My diabetes story - Part 5: Lifestyle Change
My diabetes story
It's time to make a change, the changes are small, but so hard.
This is part 5, the final part of the story and continues on from a previous part. If you want to read the whole lot, please start at Part 1: Diagnosis.
This is my story about my journey to diabetes and back. It's what happened to me, and I'm not saying that this same thing will work for everyone, but I hope that if you're out there suffering through this insidious disease, maybe you can consider doing something similar and it works for you too.
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I apologise in advance for the length of this last article. I think it all needs to go together, so can't break it up. Sorry.
Lifestyle Change
The big scary thing happened to me. I'm currently on track to lose my eyesight, limbs, have problems with my cardiovascular system, liver, kidney. I'm dying. Slowly.
Fortunately the solution is easy. Really easy and you get results within a few days. So why is it so hard to take that first step? It should be an easy choice, shouldn't it?
Sorry, but you can't have any more:
- Soft drinks (Sodas)
- Ice cream
- Bread
- Rice
- Potato
- Corn
- Beer
- Pasta
- Pizza
- Burgers
- Lollies
- Biscuits
- Cakes
- Cereal
Ahh, that's why it's so hard. You'd almost rather die than stop eating those refined carbohydrates, right? Right? Uhm...
If it's hard for me to face giving up these things, when I'm staring down the barrel of a gun, how can I expect to convince the average everyday person that's “doing alright” (ok, so maybe you've packed on a few kilos lately) that it's really in their best interest to do the same?
You're right of course. I've had very limited success convincing anyone that they're getting slowly killed by excess refined carbohydrate consumption. But that's what's happening.
So say I do convince you that you need to make a huge lifestyle change to become healthier, more invigorated, think better, have more stamina, increased libido, easier breathing, less pain, quicker healing, less hunger?
What you're going to have to do
1: Stop eating highly refined carbohydrates.
This means no Sugar, Wheat or Starches.
Restrict non-fibre carbohydrate (net carbs) input to < 50g / day. If possible < 20g / day is recommended.
This does not mean that you cut out all carbs, as a matter of fact, low net carb vegetables (especially from the brassica family like broccoli, spinach etc) that are full of vitamins and fibre are important to keep our bodies in top condition and moving properly.
Fruits and legumes should be restricted somewhat as they are higher net carbs, but you should still eat them as they are important, reduce the serving sizes, and tomatoes and berries are better than super sweet fruits.
Starchy things like potatoes, sweet potatoes, bananas etc should be cut out as much as possible, or reduced to very small portion sizes, as they are extremely high in net carbs. Oh and no milk as it is high in lactose which is high in carbs. Full fat cream and butter is still on the menu though and forms an important part.
There's a good guide of what to eat based off carb quantities over at Diet Doctor - What to eat. There's also a heap of recipes there too.
2. Start supplementing with good fats.
Omega 3's are great.
If possible, use Avocado, Olive, Macadamia, Coconut, Butter, Animal fats and Fish oils which are all good.
Avoid trans fats and polyunsaturateds as they are currently thought to be real bad for you, so no hydrogenated oils, Sunflower, Canola, Peanut, Safflower, Cottonseed, Soybean, Grapeseed or Corn oils.
And don't worry about anyone who tells you that you will die of a heart attack, because the lipid hypothesis has long since been debunked. Saturated fats actually increase HDL's and lower the bad LDL's (type B) and lower triglycerides. Many, many studies have shown that you're actually far less likely to stroke out if you are eating enough good fats and Time magazine even published a retraction of their 35 year earlier condemnation of saturated fats, saying “Oops, we were wrong, it's ok to eat butter now”.
3. Keep eating your normal amounts of proteins.
You still need protein if you want to retain muscle mass, and not have your body start eating itself (no, you don't want that, it's a quick way to weight loss but ends in a lot of problems).
You should continue to consume the same amount of protein as you used to, except now, get the fatty mince, and the non-lean well-marbled steaks, and the fatty bacon, and greasy chops, and eat that chicken skin.
4. Start drinking a lot of water and add salts.
You'll need to add salt to your food, at least half a teaspoon of salt each day.
When we're eating lots of carbs, insulin causes sodium retention, which means that we don't need as much salt on our food, and causes swelling.
Now we're not eating many carbs anymore, we need more salt, but we're not used to it, so we still try to restrict our inputs. Also due to reduced sodium retention, we also need a lot (A LOT, like at least 2 litres per day) more water.
If you're not drinking enough water and consuming enough salt you will start getting headaches, and possibly feel light-headed when you stand up.
5. Consider your vitamin inputs.
It can be helpful for some people to add additional supplements if you think you're not getting them in your diet.
Most foods like spinach, broccoli, avocado, kale, asparagus etc, (the so called super-foods) will have plenty of your required minerals and are low in net carbs. If you're getting plenty of these and maintaining your protein inputs, you should be okay without any additional vitamins.
If you're not, you'll start feeling cranky and tired around week 3 to 4. (So called Keto Flu).
6. Fasting
Sounds scary... not eating right? The funny thing is everyone thinks that, but without carbs, you don't need to eat all the time. When your body converts to fat burning mode, you go from having 4 grams of blood sugar (less than a teaspoon) to keep you powered, to having a body full of energy in the form of fats.
When you wake up in the morning, your body will have produced enough energy for you to get through the morning (even morning exercise) without having to eat. Don't believe me? I do a 5k walk every morning now, and don't even feel hungry until about 11am. You still need to have fluids in the morning and probably some salt, having a broth, or non-sugary energy drink or bulletproof tea/coffee is great for this.
After 11am's “breakfast”, I have normal food throughout the day, when I feel hungry and then stop eating at 7pm. Between 7pm and 11am the next day I'm fasting, that is for 8 hours I'm eating (and do make sure you actually eat enough during this "eating" time) and then for 16 hours I'm not. This is called a 16:8 intermittent fast.
Why am I doing this?
There's a few reasons, but the primary one is that I have plenty of fuel already in me and I need to use A LOT of it up, especially around my liver and pancreas. My body is in fat burning mode, so by not eating for 16 hours each day, my body starts in on the fuel it has been storing for the last 40 years for just this occasion.
If it seems unnatural, don't forget that before the advent of electricity, people used to go to bed at sunset and wake up at sunrise. Our bodies were built to be able to power themselves over at least 12 hours, stretching this to 16 allows me to burn off a little bit extra every day.
The second main reason is its great for detoxing, I get a mini-detox every day, without the bad tasting detox drinks.
The end result
Assuming you haven't suffered any permanent damage to your body, things will start returning to normal, some things rapidly, and some gradually.
Firstly you're going to be reducing your carbohydrate input, which means your blood sugar is going to drop as well. This will happen pretty quickly.
Within the first month you're going to lose a lot of weight around your liver, which will improve your ability to process the blood glucose into fat storage once your pancreas manages to produce the insulin you need.
Unfortunately it's going to take quite some time for your pancreas to return to full sensitivity. Some say up to 2 years before you're fully back to normal insulin sensitivity.
Once you get to about week 4, you will be fully adapted to fat burning, and as long as you keep your carbohydrate input reasonably low and don't "cheat" too much, you'll stay in this condition.
In fully adapted ketosis condition, you'll be able to think better, have more energy, and can exercise longer.
Tips
Unfortunately, it's not all roses and sunshine. We're not used to living this way like they did in the olden days. We've lost the natural instincts for what quantities of nutrients the human body requires, and living for so long on carbohydrates has taught us to be wary of fats and salts. There's good reasons for this because eating fats while eating carbs causes you to get fat. And eating salt while on carbs causes your blood pressure to go up due to sodium retention caused by insulin.
It's quite unnatural to think “I haven't had enough fat/oil today, I'll go and put a blob of butter on my broccoli, and a piece of triple brie melted on my steak”. Or “I should get some more salt and put that in my scrambled eggs”. My goodness. I can still remember when such thoughts would have had me clutching my heart in terror.
If you do start going LCHF, here's a few helpful tips that may help you along.
Lethargy.
If you have problems thinking, feel tired, headaches, cramps etc, you need more water and salt in your diet.
Ok, I tried that and I'm still tired.
Ok, I don't think you read me properly above. You need more water and salt in your diet. You seriously need about 2 litres a day of water and about a half to a full teaspoon of salt.
Can't drink that much water.
If you just find it hard to drink plain water, but are adding plenty of salt to your meals, then you can subtly flavor 2 litres (or quarts) of water with a crushed strawberry, lime half, orange half, lemon half, grapefruit half etc.
The subtly infused water will be just enough not like water to satisfy you and yet have only minimal carb content.
If you still find it really hard to drink that much plain water, you can try flavoured, sugar free, carb free, water drops. They sell these drops in the supermarket. Just make sure they are zero carb. Some even have electrolytes added as a bonus.MCT oil and fat bombs
You can get some MCT oil (make sure it's ingredients list C8 and C10 only, because if it's got 50% C12, you're essentially buying really expensive coconut oil).
MCT's (C8 and C10) are the oil equivalent of raw sugar, except faster acting.
If you're running low on energy (because you haven't been getting enough oils in your diet, naughty, naughty), you may be tempted to have some carbs (in the form of sugar most likely) just to tide you over in an emergency. Don't do it, you just need some quick energy, the good news is you can get that without sugar.
It's a good idea to get some MCT and make some fat bombs, ahead of time. You put MCT in them as you're making them so that you can get an instant energy boost when you eat them as well as the longer term energy burning.
But in a pinch a couple of teaspoons of MCT will tide you over while you consume some decent food (including longer term burning fats and oils).
Still drained
If after ensuring you're having enough water and salt and vitamins, you're still not feeling 100% in week 3, it's likely you're either not getting enough oils or you're not fully adapted enough to process them quick enough to provide you energy.
If you're not getting enough oils (you should be getting at least 150g of oil each day, probably more), you'll need to fix that. Eat some vegetables drizzled with butter or cooked in coconut oil, have some cheeses, eat some fish or have half an avocado.
Then if you are flagging or start to, use the fat bombs you prepared earlier. If you don't have any fat bombs prepared, and you're really desperate, you can take 2 teaspoons of MCT directly, it's mostly tasteless despite the oily feeling in your throat. I was out shopping during week 3 and it hit me all at once, I stumbled to the health shop, grabbed a bottle of MCT and chugged it right from the bottle. If you don't have MCT, go and get some actual fats / oils and rest for a bit.
If you're a coffee drinker you can also put some MCT in with your coffee instead of sugar, I'm not a coffee drinker myself, but I hear it's like rocket fuel. (Google "bulletproof coffee", you don't need to buy their expensive coffee beans or oils, you can make it with your own coffee and MCT, or tea and MCT if coffee's not your thing).
The other way is to put some MCT in with some broth. I like to have my broth with added salt, MCT and some butter, so I get hydrated, a bit of my daily salt requirements, some vitamins, longer burning fats and an instant energy hit.
Any way you take the MCT, within 10 minutes you'll be bouncing off the walls.
Missing carbs? Thinking of cheating?
I can tell you that I don't miss carbs anywhere much as I used to, and when I do have a craving for something there's usually ways to get what I'm craving without having to cheat.
If you do plan to cheat, actually plan to have a single cheat day. Get it all out of your system on that day, and then the next day get back on the wagon. Don't do it too often, because if you do, you'll drop out of keto, and if you drop out for too long, you'll have to go through the adaption phase again.
That said, there's a lot of things you can do to sate your cravings without cheating.
Miss ice cream? You can make really yummy keto friendly ice cream. The core component of ice cream is cream, and we're allowed full fat cream. Made right ice cream can provide a goodly portion of your daily fats.
Miss milkshakes? Full fat cream and almond milk smoothies are your friend. Just pop a couple of frozen raspberries, a few cubes of ice, about 50ml of cream and about 150ml of almond milk in a nutri-bullet or blender and blitz.
Miss chocolate? You can still have small amounts 75%+ dark chocolate in a pinch (just one or two squares). If you don't like the strong taste of dark chocolate, melt it into full fat cream in a milkshake, or just chocolate cream. Mmm.
Miss rice? You can sub in grated cauliflower for rice. It's a lot quicker to make and tastes about the same with the same texture. You can make up curries and other meat sauces and put them on a bed of cauliflower rice and you're probably not going to notice too much of a difference under the sauce.
Miss pasta? There's a few ways you can go here, you can use cauliflower rice, you can get some spaghetti squash, or you can get a spiraliser to spiralise some zucchini into "pasta", then putting your meat sauce over that. It's not the same, but you still get the taste of the sauce. The other thing you can do is find some shirataki noodles / fettuccini and use them, as they are zero carb, but they can be difficult to find. Your local supermarket may not have them, you may have more luck going to a local asian grocer instead.
Miss popcorn? You can roast up some mini cauliflower florets in the oven and slather them in butter.
Miss mashed potato? You can mash up cauliflower (again, it is great) and add cream + butter + cheese for a really great mash.
Miss bread? You can make wheat free breads with almond (or coconut) flour, eggs and baking powder. It's a bit more solid than normal bread but you can make sandwiches with it, or make it into buns for a hamburger.
Miss pizza? You can make the most yummy non-wheat pizza bases from psyllium husk, almond flower, butter and mozzarella cheese. Then just make your pizza like normal with natural ingredients. Tastes super cheesy and delicious.
Miss corn? Suck it up buttercup, corn is awesome and the one thing you'll never, ever, EVER be able to find a decent substitute for. You're just gonna have to save it up for a cheat day.
But seriously, if there's something you miss really bad, you can usually find a substitution for it that tastes as good if not better.
My family
I'm still going through the process of learning and healing, and my family and I are living healthier and better lives. Having more varied, more nutritional and better tasting meals.
I do think having an entire family to cook for makes it easier than having to make single person meals and keep on the wagon by yourself, so if you can convince your family to join you (or support you) on this journey, that is probably going to make things a lot easier.
Both my wife and I are gradually losing weight. I am lead to believe that this will stop when your body gets to it's ideal weight.
My wife has had serious bronchial asthma since she was a child, and could not exercise without taking her puffer, or sometimes having to go on the nebuliser afterwards. She would take a preventer twice a day and the puffer at least 3 or 4 times a day. Now she rarely takes the puffer anymore, and only takes the preventer if she's having a bad day, but most days doesn't take it at all.
She has also had problems with chiropractic issues, doctors have diagnosed her with all kinds of things like lupus or autoimmune, and offered to operate to relieve the pain she has in her wrists. She was unable to walk up or down stairs without pain. She has gone from nearly constant pain to mild twinges every now and then and can go up and down stairs again.
Finally she had been taking medication for depression and anxiety, and to be able to get to sleep at night and to be able to sleep through the night. She is now off the medication, is able to get to sleep and sleep properly through the night and the depression and anxiety is mostly gone.
My 2 children are along for the ride as well, but we don't restrict their inputs, they get the same things we have for breakfast and dinner, and whatever they want to eat from the fridge or pantry in-between, although there are no bad things in there for them to eat.
My oldest son was getting heavier as I did when I got to his age, but this has begun to reverse now, and he is looking better, slimmer.
My daughter is much more active and was not overweight, actually she was maybe a little too skinny, and she doesn't appear to have lost any weight, if anything she may have firmed up a bit, likely from having a better nutrition now.
She does have ASD, and it's too early to tell, but I am noticing dramatic improvements in her speech, and ability to express herself. I know this is a controversial thing to say, I'm not saying people feeding their kids breads / sugars causes autism, but taking them off seems to improve their situation, at least in my daughter's case.
I haven't seen any change in their grades as they haven't really been at school for long after we started the diet and then they were on year end holidays.
What's next?
This is the end of my diabetes story. I don't have it anymore. I can eat carbs and my blood sugar goes up, and then it comes right back down again down to normal levels, without medication.
What I have is a long journey left repairing my body, and making sure I don't go back to a situation where the diabetes will come back.
A long journey of discovery, finding new ways to keep myself and mine healthy and rediscovering the lost knowledge of the past generations.
A long journey through the remainder of my life, with my lovely wife healthy and by my side, and watching my kids grow into healthy and happy lives.
I hope this story helps you and inspires you to make changes that will improve your life, begin a journey of self improvement and discovery, and help improve the lives of those you love and care for.
If you want to read the whole series, please start at Part 1: Diagnosis
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Omg! Such a good article and it works!
Thanks, reddust!
I'm about to make some sauerkraut today, I've done my research, we'll see how it goes, lol.
Coincidence! I just sterilized my jars and I have a nice cabbage. My last batch was inedible. Put me off the whole process for two years.
thanks for sharing and shedding some light one what it's like
Great info!
I've been LCHF for most of 18 years now and every now and then the urge for carbs gets to me. Unfortunately the replacement recipes usually just make me want the real thing. For me, it's just better to learn to do without.
That said, I have seen many people make it through with exactly the tips you gave in that section. Everyone reacts differently. But you certainly did a great job of lining things up. Wonderful post.
Again, I will be resteeming and posting this up to Paleo-Trail. I just wish certain people I know IRL would at least try it.
One thing about LCHF is there's so much great stuff you can now eat that you couldn't before. Sometimes it's good just to concentrate on how lucky you are that you're now able to eat this great food that's been denied to you for so long, than regret what you're missing out on.
Thanks baerdric.
Exactly ! I just had steak and salad for dinner, and it was a fatty chuckeye steak and a full fat, homemade dressing on the avocado and eggs in the salad.
Yummm
Very well written! I think you are getting a good grasp on nutrition, and most importantly, taking charge of this serious but very manageable disease. I remember all these thoughts going through my mind when I was diagnosed with Type I....
As a senior in medical school, one of my biggest passions is helping those with diabetes. I think posts like this will help those who struggle with what to eat. I think you are going in the right direction. I don't necessarily think you need to fast, and complex carbohydrates would still be acceptable in moderation.
Excess sugar will become fat. So one could eat only carbs and no fat and be very overweight. You are correct, in that high cholesterol food is not believed to raise bad cholesterol anymore. However, eating any fat whether monounsaturated, polyunsaturated, or saturated still has many calories. I would also stay well hydrated because protein diets can cause ketosis, and if your high sugar began to cause your body to make more ketones, it could cause a bad condition called ketoacidosis (usually only seen in Type I diabetes).
I wrote on your first 1st or second post on diabetes and was trying to share with you the pathophysiology of type II diabetes. I wrote those two posts about 3 months ago, and feel that they would be very beneficial for you as you go through these changes. By no means am I asking you to upvote them haha. My number one mission is proper education.
Thanks again for a great post!
What an amazing article. Both my parent's have diabetes and I watch them struggle with their diet and making healthy choices. My mom is in total denial that she needs to make changes, which is frustrating to watch. I am going to pass your articles on to her. Hopefully it will inspire her to take control of things.
My mother in law is completely against it because her doctor doesn't agree with it, and no amount of reasoning will convince her otherwise.
My mother is actually diabetic, and she is passively resisting. She keeps sneaking in carbs, and is not getting into ketosis. But she's reduced her carb intake down to where she doesn't need to take medication anymore to keep under 8.5 mmol/L, so that's good at least.
good detailed brave story @triddin
you adjust your self fast and went through it wisely , i think this because you are well educated and have a strong well to make things right , really happy for you
after your permission i want to tell the story to patients and also in my next blog about DM , only if you agree .
Cheers
I am all about getting the word out and helping people slay the beast. Please feel free to make reference to my story, and tell any patients.