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Is it possible...

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Defren

Well-Known Member
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As some of you saw last week, I had a bit of a meltdown over things. Anyway, yesterday I tested for Ketones and I now have a 'trace'. BUT! My calories intake has been slashed. Yesterday for example I managed only 384 the lowest so far. This is not my choice, but side effects from the Metformin. My GP has said to persevere until my next script, due next week. Is it possible that due to my very sedentary lifestyle, due to other health issues, my body actually needs fewer calories? My BG is pretty stable, and my carb intake yesterday was 5g.

I'm asking because a few people have warned to to beware, but my GP says I will be fine until I get the SR, and truth of the matter is I feel better than I have for quite a long time. I am concerned about my calories per day, but the ultra low intake seems to be doing me good. Is this possible to sustain long term if I can't get my calories up, or am I walking into trouble? I want to be as fully prepared as possible to speak with my GP. Thank in advance.
 
This amount of calories would not be sustainable long term.
The article here suggests nutritional deficiencies, gall stones and heart problems.
http://www.nhs.uk/Livewell/loseweight/P ... diets.aspx

Most low carbers would not be aware of their calorie intake unless they did the maths but I bet there are very few, if any, that went this low. They are probably eating fewer than they did pre diet but this amount needs monitoring by your G.P. IMHO.
 
catherinecherub said:
This amount of calories would not be sustainable long term.
The article here suggests nutritional deficiencies, gall stones and heart problems.
http://www.nhs.uk/Livewell/loseweight/P ... diets.aspx

Most low carbers would not be aware of their calorie intake unless they did the maths but I bet there are very few, if any, that went this low. They are probably eating fewer than they did pre diet but this amount needs monitoring by your G.P. IMHO.
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Thank you CC. I don't have a gall bladder as I had that removed quite a few years ago now, but the rest is troubling. I only know about my calories as I use http://www.myfitnesspal.com/ This site tots up all the carbs in what you are eating, as well as protein, fibre, fat and sugar. I can feel quite drastic weight loss as things like rings are much looser, chains hanging considerably lower, and my ankles which were so large I couldn't wear shoes, almost down to normal. I am guessing quite a lot of that is water, but with the ketones, think it's safe to assume body fat as well. My GP didn't sound concerned, just that we will 'discuss it' next week.
 
Defren I count calories as well as carbs. At the moment am averaging under 40g carb / day and register + or ++ on the ketostix. If you are averaging far less than 30g you must be in Ketosis regardless of what the sticks tell you. A lot of things like how much you are drinking will effect the keto reading.

As a man still average around 1500 cals / day. My wife who as a non diabetic is doing even more ULC than me is averaging around 1200 cals / day. This is giving us both a nice steady 2lb / week weight loss so we're happy but both of us recognise that at some point we will may need to up calories when we get to the point where we want to stop losing weight and need to stabilise.

I would say you need to be careful about dropping to the low calorie levels you are saying and you need to talk to you doc about it when you see him / her next. Even in countries where ULC is not discouraged for diabetics their recommendations are that ULC should be closely monitored by an HCP especially in the early stages for the kind of reasons you are talking about. Ultra low carbs yes but ultra low calories not sustainable imo.
 
xyzzy said:
Defren I count calories as well as carbs. At the moment am averaging under 40g carb / day and register + or ++ on the ketostix. If you are averaging far less than 30g you must be in Ketosis regardless of what the sticks tell you. A lot of things like how much you are drinking will effect the keto reading.

As a man still average around 1500 cals / day. My wife who as a non diabetic is doing even more ULC than me is averaging around 1200 cals / day. This is giving us both a nice steady 2lb / week weight loss so we're happy but both of us recognise that at some point we will may need to up calories when we get to the point where we want to stop losing weight and need to stabilise.

I would say you need to be careful about dropping to the low calorie levels you are saying and you need to talk to you doc about it when you see him / her next. Even in countries where ULC is not discouraged for diabetics their recommendations are that ULC should be closely monitored by an HCP especially in the early stages for the kind of reasons you are talking about. Ultra low carbs yes but ultra low calories not sustainable imo.
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Thanks xyzzy, I did wonder if I needed less calories due to my lifestyle, but always realised they shouldn't be this low. I really am struggling with food. I can only manage around 2/3 of a reduced portion sized meal. I tend to try to pick at it through the evening to ensure I do eat a full meal, however spread out it may be. I do need to loose weight and reconise this loss is likely to be a lot of water, but my GP seems to think all is well and a few days won't hurt. The problem is it is now just short of two weeks and not a few days, and will be another week before I see him. As I say though, I do feel better than I have for some considerable time. I'm sure I need to get the pounds off, just not this way. I am more concerned than my GP seems to be :?:
 
Your calorie requirements do reflect the amount of activity that you do . Your Doctor is right. A VERY low calorie intake over a short period won't do any serious damage. If you have weight problems, it might even do some good.
I've had an upset stomach recently, probably an infection caught from one of my grandchildren and a couple of days, I've probably managed to eat even less than 300Cals. I'm over the worst now, But delighted by what the scales are telling me. Just hoping it's not all fluid and won't come back after a cup of tea. Hope the Met SR suits you
Hana
 
hanadr said:
Your calorie requirements do reflect the amount of activity that you do . Your Doctor is right. A VERY low calorie intake over a short period won't do any serious damage. If you have weight problems, it might even do some good.
I've had an upset stomach recently, probably an infection caught from one of my grandchildren and a couple of days, I've probably managed to eat even less than 300Cals. I'm over the worst now, But delighted by what the scales are telling me. Just hoping it's not all fluid and won't come back after a cup of tea. Hope the Met SR suits you
Hana
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Thank you Hana, you have reassured me a little. Each meal time I try to eat the highest calorie food, yesterday fresh fish, today chicken, and pick at the salad later. I have just had dinner today and not even all the chicken is gone, but I feel so full I could pop. This has never been me, as you can see by me needing to loose some weight. The calorific content of dinner today is 269, I would say I have at the moment managed around half of that.

I'm pleased you're on the road to recovery, but the illness helped the scales. Always look for positives in negatives :D
 
Defren said:
Yesterday for example I managed only 384 the lowest so far. This is not my choice, but side effects from the Metformin. My GP has said to persevere until my next script, due next week. Is it possible that due to my very sedentary lifestyle, due to other health issues, my body actually needs fewer calories? My BG is pretty stable, and my carb intake yesterday was 5g.
Click to expand...

Your calories are too low and your carbs are too low (and if I'm telling you your carbs are too low then they really are too low - you need to eat some veg). If your Doc isn't concerened, and things improve quickly on Metformin SR then it's fine. But as Catherine said, your calorie intake is unsustainable in the long term.

Defren said:
I'm asking because a few people have warned to to beware, but my GP says I will be fine until I get the SR, and truth of the matter is I feel better than I have for quite a long time. I am concerned about my calories per day, but the ultra low intake seems to be doing me good. Is this possible to sustain long term if I can't get my calories up, or am I walking into trouble? I want to be as fully prepared as possible to speak with my GP. Thank in advance.
Click to expand...

I think you're walking into trouble if you don't start eating more kcals. Most low-carbers will end up eating less calories (because of satiety and the lack of snack options), but not as few as you are eating. One obvious problem is that you almost certainly aren't eating enough protein - so your body will start to cannibalize lean muscle tissue as well as fat to keep you properly fuelled).

I agree with your Doc, you can sustain this in the very short term, but you need to up your calorie intake as soon as possible. If the SR doesn't work, I'd ask your Doctor about coming off Metformin all together. I doubt it's doing very much (other than ruining your appetite) at your level of carb intake.

You've done really great with the carb thing Def, I'm proud of you, the next step is to transition to a diet that you can live with for the rest of your life. I'm very confident you can do it. :thumbup:
 
Defren said:
my GP seems to think all is well and a few days won't hurt.
Click to expand...

That's the important thing.

Like Hana says I don't think a few days will make a lot of difference but just be aware its a long term life changing choice you are making. You say you are feeling fine which is great, just be careful down the line that you don't start fooling yourself that you are feeling fine if that makes sense. Get your head around making a long term plan that YOU want but make it flexible enough to support outcomes that are maybe not perfect.
 
borofergie said:
Defren said:
Yesterday for example I managed only 384 the lowest so far. This is not my choice, but side effects from the Metformin. My GP has said to persevere until my next script, due next week. Is it possible that due to my very sedentary lifestyle, due to other health issues, my body actually needs fewer calories? My BG is pretty stable, and my carb intake yesterday was 5g.
Click to expand...

Your calories are too low and your carbs are too low (and if I'm telling you your carbs are too low then they really are too low - you need to eat some veg). If your Doc isn't concerened, and things improve quickly on Metformin SR then it's fine. But as Catherine said, your calorie intake is unsustainable in the long term.

Defren said:
I'm asking because a few people have warned to to beware, but my GP says I will be fine until I get the SR, and truth of the matter is I feel better than I have for quite a long time. I am concerned about my calories per day, but the ultra low intake seems to be doing me good. Is this possible to sustain long term if I can't get my calories up, or am I walking into trouble? I want to be as fully prepared as possible to speak with my GP. Thank in advance.
Click to expand...

I think you're walking into trouble if you don't start eating more kcals. Most low-carbers will end up eating less calories (because of satiety and the lack of snack options), but not as few as you are eating. One obvious problem is that you almost certainly aren't eating enough protein - so your body will start to cannibalize lean muscle tissue as well as fat to keep you properly fuelled).

I agree with your Doc, you can sustain this in the very short term, but you need to up your calorie intake as soon as possible. If the SR doesn't work, I'd ask your Doctor about coming off Metformin all together. I doubt it's doing very much (other than ruining your appetite) at your level of carb intake.

You've done really great with the carb thing Def, I'm proud of you, the next step is to transition to a diet that you can live with for the rest of your life. I'm very confident you can do it. :thumbup:
Click to expand...

Thank you. It is so reassuring to have the advice I have today from people who know what they are talking about. Protein today has been 46g mainly from the chicken. I have to say hearing you say I was too low carb made me sit up :D I truly didn't thing it was possible to go too low, but as almost every day since diagnosis, another lesson learned. Snacking is just completely out of the question, I can't face breakfast or lunch. Last week I was able to have wafer thin slices of ham with a little dollop of Philly cheese and chives rolled up - not this week, I can't even go near the fridge without my stomach doing flips. One other thing this week, I used to have milk in my tea, now I can't stand it, it makes me feel sick, so have had to resort to black tea. As I only drink Earl Grey I really don't mind it black, but there is more calories lost, no matter how few they may have been - sigh! Has anyone ever heard of a reaction to Metformin as bad as this? I have no other side effects apart from a dodgy tum if I take on an empty stomach.
 
xyzzy said:
Defren said:
my GP seems to think all is well and a few days won't hurt.
Click to expand...

That's the important thing.

Like Hana says I don't think a few days will make a lot of difference but just be aware its a long term life changing choice you are making. You say you are feeling fine which is great, just be careful down the line that you don't start fooling yourself that you are feeling fine if that makes sense. Get your head around making a long term plan that YOU want but make it flexible enough to support outcomes that are maybe not perfect.
Click to expand...

That sounds like good, solid advice to me - thank you again.
 
Hi Defren
Metformin is an appetite supressent and it afffects different people in different ways I am an underweight DB so it affected me badly especially my evening meal where I really had to force down my food .Before I was diagnosed I always enjoyed my food .I learned to eat more in the morning when I felt more hungry and also to snack if I felt like something .Now my GP has suggested halving my Metformin and I am eating more and feeling better .I think the lesson is to try to ballence what your body needs by testing your BGs but also listening to your body and how you feel ,not easy I know but DB is not easy to manage but it is for life so we need to try to stay well and happy
CAROL
 
I wish Metformin would suppress my appetite :shock: :lol:

More seriously, Defren, can you face eggs at any time of the day? I have a two-egg omelette for breakfast every day, which fills me up nicely and is kind to the stomach, but if eggs make you nauseous, no good!

I sometimes have a small can of soup for lunch - Heinz Chicken is quite low carb, and very soothing.

Can you eat yoghurt? I like Greek-style live yoghurt, and if you can get sheep or goat's milk yoghurt they are even kinder to the stomach than cow's milk. The bacteria are good for you, and you can always sweeten with a little Splenda etc.

As Borofergie said, 5g carb is too low, even for me, particulary if you're eating very little. If you're getting plenty of protein your body will convert some to glucose, but it doesn't seem as if you are at the moment. Also you need to keep an eye on your veg intake because that's where many of the nutrients are.

Try not to worry too much - in the short term you'll be okay - but do try alternatives. You may be better grazing all day than trying to eat a full meal.

Let us know how you get on! :D

Viv 8)
 
Defren meant to post this yesterday but forgot.

To work out a rough guide to calories per day I use something called RMR in my all powerfull spreadsheet. RMR stands for resting metabolic rate and its supposed to tell you how many calories you can eat each day and MAINTAIN your current weight. So the theory is if you eat less than your RMR you should lose weight and if you eat more you should gain weight.

The calculation is

10 times your_weight_in_kilos then add
6.25 times your_height_in_cms then subtract
5 times your_age_in_years

from that final figure subtract 161 for women but for add 5 for men

That gives you a value in calories. Next you have to adjust that value by an activity factor based on how much "E" you do on average. Judge your own activity factor based on the following.

Activity Factor - Category - Definition
1.2 - Sedentary - Little or no exercise and desk job
1.375 - Lightly Active - Light exercise or sports 1-3 days a week
1.55 - Moderately Active - Moderate exercise or sports 3-5 days a week
1.725 - Very Active - Hard exercise or sports 6-7 days a week
1.9 - Extremely Active - Hard daily exercise or sports and physical job

So based on my "walk the dogs for an hour most days" I choose a value of 1.325 so half way between sedentary and lightly active. So I multiply the number I calculated by 1.325 to give me the calories I could eat each day and maintain my sylph like state.

If you are a numbers freak like me you can then work out the difference between your RMR and how many calories you are eating and project an average weight loss (or gain) you should be achieving each day. I must say for me and the wife it has been uncannily accurate but like most things opinions vary. I just do it cos I like numbers in my spreadsheet!

You can read more about it here http://www.caloriesperhour.com/tutorial_BMR.php
 
Or you can work out your BMR (from the Harris benedict equations) using an online tool:
http://www.bmi-calculator.net/bmr-calculator/

Interestingly the online calculator gives me 2354 kcal
xyzzy's eqn gives me 2160kcal

A difference of almost 200kcal, an error which would account for almost 20lbs of weight gain or loss if I overate by that amount. That's one of the points that Gary Taubes makes in his book - a few calories here or there integrated over 20 or 30 years would lead to a considerable weight gain (or weight loss).
 
Calculator wars!

Yes your's is BMR, RMR is a later version of the same thing I think but am probably wrong as "E" isn't my area of expertise. :lol:
I started with BMR then found RMR later on.

Look here http://www.caloriesperhour.com/index_burn.php for a calculator that does both and you'll see RMR is slightly stricter.
 
That RMR equation works well for me.
Interestingly the 'diet' I was given by the dietitian at diagnosis worked out at 1800 calories (40% carbs is 180 which is what i was 'prescribed') . The RMR equation for me then works out to 1818.(presuming moderate activity 3-5 days a week)
I don't normally count calories but I normally eat the same sorts of proportions and on odd times I have counted it always works out at around 1800.
When I was doing a lot of running, ie very active I did lose weight. On backpacking holidays I can eat huge amounts and lose weight. ( my Garmin which measures distance /elevation/speed says I am using up more than 5000 calories on some days and I don't think I ever eat that much!)

At the moment as long as I keep up the moderate activity ie running a couple of days, long walks on 2 or 3 more then I'm weight stable but if I have a 'lazy week or drink too much wine it shows on the scales. (RMR+moderate ex is now down to 1772,)
 
Think I have done xyzzy's calcs wrong as it is giving me 3560 a day.

Thinking about it though it maybe is what I ate pre LC'ing with hubby and my weight never really fluctuated much. Will do the RMR one and see what that says :)
 
2146 so quite a difference! I think it has to be my maths with xyzzy's - I was always useless at it at school! :wink:
 
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