January/February weight loss thread

[GLC1968]

Trisk - I do think I'm very carb sensitive. When I have too many, I don't lose. And more importantly, the more I have, the more I crave, which is how I let my weight get out of control. This applies mainly to starchy carbs, of course. I have never over eaten broccoli or spinach!

My issue isn't that WW doesn't work when I follow it, it's just that I am not even slightly motivated to stick to it. I hate the 'points' thing - I always have and I don't know why I thought this time might be different. I like REAL numbers that I can sink my teeth into and that mean something to me in the long run. WW has a great website, great tools, and a lot going for it...it just doesn't do it for me. Go figure. I've always been a numbers geek, so I don't know why I thought that simplifying that was going to be motivating for me...quite the opposite, actually. Eh.

Susan - great job at mixing up those daily calorie levels! Way to keep your body guessing!

[Triskeliongirl]

In response to the query how to measure your glucose tolerance, here is something I put together for another website I frequent.

Also Susan, I do teach biochemistry to medical students, and in particular amino acid metabolism. What I stress is that while there may be standard recommendations for 'normal' folks, when you deal with people that have metabolic disorders, one needs to modify those. Just like you wouldn't recommend a high protein diet for someone with kidney damage, for someone with impaired glucose tolerance its just the ticket. Also, in the range I am talking about, 1 g protein/ lb of LBM, should not stress the kidneys of a person with normal kidney function.

MEASURING GLUCOSE TOLERANCE: Here is a blurb I wrote up before and modified slightly for you guys (some of which was copied from wiki) on how to measure your glucose tolerance. Notice the info. on the home test which is what many of you may want to start with unless you can convince your docs to run one in a lab for you:

This is how an OGTT (oral glucose tolerance test) works in a lab (from wiki):

The patient should have been fasting for the previous 8-14 hours (water is allowed).
Usually the OGTT is scheduled to begin in the morning (0700-0800) as glucose tolerance exhibits a diurnal rhythm with a significant decrease in the afternoon. A zero time (baseline) blood sample is drawn.

The patient is then given a glucose solution to drink. The standard dose since the late 1970s has been 1.75 grams of glucose per kilogram of body weight, to a maximum dose of 75 g. It should be drunk within 5 minutes. Prior to 1975 a dose of 100 g was often used.

Blood is drawn at intervals for measurement of glucose (blood sugar), and sometimes insulin levels. The intervals and number of samples vary according to the purpose of the test. For simple diabetes screening, the most important sample is the 2 hour sample and the 0 and 2 hour samples may be the only ones collected. In research settings, samples may be taken on many different time schedules.

To do an OGTT test at home, it is good to take additional time points, especially to check for reactive hypoglycemia. If you are not sure of your technique, you may even want to take duplicate measurements, especially at the 60 and 120 minute points, and remember to wash your hands before each measurement:

You can order a very good glucose monitor here for only $20 (uses small sample volumes and has excellent accuracy): http://shopcart.shopmash.com/manu/10...5/product.aspx
The test strips are expensive, but if you get your doctor to write a prescription they are cheaper. The meter will come with 10 to get you started. You can also order the strips from the same supplier.

This is the test. Don't eat after you evening meal. Next morning, measure you blood glucose per the instructions with the meter. Then drink 75g of pure glucose (you can use cycling gels, usually they have 25 g of carbs in the form of maltodextrin which is essentially glucose so you would take 3, or how ever many add up to 75g of the brand of your choice, you can rinse them down with water). DO NOT EAT AGAIN UNTIL AFTER THE TEST IS OVER ALTHOUGH YOU CAN DRINK PLAIN WATER. Call t=0 when you first started eating the glucose. Measure the values at the following points: 30 min., 60 min, 120 min, and hourly thereafter until it comes to a value less than 100 (6-8 hours). The 1 hour reading should be less than 200, and the 2 hour reading should be less than 140 if you are 'normal'.

While I have given this test to lots of people, I have seen there is a huge range in the responses. Some folks never go above 120 at the 1 hour point, while others can be anywhere between 120 and 200. While these folks don’t meet the medical definition of impaired glucose tolerance, they definitely have less glucose tolerance than folks that never go over 120, and they often tend to take too long for the glucose load to clear. These folks often benefit greatly from a low carb diet. When you are feeling bad on the bike (if this happens to you after a high carb pre-ride meal), take a measurement as well. Also record how you are feeling.

So, what I (and my doctor) think is even more important for optimum health (not exposing your body to high blood sugar levels which harms your organs) is finding out how you react to diff. foods/combinations of foods, and only eat foods that keep your blood sugar under 120 after 1 hour (after the first bite) and under 100 after 2 hours (after the first bite). Exercise can be used to raise glucose tolerance. So, while you may find that your blood sugar goes high if you eat fruit pre-ride it may be fine post-ride.

Interpretation of OGTT results (from: http://en.wikipedia.org/wiki/Glucose_tolerance_test )
Fasting plasma glucose should be below 6.1 mmol/l (110 mg/dl). Fasting levels between 6.1 and 7.0 mmol/l (110 and 126 mg/dl) are borderline ("impaired fasting glycaemia"), and fasting levels repeatedly at or above 7.0 mmol/l (126 mg/dl) are diagnostic of diabetes.

The 2 hour glucose level should be below 7.8 mmol/l (140 mg/dl). Levels between this and 11.1 mmol/l (200 mg/dl) indicate "impaired glucose tolerance." Glucose levels above 11.1 mmol/l (200 mg/dl) at 2 hours confirms a diagnosis of diabetes.

Here is a More detailed way to look at your values From the National Library of Medicine http://www.nlm.nih.gov/medlineplus/e...rmal%20Values:

Normal blood values for a 75-gram oral glucose tolerance test used to check for type 2 diabetes:

Fasting: 60 to 100 mg/dL
1 hour: less than 200 mg/dL
2 hours: less than 140 mg/dL. Between 140-200 mg/dL is considered impaired glucose tolerance or pre-diabetes. This group is at increased risk for developing diabetes. Greater than 200 mg/dL is diagnostic of diabetes mellitus


What next?

If you have impaired glucose tolerance, follow the diet in this book, Dr. Bernstein's Diabetes Solution. You can also order it from amazon, etc. http://www.diabetes-normalsugars.com/ (although I do eat tomatoes, carrots, etc. which he doesn't recommend, depends on how severe your impaired glucose tolerance is). I also supplement with no carb protein shakes and almonds during exercise (Jay Robb Whey Protein which they sell at HEB Central Market, also contain electrolytes: http://www.jayrobb.com/cat_proteinWheyAll.asp), and am careful to eat plenty of protein to fuel activity. The amino acids are deaminated to carbon skeletons which can be burned for energy via the TCA cycle, and also used to do gluconeogenesis, but making glucose at a slower rate than consuming carbs on the bike. I have also trained myself to run on a high ratio of fat to glucose.

General info. on how to eat higher protein lower carb can be found in Protein Power by the Eades, although it is less based on glucose readings and allows fruits that raise my blood sugar too high. Another good book is good calories/bad calories by Gary Taubes. Even if you don't have impaired glucose tolerance, I believe it is a healthier way to eat although you would not be as restrictive as a person with impaired glucose tolerance. My husband doesn't have impaired glucose tolerance, but he eats the same as me although he sometimes supplements w carbs (like fruit, sometimes bread). But on the bike, he prefers a shake that contains carbs and protein to a pure carb one (cytomax, also has electrolytes which is key). I think its important to select a diet based on how it makes you feel. If you feel better by shifting the balance away from carbs and towards protein then you should do it regardless of what the test results show. I also think the carbs in veggies and fruits are then better for you than the carbs in wheat, sugar, rice, and processed foods. Protein is also more satiating so you'll be able to reduce meal frequency more easily, and even restrict calories more easily, if that is desirable. I lost 35 lb eating this way and never felt like I was on a 'diet' or excessively hungry, just like my weight 'normalized' as my blood sugars and hormones 'normalized'. But I don't think about myself as a sick person. While my endo labeled me a diabetic a colleague of mine who is a diabetologist said I am not a diabetic based on my blood sugar levels on my regular diet. Now, if I ate a different diet, my blood sugars would be high and I would be a diabetic. But, as long as I feed myself the foods I can metabolize correctly, my blood sugars are normal.

Having impaired glucose tolerance does not mean that you are insulin resistant. Impaired glucose tolerance can be caused by either insulin resistance, or insufficient insulin secretion. To find out, you need to get your doctor to monitor both insulin and glucose during an OGTT. From the ratio of glucose to insulin, it can be inferred how responsive your body is to insulin.

My problem is that I undersecrete insulin. The first clue was that my fasting insulin levels are below range although my fasting glucose was only marginally, if at all, elevated.. When I eat carbs (except small amounts of non starchy carbs from veggies), they make me sleepy, lethargic, and depress my body temperature. They also make my blood sugar go too high and stay too high for too long.

[Triskeliongirl]

What does this all have to do with weight loss?

Well, when we eat carbs, we put our bodies in a hormonal state where insulin>glucagon. In simple language, insulin is a fat storage hormone while glucagon is a fat accessing hormone. If someone has really good glucose tolerance, then the time they spend in this state is small, so it shouldn't effect weight loss. But the more impaired your glucose tolerance is, the more time you spend in this state of insulin>glucagon. For me it meant I felt like I was starving on the bike, despite having glucose coarsing through my veins and fat stored all over my body And I was, cuz I still didn't secrete enough insulin to get the glucose into my cells, but as long as I was making a little insulin it kept glucagon down so I also couldn't access stored body fat either (and I was symptomatically hypoglycemic but when I would measure my BS I found out I was hyperglycemic when I felt this way). That is how I gained weight eating 1200 cal a day and biking 100 miles a week!

Like you Catherine this also happened as I cycled more. I think it was cuz I thought I needed to eat more carbs to cycle. It also happened cuz coincidentally our son's GF was eating with us a lot, and vegetarian, so we started to eat more pasta and dishes with a higher proportion of carbs to protein. I finally made the connection when I passed out after eating a plate of pasta and having my body temp plummet to 96! With the help of a very good endocrinologist we sorted it all out.

Another observation I've made is when I was heavier and rode with heavier women, they ate carbs constantly on the bike. As I leaned out and rode with leaner, faster, folks, I noticed they ate a lot less (both in terms of amount and frequency). Many also consume protein/carb combo drinks. I forgot to say that in addition to my protein drinks I eat almonds on long rides.

[Triskeliongirl]

154lbs.

I also find the discussion very interesting. When I start cycling (about 150miles per week at least - on a fixie) I was recommended to eat before long rides carbs but they just made me tired, sleepy and left me hungry.

Martina

FYI, those are symptoms of hyperglycemia.

I am not bashing carbs as a good source of energy for cyclists with normal metabolisms. But I have found that many women, especially athletic ones that think they are doing everything right, yet are still struggling with their weight, often have issues with glucose tolerance.

[Possegal]

Sorry for the delay folks, I was out of town. My new fridge comes tomorrow and I can't wait to get back to eating at least semi-normally, which I've not been able to do as long as the fridge was luke warm at best. UGH.

http://spreadsheets.google.com/ccc?k...pm8CAodYUC3EPw

[martinkap]

FYI, those are symptoms of hyperglycemia.

I am not bashing carbs as a good source of energy for cyclists with normal metabolisms. But I have found that many women, especially athletic ones that think they are doing everything right, yet are still struggling with their weight, often have issues with glucose tolerance.

Triske, hyperglycemia after eating sugars or carbs could suggest impaired glucose tolerance. Or am I completely confused?

Martina

P.S. I find your posts extremely educational and helpful. It makes huge sense to me. Thank you for taking the time and writing it up.

[Triskeliongirl]

Triske, hyperglycemia after eating sugars or carbs could suggest impaired glucose tolerance. Or am I completely confused?

Martina

P.S. I find your posts extremely educational and helpful. It makes huge sense to me. Thank you for taking the time and writing it up.

ABSOLUTELY! In fact, in addition to taking the home OGTT, you can then test how you respond to different combinations of food and exercise. The rule of thumb I have is to not eat any meal that lets my blood sugar go higher than 120 at t=60 min and higher than 100 at t=120 min.

In the end for me it meant giving up everything but non-starchy veggies most of the time. But for some of you, it might just be shifting the balance, that is instead of eating a pure carb breakfast, choosing a slower acting carb and then combining it with protein and fat which would further delay the rate at which it turns to glucose in your body. This is where a blood sugar meter can really be your friend. Remember your glucose tolerance always improves in the 1-2 hour window after exercise too, so this is when I get to eat strawberries!

Much of this is missed by docs who won't give you an OGTT if you have a normal fasting blood sugar. But despite my low insulin levels, I also have unusually good insulin sensitivity, so I can maintain glucose homeostasis when not challenged with carbs. So, for me the problem was only picked up following a glucose challenge. Then I had a colleague willing to do a research study on me who took frequent measurements of both my glucose and insulin in a research lab setting to quantify both the kinetics of my insulin response as well as my insulin sensitivity. I think he did it cuz he didn't believe I had the problem I had for the reasons I had it. He assumed I would be insulin resistance like most adult onset diabetics, but his data let us firmly establish what is going on which was already indicated in the less rigourous clinical lab tests.

I worried I gave you guys too much info., so I am glad it helped. It only took me 50 years to figure out!

[Susan Otcenas]

I ran my ratios on today's meals. Here's what I came up with.

1065 calories. 14.5g fat, 164g carb, 80.5g protein. (11.8%, 59.1%, 29%)

This amount of protein seems more typical for me, based on my normal diet.

Susan

[jesvetmed]

Forgot to report in! Actually forgot to weigh in! So this afternoon (which is MY morning ) I was 171.6. Sorry to be so late!

[3for3]

I forgot to send in my update. 128.8. grrrrr. I was insatiably hungry last week which probably accounts for that. But the last two days I'm finding most foods totally unappetizing. No morning sickness, just aversions to foods.

[solobiker]

Trisk - I do think I'm very carb sensitive. When I have too many, I don't lose. And more importantly, the more I have, the more I crave, which is how I let my weight get out of control. This applies mainly to starchy carbs, of course. I have never over eaten broccoli or spinach!

My issue isn't that WW doesn't work when I follow it, it's just that I am not even slightly motivated to stick to it. I hate the 'points' thing - I always have and I don't know why I thought this time might be different. I like REAL numbers that I can sink my teeth into and that mean something to me in the long run. WW has a great website, great tools, and a lot going for it...it just doesn't do it for me. Go figure. I've always been a numbers geek, so I don't know why I thought that simplifying that was going to be motivating for me...quite the opposite, actually. Eh.

Susan - great job at mixing up those daily calorie levels! Way to keep your body guessing!

I too have not had sucess with WW. I have tried 2x, each time for 6 weeks. I know when I increased my protien and decreased sugars my weight decreased a bit. I have tried to do this again and it does not seem to work. I am getting rather frustrated at the whole situation. For those on a higher protien diet/eating plan, what do you have for breakfast. I dont like eggs so that is out. I would love to hear any suggestions. thanks

[Triskeliongirl]

My typical breakfast are turkey sausages. I buy ones flavored with cheese and jalapeno peppers.

Another one I like is plain full fat yogurt flavored with stevia and unsweetened cocoa powder, or if you are less carb sens than me fresh fruit.

I noticed Susan eats very little fat and very few calories on her WW plan. I would feel awful if I ate that way. I feel terrible if I don't eat enough protein, fat and salt!

I know you said you don't like eggs, but for others that do, our 'Jim's' Restaurant serves a low carb omellete that is a veggie omelet served with bacon and sliced tomates. You could try grilled tomatoes to complement the sausages too.

[Susan Otcenas]

I noticed Susan eats very little fat and very few calories on her WW plan. I would feel awful if I ate that way. I feel terrible if I don't eat enough protein, fat and salt!

I don't feel awful at all. Sometimes I'm hungry, but then I try to eat something sensible to fill the void.

I'm all about food VOLUME. I love to eat. I want LOTS of it. So, I make choices that give me lots of volume without lots of WW points. By default, that rules out most fatty foods, as they are dense (read: small). Believe it or not, I am not purposely following a low fat diet. I'm following a high volume, low calorie diet, which has *naturally* resulted in a low fat diet. I eat heaps of veggies and salad along with my dinner. Sometimes so much that I can't eat it all. Gimme volume, baby.

One of my favorite snacks is plain hot air popped corn. I get that satisfying hand-to-bowl-to-mouth over and over again for very few calories.

[solobiker]

Thanks so much for your reply, I will try the turkey sausage and the yougurt..not together of course I too would not feel very well on the limited amount that Susan eats. Please, don't take offense Susan as I do not mean anything against you at all. And if it works for you that is totally awesome and great. Congrats on your weight loss.

[solobiker]

I could probably try eggs again, it is just hard for me because I get up at 5am and leave by about 520 to get to work. I honestly have not tried a hard boiled egg. Not sure if I would like it.