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What to try next?

paulmh

Well-Known Member
Messages
245
Location
Wigan
Type of diabetes
Type 2
Treatment type
Diet only
I weighed myself today, drifted back up to 86kg, BMI of 26. I’m ready to try something new to get rid of that stone I’d like to shift, and I’m looking for suggestions.

Currently I have a pretty simple programme, I try and eat less than 100g carbs a day and for the most part I meet that. I don’t eat potatoes, pasta, rice or bread. My carbs come from things like cheese oatcakes and dark chocolate, along with loads of suitable vegetables. I do tend to eat too much chocolate when my carb count for the day isn’t high. The bulk of my eating happens in the evening.

I shifted weight when I counted calories meticulously. I thought I had established a maintenance diet but clearly I’ve been slowly slipping. So I’m thinking I’d like to commit to something new. I hear all sorts about different methods around the T2 forums, but I don’t know which to go with.

Any suggestions from experience?
 
Well, I did alright on low carb/high fat until I stalled, like you. But I was at 75 grams a day when that happened. Then I tried Keto, and added intermittent fasting to it later. (2 meals a day tops, snacks in between those meals, 20 grams of carbs a day at most, usually less. And still eating chocolate.) That got rid of some additional pounds, about 10 of them... Things have stalled again because of meds I have to temporarily take, but I'm still seeing perfect bloodsugars on the keto/IF diet, so I'm sticking with it and hoping the weight'll start going off again when the meds stop.

Maybe just try going for eggs with bacon rather than the oatcakes? Keto is quite sustainable, just be aware that you'll get hit with a ton of bricks when you start, as keto- or carb-flu is an actual thing. (Consider it going cold turkey from carbs, really... Bone broth, salt and coconut milk help you get through it.).
 
My carb intake is 40gm a day max.
It is suggested in New Diet Revolution(Atkins) that a young man doing a lot of vigorous exercise - 45 minutes five days a week, might be able to maintain on over 90 gm per day, but there wasn't the usual optimism about that.
 

I consider that a max for me too. Although often well below that.


Op. When your eating in the evening, choc and such. Is it nibbling across the evening. That may kick off an insulin rise blocking loss.

My waist has shrunk going to omad. That may be an option. Even drop more carbs.



Edit. Stupid unintelligent spellcheck
 

I’ve never really got the detail of LCHF. I see people recommending high fat meats, cream etc and it’s counter intuitive for me. So I do eat loads of meat and fish but it’s lean. I cook with butter rather than oil. I eat more eggs than you could shake a stick at! The (cheese - higher fat, lower carbs) oatcakes only a couple of times a week. In all honesty I think my problem is the ****** quality of the carbs I’m eating, and the fact that I’m having the bulk of them in the evening.

I can’t decide between committing to Keto or IF. The sort of person I am, I like to follow clear instructions - can you link me to some detailed programmes for either or both of these? I don’t like to spend lots of time researching this sort of stuff. I do that sort of thing for a living, and it requires me to do it in depth. I’m more keen to just adopt a recommendation and go with it for my T2 management.
 

It *is* counter-intuitive, because we've been hearing for 4 or 5 decades that fats are bad for us. So it does take a bit of a mind flip, after all that. Okay, the basics, which you probably already know: There are 3 macro nutrients. Fats, carbs and protein. If you cut one, you have to up at least one of the others, otherwise you won't get enough micro-nutrients, and be hungry all the time as well. You need to get enough vitamins and minerals, or you're going to crash and burn (fatigue, malnutrition, heck, even scurvy can happen if one goes to extremes, but you seem like a level-headed type, so...). Carbs make bloodsugars skyrocket, protein makes them go up a little but not a lot, fats however... Fats are a bloodsugar flatline, they won't impact them negatively at all. Better yet, if you have fat with the carbs you do eat, it slows down their uptake, keeping your BS from spiking as badly as they would have otherwise. So for a T2, fats are good. And cheeses and eggs are fatty as well, as is oil, so yeah, that's all okay... It's just the oat part that might trip you up, but it's really up to you how many carbs you want to eat per day. I kept dropping lower because my weight-loss stalled and I really, really want to get rid of my fatty liver. (I had so much fat packed on there when diagnosed, they thought the entire liver was a tumor and I was about to kick the bucket. Still here, no cancer, never was. Woohoo.) Anyway, Keto and IF help me do that, tackle what I need to tackle. But it really is different for everyone.

A lot of people combine keto with IF because they do complement each other. On keto you start burning (stored) fats instead of carbs for fuel, so you have to be careful about staying in ketosis as long as you want to stay in, because if your carb intake creeps up, you're out of ketosis and you start burning carbs again. (Getting back into ketosis takes a few days. And I hate those days because I ache all over when that happens.) If you are in ketosis, you feel hungry less, so then it is easier to start with intermittent fasting, which can take a load of shapes... For me, I skip breakfast and postpone having lunch as long as possible. Usually that means I eat two meals a day. Some go OMAD (One Meal A Day), others fast 24 hours, two non-consecutive days per week... All depends on what you want to do and what you feel works for you, your rythm and your body. So while there's loads of methods I can point you to, it really is a highy personal choice. But alright: dietdoctor.com caters to LCHF, Keto/IF, and the Diabetes Code book by Dr. Jason Fung is an excellent (and not dry) read with everything you ever wanted to know and more you didn't even know you needed to know. Then there are apps like Keto Diet Tracker where you log your meals, and they figure how many macrontrients you need per day, depending on age, weight, sex, so that's helpful and rather straight forward.

Basically, if you don't want to figure out what works for you at length, just go for a one-size fits all. LCHF, you kinda have to figure out for yourself as it depends on how many carbs you want to eat/can process. Keto, well... That's just 20 grams of carbs a day or less, plenty of fats and fluids, moderate protein, done. (Let an app calculate your needs if you want specific numbers to stick to.). Can't get much more straight forward than that, really. No idea of this helps at all, but one can hope.
 

I’m doing up to ten sessions a week, my trainer - who is obviously no specialist in T2 - says 100g of carbs a day is too little for the amount of training I do. I feel fine on that amount. I’d be happy to commit to a lower amount of carbs if it was going to lead to weight loss. When you say “not the usual optimism”, do you mean that Atkins would be less likely to be effective on 90g or more?

Just for completeness Resurgam, daily menu is pretty repetitive but goes - three mornings a week I exercise early so can have a cooked breakfast after, usually three each of eggs, sausages and bacon. Other days I train a bit later so won’t eat till lunch. Lunch is always salad, often tuna mayo. Evening meals are usually steak or mackerel or other fish with green vegs, sometimes a stir fry. I don’t l8mit protein at all. Snacks are nuts and chocolate, usually dark, sometimes not. I’m a sucker for coated peanuts which are higher in carbs. If I know my carbs have been lower than my 100g target then I sometimes allow myself a packet of crisps or a snack bar. If I allow myself to bring home, for instance, a multipack of small bags of popcorn at 9g a pack then I’ll end up eating a few bags - so I tend to not have those th8ngs in the house. It’s all very samey! Evening grazing though might be an issue, but I’m nothing like how I used to be. Writing that out makes me think I’m eating to my carb limit in the evenings because I’m telling myself that’s what I’m “allowed”..

My bloods consistently are sixes in the morning and fives by 6pm. I can get peaks after exercise as high as nine which quickly fall away. So my bloods are relatively well managed though could be better.

I can’t decide whether to reduce my carbs or to reduce my calories. Am I right in thinking that Keto and Atkins are the same thing? People here seem to use keto to manage their bloods, but because my bloods are acceptable I’d like to prioritise weight loss.
 

“Insulin rise blocking loss”? I’ll have to look it up! Omad too!
 
At ~100g per day as an insulin resistant diabetic you will still be preferentially burning glucose as your primary fuel source. As your body quite likely still has a reserve of glucose to draw from (irrespective of blood glucose), it will continue to use this fuel as a priority. This in turn will keep insulin levels elevated and prevent you from efficiently burning stored fat.

For reliable results in this situation you would ideally need to switch metabolic pathways from glycolysis to ketosis. Typically meaning ~20g or less per day of carbohydrate. Fasting will have a profound effect but fasting is best undertaken from a position of ketosis in order to avoid hunger.
 
D**n it Jim, must you be so brilliantly succinct? Now I feel like I just go on and on, and you got to the point right-quick! Ah well...
 

Definately agree on the keto/fasting hunger point. If your still eating carbs in quantity. You will be climbing the walls.
 
One thing I noticed was that by including a small amount of carbs at breakfast my BG was more stable throughout the rest of the day.
I only eat twice a day and have just a few carbs, no more than ten gm with my first meal - rather than none at all.
I do not snack at all. as adding in hefty chunks of carbs in small amounts of foods - which I suspect is what you are doing, would have an then impact on BG levels throughout the following day. If you respond to that my producing more insulin then that would make weightloss more difficult, countering the increase in metabolism which should follow exercise by holding back on the release of energy from glucose stores and fat from cells in general.
 

Thanks Resurgam - when you say 10g of carbs with your morning meal what might that typically be?

I'm committing to experimenting with very low carbs for a while. I had less than 40g yesterday and less than 20g today (I think - I might have gone over with some milk in my 2 or 3 teas). Almost all the carbs came from two burgers from the freezer I had which I thought would be almost zero carbs but when I checked they were 7.5g each - so that's pretty much all I've had. I'll forego my two squares of dark chocolate! I snacked today on peanuts only - they'll have contributed something to the carb count. Main middle of the day meal was steak and fried cheese with some lettuce and a zero carb dressing.

I'll do some more reading in the Keto forum but am I right in thinking that I can have "as much" fat and protein as I want or do I need to be monitoring that too>
 
typically scrambled eggs, grated cheese and thinly sliced tomato, but sometimes cauliflower steamed until really hot, then covered in cream cheese then grated cheese and kept warm until the cheese melts, sometimes leftover sausages from dinner, with mushrooms or sweet pepper.
 
So after 2 weeks or so trying to practice Keto, some thoughts, as much for the record as anything..

  • FBGs consistently in the fives, as opposed to consistently in the sixes
  • Definitely noticed an increase in alertness, maybe linked to Spring arriving though!
  • Also noticed a quite marked reduction in appetite which is interesting - no desire to snack for instance
  • Have reversed the weight gain trend but only lost a pound in the last two weeks which was surprising because I definitely look much leaner.
  • Negative side effects primarily to do with bowel, but manageable. Some headaches a week ago but they’re gone
  • Still spiking BG immediately after exercise - consistently tens and elevens. Returns in range within two hours. Will give the keto a period to bed in then have a look at the techniques for managing spikes with exercise
  • Don’t think I’m yet “ in ketosis” though - no tell-tale ketotic smells?
  • Struggling to keep protein consumption at the right level which can be the only reason I’m not in ketosis - though my consumption of ANYTHING is really low. Yesterday for instance, had a half litre of home made veg soup for breakfast, sausage bacon eggs mushrooms and a couple of toms for lunch, steak, spinach and avocado (mixed with horseradish - my new favourite thing!) for evening meal, handful of peanuts for snack - that’s fairly typical, so only picking up carbs from vegetables.
All in all though I’m pleased with how natural this has become, and how my appetite seems to have changed.
 
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I try to do both but I am prone to lapses so the effects are blunted, but I still have greatly improved average sugars and am slowly losing weight. (Edit: I do have a lot to lose so it's relatively easy for me at the moment).

For me the research was crucial to my motivation, but then I'm a quick reader who doesn't have anything else piling up to read nowadays, so I enjoyed it. Time was if it wasn't a philosophy text, it didn't get read!
 
Oops, late to the party again, sorry!
 
jpscloud said:
Oops, late to the party again, sorry!
Click to expand...

Never too late, I still update this thread for myself sometimes, as much as a record as anything else. And my first degree was in philosophy so, if you have any book recommendations.....

Saying that, more than a month in to keto, my steady weight loss (averaging about a pound a week) continues and I'm now 13 stone 1 lb (83kg). I continue to be impressed with how much my desire to snack has gone down, and appetite generally which can only be down to the cream in the coffee! I've experimented a little more with keto recipes so that's good. My FBSs tend to be good with the odd unexplained blips, but the thing is that I know I'm not cheating or slacking so whatever causes it isn't diet.

I'm wrestling with a missus who is a health care professional and who has done lots of research and she keeps "suggesting" that I try a plant-based diet... I may experiment with it later this year, but from the anecdotes I've read on here it doesn't sound good...
 

Drop the carbs lower, 100g carbs a day is still quite a lot, plus dark chocolate can still have quite a bit of sugar added. You could also try the Wheat Belly diet(Dr Willaim Davis) which a lot of people find improves their health.
 
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