (sample set = 1) account of my weight loss and healthy restoration journey. Each person's results will be different.

This morning I went to do my exercises and realized that it’s been 10 months since I took my last photo in gym clothes and decided it was a good time for an update.

During the first year of my “journey”, I didn’t exercise at all except for walking and had set the goal of implementing some weights and resistance training during this second year, beginning March 5th, 2018 (my one year “anniversary” of adopting a low carb lifestyle). I was inspired by some doctor colleagues in the Canadian Clinicians for Therapeutic Nutrition group and decided to start slow HIT (slow high intensity training) following the method of Dr. Doug McGuff (Body By Science) but in hindsight, given my age and the number of years I had not exercised, I probably should have started by retraining major muscle groups and strengthening my core first.  I didn’t and ended up aggravating an old back injury and spent most of the summer going through physiotherapy for that. I was in so much pain that even walking was difficult at first, so exercise outside of daily physio was set aside.

As a result of my back injury, I engaged the help of a terrific kinesiologist, and asked her for exercises to build up my knees and shoulders, as well as my back as I knew these were “weak links“.  I faithfully worked on training one of those areas daily, until I ended up injuring one of my knees (also an old injury!) getting out of one of my son’s low-slung car! Sheesh, I felt like I couldn’t ‘win’. Years ago I had each of my knees operated on (torn meniscus in each) after various injuries from years of dance, horseback riding and karate, so my best made plans for exercise this year did not turn out as I  intended.

February 2, 2018 – December 30, 2018

Even without doing most of the exercise that I planned to do during this past year, my body shape evolved, as can be seen in these two photos.  The one on the left was taken February 2, 2018 and the one on the right, this morning (Dec 30 2018).

For the last 6 weeks, I have been both resting my knee injury as any amount of weight bearing hurt and only worked to gently build up the supporting muscles in that knee. Last week after much patience and frustration, I was finally able to walk up the stairs without pain (provided I didn’t try to carry anything heavy at the same time)!

Since I didn’t want to overdo it but knew I needed to start moving forward with my exercise commitment, I began by doing a few slow deep-knee bend squats each day; first 5 at a time.  The last week, I began adding a set here and there whenever I went upstairs for something (a random excuse which served as a reminder).  By the end of this week I was doing 20 – 30 full-knee bend squats per day, 5 at a time.  This is HUGE progress! My goal now is to begin exercising regularly WHILE NOT injuring anything by not being adequately focused on my body mechanics!

While my exercise plans this year didn’t turn out as I hoped, in the end I did end up strengthening my core muscles and building up my knees, lower back and shoulders (one of which is still causing me a bit of grief). I am not letting these setbacks deter me — any more than I let past weight loss stalls deter me.

My goal is to get as healthy as I can and that takes me being dedicated to the process regardless of setbacks.  Setback happen.  They happen to everyone.

Here’s my recap of my progress so far;

In the first year (March 5, 2017 – 2018) I lost a total of 32 pounds and lost 8 inches off my waist. I no longer met the criteria for Type 2 Diabetes (when I began my blood sugar was uncontrolled) and at the end of the first year my blood pressure ranged from between normal and pre-hypertensive  (when I began it was dangerously high). At the end of the first year, my triglycerides were ideal and I had excellent cholesterol levels.

This past year, I lost an additional 18.5 pounds and another 4 inches off my waist; making it a foot in total! My waist to height ratio is now below .50 so I am satisfied. I am 1.5 inches from my final goal weight and am trying to decide if I want to lose another 5 pounds or if I want to focus on toning up my muscles, or both.  For details on exactly what I lost from my arms, legs, belly etc. you can read more here.

Two and a half years of change – from April 2015 – September 2017

Twenty-two months ago this coming week, I was an obese, metabolically very unwell Dietitian with Type 2 Diabetes, very high blood pressure and abnormal cholesterol.

February 2, 2018 – December 30, 2018

I certainly haven’t “arrived” by any means, but I am a whole lot healthier and feel better than I have in years.

As I tell my clients, its about “progress“, not “perfection“.

 

 

I hope my journey has inspired you that losing weight and getting healthy can be done and while it’s not a straight-forward line of progress all the time, and stalls and setbacks do occur, goals that are realistic set CAN be accomplished. Sometimes they just take a little longer than planned.

If you’d like to know more about how I can help you accomplish your health and nutrition goals this coming year, please have a look at the Services I offer and if you have questions, please send me a note using the Contact Me form located on the tab above. If you’d like some help setting some realistic goals for this coming year, please have a look at the special package I put together which is at a special price during the month of January.

Wishing you and yours the very best for a healthy and happy New Year!

Joy

You can follow me at:

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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.

 

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 emergencyI 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

  https://www.facebook.com/BetterByDesignNutrition/

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 Own Experience Following a Low Carbohydrate Lifestyle – 19 month update

This week has been 19 months since I started a low carbohydrate lifestyle and 10 months since I began following a ketogenic diet with my doctor’s and endocrinologist’s oversight and I’m very close to reaching most, if not all of my health and weight loss goals. Here’s an update.

Weight

When I began my health and weight loss ‘journey’,  I had 30 lbs to lose to get to the preliminary weight goal that I set for myself — which was still in the overweight classification, but was the only goal that seemed theoretically attainable at the time.

When one is obese, it's difficult to imagine being anything but "only overweight", even for a Dietitian. As I do with my clients, I set a preliminary weight target that seemed it may be attainable.

I reached my preliminary goal weight in February of this year and said to myself “okay, now what“?  My waist circumference was still not 1/2 my height (associated with the lowest risk of cardiovascular disease, described in this article) so I carried on.

So far this year, I’ve lost 15 additional pounds and 4 more inches off my waist.

As I jokingly quipped on social media recently;

“my waist circumference is FINALLY half the height I was before I started shrinking… does that count?”

Based on my current height (an inch less than I was as a younger adult), I have another inch to lose. I’m so close!

I’m also 10 pounds from the weight I was before I had children — and given my twins will be 26 years old soon and my singleton will be 25 at Christmas, achieving my “pre-baby weight” has been a long time coming!

Me with my 3 sons in 2002

What We Believe is What We Achieve

I realized yesterday that what we believe is possible has a lot to do with what we achieve.

There are a handful of life goals that I thought I’d never achieve because I didn’t believe they were attainable, but after a few years of using a low carb approach with my clients and seeing their success, I started “practicing what I teach”… and here I am, 10 pounds from the weight I was before I had children. With having had twins and then a singleton within 14 months of each other, that is a lot of weight that was not lost previously by trying to cut calories and exercise more…plus the added weight I gained from eating foods that were a mixture of fat and carbohydrates because they were irresistible.

For the last number of months I have been steadily losing inches off my waist but without losing any weight at all. I knew that as long as I was losing either inches or pounds, I was not at a “plateau”, so I carried on.

Adapt Your Life Vancouver – September 15, 2018

September 15th, a little less than month ago, I had the opportunity to hear Dr. Eric Westman speak in Vancouver on the ketogenic diet that he uses in his clinical practice.

Dr. Westman is Associate Professor of Medicine at Duke University Health System and the Director of the Duke Lifestyle Medicine Clinic and is an internationally known researcher specializing in low-carbohydrate nutrition. Dr. Westman is currently the Vice-President of the American Society of Bariatric Physicians and a fellow of the Obesity Society and the Society of General Internal Medicine and has co-authored three books to date, including The New Atkins for a New You (co-authored with Dr. Stephen Phinney and Dr. Jeff Volek).

I welcomed the opportunity to learn from someone that has been following a ketogenic lifestyle, researching and publishing about it and teaching it to his patients for many years.

One of things I learned was a very practical way to determine one’s idea body weight. According to Dr. Westman, it’s the adult weight that a person felt and looked their best at. The other thing that I learned was in his approach to following a strict ketogenic diet, there is a need to eliminate fruit and nuts. More on that later…

I began to think about what was the adult weight I felt and looked my best? 

I came up with what that weight was and thought to myself; “What? Really? That’s very…low!” To try to look at it more objectively, I asked myself if that weight was either unrealistic or unattainable.

My ‘best’ adult body weight is 18 pounds more than my lowest adult body weight (where overweight family members were concerned I had an eating disorder!) but is 5 pounds less than the weight I was before I had my children, including multiples. I concluded that this weight seems both attainable and realistic.

When I calculate my Ideal Body Weight, it’s the weight I was at 21 years old when family members worried about me and which was only sustained for a  very short time before my wedding. It was certainly not where my natural set point was when I was physical active and fit. That weight was where I looked and felt my best. Dr. Westman’s method made sense for me.

Calculated Ideal Body Weight

I’ve always found that calculated Ideal Body Weight (IBW) based on established formulas to be a discouraging and unattainable goal for my overweight or obese clients.

Ideal Body Weight (IBW) Formulas

Men: 50 kg + 2.3 kg for each inch over 5 feet
Women:
45.5 kg + 2.3 kg for each inch over 5 feet

Clinically, I’ve tended to use Adjusted Body Weight (ABW) as “ideal” with my overweight and obese clients as it is applicable if a person’s Actual Body Weight (what they currently weigh) is greater than 30% of the calculated Ideal Body Weight (IBW)To most, if not all of my overweight and obese clients, achieving Adjusted Body Weight usually seems like a Technicolor dream.

Adjusted Body Weight Formulas

Men and Women: IBW + 0.4 (actual weight – IBW)

For me, my Adjusted Body Weight is also the adult body weight that I felt and looked my best at so that is my next goal.

Using Dr. Westman’s method of aiming for the adult weight that I felt and looked my best, which is also my Adjusted Body Weight,  I still have ~15 pounds to lose.

The Exercise Factor

Something else I needed to factor in to my weight loss plan is the “exercise factor“. Now that my eating is no longer driven by cravings for carbohydrate, made worse by high insulin levels, I am naturally “eating less and moving more“; which is a natural outcome of eating a low carbohydrate diet, not a means to an end! I am ABLE to move more BECAUSE I am eating less!

For the last 6 weeks, I’ve been doing resistance training 4-5 times per week (using body weight, resistance bands and dumbbells and barbells) and this is resulting in me building and toning muscle.

I expected that my weight loss would be slowed because muscle is heavier, but that’s not actually happening.

Strict Ketogenic Diet – Dr. Eric Westman’s Approach

Since January (i.e. for the last 10 months) I have necessarily been following a ketogenic diet in order to lower my blood sugar to below the Diabetic range, eliminate high blood pressure and to achieve and maintain a waist circumference that is half my height. As I’ve told many of my clients, my level of carbohydrate intake is significantly lower than any Meal Plans that I have designed for others and this is because of the degree of metabolic disruption I had previously caused myself. I had been Type 2 Diabetic for 10 years, was obese and worse, was in complete denial about the health risk to myself until March 5, 2017 when this ‘journey’ began.

Dr. Westman taught at the conference was that in the weight-loss phase of a strictly ketogenic diet he recommends that his patients stick to real protein foods (meat, poultry, fish and shellfish and eggs), salad greens and low carbohydrate vegetables, plus limited quantities of healthy fats and oils, cheese and cream. What isn’t included in this phase of the ketogenic diet he has his patients follow is fruit and nuts, not even on salad.

Since I saw Dr. Westman speak on September 15th, I gave up nuts and fruit and since then, I’ve since lost 2 pounds and another 1/2 inch off my waist.

Effect on Blood Glucose

The effect of giving up fruit on blood glucose is also observable.

September 15-October 10 2018 blood glucose versus previous 2 months

During July and August it was local blueberry and blackberry season and I ate far too many, way too often. I justified that they are good antioxidants, which they are, but they are not ideal foods for someone like myself who’s been Type 2 Diabetic for 10 years…at least not at this stage of my metabolic reversal.

As can be seen in the graph of my own glucometer readings (above) my average blood glucose in July and August was 6.3 mmol/l (114 mg/dl). Since September 15th, I’ve cut out all fruit, not even a few berries on my salad and I no longer reach for nuts as part of a mid-day meal, but a hard boiled egg or hard cheese or fish, instead. My average blood glucose has dropped to 5.1 mmol/L (92 mg/dl).

Based on the literature, about half of this effect is due to the Metfomin that I continue to take (protective measure given the Alzheimer’s diagnosis of my father and family history of cardiovascular disease) and the other half is due to me having stopped eating fruit.

I am currently achieving normal blood sugar levels, which is amazing! Both my endocrinologist and I hope that in time she can withdraw the recently prescribed Metformin and I will be able to sustain my blood glucose with diet alone, once my liver and pancreas have more fully healed. Time will tell. In the meantime, I am doing everything I can do to get well and stay well.

NOTE: Keep in mind, these are my (n=1, sample set of 1) results based on my specific medical history and metabolic conditions. Since everybody's needs are different, there is no one-size-fits-all "low carb" diet for everyone.

Perhaps you wonder how a carefully-designed low carbohydrate diet could help you improve symptoms of Type 2 Diabetes, lower high blood pressure or simply lose weight? Please send me a note using the “Contact Me” form above to find out more.

Feel free check out the various services that I offer under the Service tab or in the Shop and if you’d like to get started, you’ll find everything you need there.

I provide both in-person in my Coquitlam, British Columbia office or via Distance Consultation on Skype of long distance phone, so please let me know how I can help.

To our good health,

Joy

You can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/BetterByDesignNutrition/

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.

 

Coming Out of Denial to Achieve Health

A month into following a low carbohydrate diet I came out of denial with respect to how very unhealthy I was (and had been for a very long time).  I had Type 2 Diabetes for 10 years, was obese and had dangerously high blood pressure and high cholesterol. My fasting blood glucose was close to 12 mmol/l (216 mg/dl), my blood pressure ranged between Stage 1 hypertension about 50% of the time to 1/3 of the time in Stage 2 hypertension (with one hypertensive emergency that was the impetus for me beginning this “journey”), and my LDL cholesterol was higher than it should have been given my family history. The fact was I was an obese Dietitian (BMI > 30) and coming out of denial enabled me to plot my course for what I had to do to get healthy and what that needed to “look like” — how much my blood sugar, blood pressure and cholesterol needed to come down and how many pounds and inches around my waist I needed to lose. It seemed daunting!

So here I am coming out of denial again — just a different type of denial this time.

The cold, hard truth is that I am out of shape. Sure, I no longer get puffed out walking briskly for a few kilometers as I did at the beginning of my “journey” (as these two really short video clips testify), but my efforts at implementing slow high intensity workouts has failed miserably. While I still have relatively strong arm and leg muscles and can lift and carry heavy objects, my “core” is hit and miss — mostly miss. Our “core” are those muscles in the trunk of our body that are responsible for supporting the heavy lifting work that the muscles in our arms and legs do. When they aren’t sufficiently strong, pain and injuries occur.

Core Muscles

Over the last few months of continuing to do slow high intensity workouts (working large muscle sets until failure), I’ve suffered with sore knees and periodically a sore back, too. Since I’d had both knees operated on a number of years ago (after years of martial arts and dance) my knees bothering me really wasn’t too much of a surprise. Neither was my intermittent lower back pain as I was hit from behind in a car accident a decade ago and was in physiotherapy for many months.

I thought I was engaging my “core muscles” when I was lifting, but I wasn’t —at least not all of them. While I remembered where my ‘transverse abdominals‘ were (having learned in physio) and was engaging them when lifting weights, I had completely forgotten about using my pelvic floor muscles in tandem with them, as well as the other muscles that make up my ‘core’. I wasn’t consciously aware of it, but little by little I was injuring myself; my knees, my shoulder and my back. The ‘last straw’ was me setting up a gazebo for a family BBQ at which point my back made it clear that I could not continue.  I was in terrible pain like I had not been since the car accident a decade ago and had to stop everything. I couldn’t sit for long, walk for long or stand for long so that didn’t leave much. I needed help.

After a few weeks of applying ice, rest and taking anti-inflammatories, I am now in active rehabilitation — doing many of the same exercises that I did a decade ago after my car accident. The harsh reality is there is no “quick fix” to my physical health, just like there wasn’t with my metabolic health when I began changing how I ate 18 months ago. I will need to work on this 3-4 times a week for an hour or more at a time over the next few months. But I will get healthy.

Why am I sharing this?

Because achieving health isn’t something we can always do on our own.

We can all workout on our own and make our muscles stronger, but the fact is if we aren’t working with a kinesiologist who has studied muscle physiology, then we will only be achieving partial results while putting ourselves at risk of injury. We can convince ourselves that a book or a friend or the “trainer” at the local gym can help us (and they can to a point), but they are  not kinesiologists. If we have had previous injuries or for those that have never really exercised regularly before, then we need to work with someone that can teach us how to do it safely and design a program for us to make progress without getting hurt or doing ourselves damage.

Likewise, people can buy a book or find a generic ‘diet’ on the internet to lose weight, lower blood sugar and blood pressure a few points and bring their cholesterol down, but if they have metabolic conditions and especially if they are taking medications for them, they are putting themselves at risk doing it on their own (more about that in this article). Getting nutrition advice from a book, or a friend or the “nutritionist” at the gym is not the same as working with a Registered Dietitian and/or a physician who specializes in it, and who can design a individual diet based on a person’s specific needs and supervise their progress. To put Type 2 Diabetes into remission, reverse the symptoms of high blood pressure and high cholesterol and to get off medications for these conditions takes working with a professional.

I’ve learned my ‘lesson’ the hard way but it need not have been so.

The first step for any of us is coming out of denial — in admitting how unhealthy we are and to seek the help of a healthcare professional that is qualified to help.

Perhaps you’ve never considered getting the support of a Dietitian such as myself and have questions, or maybe you are where I was at 18 months ago and feel overwhelmed with the amount of weight you have to lose and what needs to occur to get metabolically healthy.

I can help.

Please feel free to send me a note using the Contact Me form above and I will reply as soon as possible.

To your good health!

Joy

 https://twitter.com/lchfRD

  https://www.facebook.com/BetterByDesignNutrition/


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


you can follow me at:

 https://twitter.com/lchfRD

  https://www.facebook.com/BetterByDesignNutrition/

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.

Sixteen Months Later – a Dietitian’s Journey

This morning I went for a walk at one of my favourite places (Como Lake Park) and decided it was time to post a video update. It’s short (1:36 seconds) and stands in sharp contrast to the video that I made and posted 16 months ago on March 16, 2017 (1:35 seconds) at the very start of my own low carbohydrate journey, a Dietitian’s Journey.

Looking at the two videos (posted below) there’s no mistaking how significantly overweight and out of shape I was on March 16, 2017 compared to today – and I’m not done yet.

July 25, 2018 – today’s video

March 16, 2017 – my first video

Looking at freeze-frame photos from both videos one on top of another (below), the progress I’ve made is unmistakable.

I have 4- 1/2 years experience teaching a low carb lifestyle to my clients, and I have 16 months living it myself, with weight loss and clinical results that are visible and verifiable. You can review my latest lab test results here.

A Dietitian’s Journey – 16 month video update (March 16, 2017 – July 25, 2018)

I am no longer an obese Dietitian with uncontrolled Type 2 Diabetes, high blood pressure, abnormal cholesterol and high insulin levels.  I “practice what I teach”.

If you would like to begin your own “journey” and want the professional support of a knowledgeable Dietitian that’s been there, then please feel free to send me a note using the Contact Me form on this web page or you can send me the completed Intake and Service Option Form if you’d like to get started. I provide services via Distance Consultation using Skype or long distance telephone, as well as in-person in my office. You are welcome to begin with a single visit to get to know me and my teaching style or to take a package which will give you everything you need to get started on your own journey. A complete description of each package is available under the Services tab as well as in the Shop, with a summary on the form.

I greatly look forward to helping you recover your own health, as I’ve been able to recover my own.

To your good health,

Joy


 https://twitter.com/lchfRD

 https://www.facebook.com/BetterByDesignNutrition/

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.

Type 2 Diabetes IS 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.