Friday, May 13, 2016

THE KINDER, GENTLER CHALLENGE - WEEK 19 RESULTS

                               Today is the end of Week 19.  In the past week, I have:

Rebecca in size 6 jeans on May 13, 2016
Lost 0.4 pounds on the scale
Gained 1 pound of body fat (est.)
Lost 1.4 pounds of lean mass (est.)
Gained 1/8" around my neck
Gained 5/8" around my waist
Gained 1/8" around my hips
Body fat from 30.3% to 31.1% (est.)
Lean mass from 69.7% to 68.9% (est.)
Feasted 6 days and fasted 1 day
Lifted weights 1 time
Did treadmill HIIT 1 time
Walked 3 miles 1 time

Since January 1, 2016, I have:

Lost 18.6 pounds on the scale
Lost 18.0 pounds of body fat (est.)
Lost 0.6 pounds of lean mass (est.)
Lost 1/2" around my neck
Lost  3 5/8" around my waist
Lost 3 3/8" around my hips
Body fat from 39% to 31.1% (est.)
Lean mass from 61% to 68.9% (est.)
Feasted 82 days and fasted 52 days
Lifted weights 5 times
Did treadmill HIIT 9 times
Walked 3 miles 5 times

Size 6 jeans, come to Mama!  Five and a half months ago, I was wearing a very tight size 12, and now I am wearing a properly fitting size 6.  It feels great!

I made a few charts to track my progress.  On the first chart, the grey line is my long term goal. The blue line is my actual weight.  The red line is my 7-day average. The second chart is a little heat map to show at a glance how often I have actually had to fast to achieve the results I am after. Click on any chart to enlarge it.


I have to admit that I broke my rules a few times this past week.  On Mothers Day, I was over my goal weight for the day, but I ate anyway because it was a holiday.  On Monday and Tuesday, I was over my goal weight for those days, but I was having a hard time mentally getting back in the swing of things.  I was back on track fasting on Wednesday, and have been following my rules since.

I did gain a little bit in inches, but I am not concerned.  Weight and inches naturally fluctuate up and down.  Improvements in body composition are never linear.  I'm looking forward to a good week!


Below is my chart for the Body By Science "Big Five".  It shows the exercises I am doing, along with the weight, reps and TUL, which stands for Time Under Load.


This is my chart for treadmill HIIT, which shows that I am now up to 6.6 mph during the running time.  I am going to keep pushing that up by 0.1 mph each time to see how fast I can go.  I will stop increasing the speed when I go flying off the treadmill! 


This is my chart for walking:



There are seven weeks remaining for this kindler, gentler challenge.  If I achieve my goal of 130 pounds with 25% body fat, I'm not sure where I will go from there.


This is a personal challenge just for me, but if anyone reading would like to join me, please talk to your doctor and make sure that it will not conflict with your current medical condition or medications.  If you are taking the challenge, please be sure to let me know how you are doing!  Thanks for reading!

To find out more about this challenge - the rules and how it started - click here.

Friday, May 6, 2016

THE KINDER, GENTLER CHALLENGE - WEEK 18 RESULTS

Today is the end of Week 18.  In the past week, I have:

Lost 0.8 pounds on the scale
Lost 1 pound of body fat (est.)
Gained 0.2 pounds of lean mass (est.)
Lost 1/8" around my neck
Lost 1/4" around my waist
Lost 1/4" around my hips
Body fat from 30.8% to 30.3% (est.)
Lean mass from 69.2% to 69.7% (est.)
Feasted 3 days and fasted 4 days
Lifted weights 1 time
Did treadmill HIIT 2 times



Since January 1, 2016, I have:

Lost 18.2 pounds on the scale
Lost 18.9 pounds of body fat (est.)
Gained 0.7 pounds of lean mass (est.)
Lost 5/8" around my neck
Lost  4 1/4" around my waist
Lost 3 1/2" around my hips
Body fat from 39% to 30.3% (est.)
Lean mass from 61% to 69.7% (est.)
Feasted 76 days and fasted 51 days
Lifted weights 4 times
Did treadmill HIIT 8 times

I made a few charts to track my progress.  On the first chart, the grey line is my long term goal. The blue line is my actual weight.  The red line is my 7-day average. The second chart is a little heat map to show at a glance how often I have actually had to fast to achieve the results I am after. Click on any chart to enlarge it.




Below is my chart for the Body By Science "Big Five".  It shows the exercises I am doing, along with the weight, reps and TUL, which stands for Time Under Load.


This is my chart for treadmill HIIT:




This is my chart for walking, which I did not do any of this week, for various reasons:



There are eight weeks remaining for this kindler, gentler challenge.  If I achieve my goal of 130 pounds with 25% body fat, I'm not sure where I will go from there.


This is a personal challenge just for me, but if anyone reading would like to join me, please talk to your doctor and make sure that it will not conflict with your current medical condition or medications.  If you are taking the challenge, please be sure to let me know how you are doing!  Thanks for reading!

To find out more about this challenge - the rules and how it started - click here.

Friday, April 29, 2016

THE KINDER, GENTLER CHALLENGE - WEEK 17 RESULTS

Today is the end of Week 17.

It hasn't been quite a week yet since I started my kinder, gentler challenge, but I need to catch up so that my charts line up with a week ending on a Thursday.

As I mentioned in my last post, I have taken a month off and am now engaged in my next challenge, which is to reach a weight goal of 130 pounds and a body fat goal of 25%.

I'm not sure I am going to be able to accomplish this, but I am giving it my best effort!



 Here are my rules:

Rule #1. I will lower my weight goal by 0.12 pounds per day, which comes out to less than a pound per week.  Each morning, I will weigh on my bathroom scale, and if I do not exceed my goal for the day, I will feast.  If I exceed my goal for the day, I will fast until the next morning.  This time, I will not be using my fasting blood glucose as a rule.  As long as I eat right, my blood glucose is stable, so I am only going to check my BG occasionally.

Rule #2.  Stay active, as outlined below.

I will have two ways of eating, and they will look like this:

FEASTING

Eating ketogenic diet, which means high fat, moderate protein and very low carb.  What does that mean for me?

First of all, I have come to agree with those that believe it is a mistake to eat high fat when there is already excess fat on your body.  In my case, High Fat Low Carb means that I will be "eating" high fat from my body and low carb from my plate.  Dr. Stephen Phinney explains this concept quite nicely in this video, where he shows the following graphic:

 
As you can see, even in the first phase, when a person has excess body fat, it is still a high fat diet, with 25% of the needed daily fat coming from what you eat, and an additional 50% coming from your own body.  This body fat needs to be taken into account when determining if a diet is "high fat" or "low fat."  According to what you are eating alone, it appears to be low fat, when, in actuality, it is still a high fat diet.  As body fat is "eaten", the percentages change until all of the fat needed is being eaten off the plate because there is no more excess body fat to "eat."

So, for the time being, I am eating the majority of my needed daily fat from my own body fat stores.  Research has shown that the body needs at least 30g of fat per day to supply the body's needs, for brain activity, vitamin absorption and gallbladder function, to name a few.  I will be attempting to keep my fat intake between 68g and around 80g.

For protein, I will be following the advice of Jonathan Bailor, who I mentioned here, to keep nutrient-dense protein at 1 gram per pound of body weight.  For me, that would mean around 136g of protein per day for my current weight, and 125g of protein when I get down to my goal weight of 125 pounds.  Pretty simple, huh?  This also is in line with the recommendations of the Optimal Ketogenic Living Facebook Group (also mentioned in that same blog post) that is between 91g and 136g for a woman my height.

Carbs will probably always be very low, because I find that I can manage my blood glucose quite easily when I stay low carb.  Jonathan Bailor says to eat 10 servings of vegetables per day, but I'm not sure if that would be a good idea for me, so I will probably stick with the OKL recommendation of 23g of net carbs per day, which is total carbs minus fiber.  If I am eating that all in green vegetables, that is still quite a lot of vegetables, so I think I'm doing good in that department.

I am still sort of tracking my food.  I am getting used to how many grams of protein, fat and carbs I need to make a nice meal, so I am doing the math until I have a better handle on it.

FASTING

On the days that I don't meet my weight goal, I will be fasting.  Although some fasting gurus say that a fast is only water, others say that incorporating very low caloric liquids is okay.  I have decided that fasting for me will include water, coffee, tea and broth, all without added caloric sweeteners or fat.  I do allow myself to have a few drops of liquid Stevia extract in my coffee and tea.  It does not affect my BG, and I like it.  And you can't stop me.  I did it this way in the first three months of this year, and I suffered no ill effects.

My weight loss goal is now at a slower pace (about 50% slower), which should translate into more feasting and less fasting.  In this past few days, I ate two days in a row, which was not that frequent as time went on in the last challenge.  Since starting this, I have not fasted more than one day in a row, although that could certainly start to change again as I get closer and closer to my new goal.

I made a few charts to track my progress.  On the first chart, the grey line is my long term goal. The blue line is my actual weight.  The red line is my 7-day average. The second chart is a little heat map to show at a glance how often I have actually had to fast to achieve the results I am after. Click on any chart to enlarge it.



As for Rule #2,  part of this challenge is that I have also made some commitments to build muscle and increase insulin sensitivity.  I have committed to one day per week of heavy, slow motion weight lifting, using Body By Science as my guide.  I have committed to HIIT twice per week on the treadmill at the gym.  I have committed to taking 3-mile walks as often as I can, maybe twice or three times per week.  The weight lifting should take care of the "gaining muscle" portion of my new challenge, and the HIIT and walking should continue to help with my insulin sensitivity.  Notice that I am not trying to "burn calories" with my exercise.  I'm done with that nonsense.  It's not a problem of too many calories that need to be "burned off".  It is a problem with hormonal imbalance that keeps body fat trapped and unable to be used for energy.  The solution for that is to balance hormones, not to eat less and move more!

Below is my chart for The Big Five.  It shows the exercises I am doing, along with the weight, reps and TUL, which stands for Time Under Load.  The system is to lift weight very slowly up and down, and to attempt to exceed one minute and thirty seconds on each exercise.  Each time that goal is reached, you increase the weight by at least another 5% for the next session.  As you can see, I did not exceed 1:30 this past week, so there was no increase in weight.  One of the great things about lifting this way is that the whole thing takes about 15 minutes and you only do one set on each machine.  No more being in the gym for hours and doing multiple sets on each of twenty different machines!  In and out fast, with the same or better results.  My kind of workout!




Twice per week, once on the same day as weight lifting, and once a half week later, I do High Intensity Interval Training (HIIT) on the treadmill at the gym.  I begin by walking at 1.5 mph with 0 incline for about 2.5 minutes, then ramp up to a run for 30 seconds at over 6 mph (I keep increasing it each time) with an incline of 3.  After the run, I go back to the walk for 2.5 minutes, then back to the run for 30 seconds.  I do three of these intervals, ending with a walk, then a 5 minute cool down.  I am on the treadmill for a total of 17 minutes, including the cool down.


The last activity I am doing is walking, at a leisurely pace, around my neighborhood or other beautiful places, or, if it is yucky outside, I will get on the treadmill at the gym.  I would like to do this at least twice per week.  I found a cool app for my phone that tracks my route, along with miles per hour and total distance.  When I walk, I aim for around three miles in one hour.  Here is what a normal walk looks like, and below that is my walking log:


 



There are nine weeks remaining for this kindler, gentler challenge.  If I achieve my goal, I'm not sure where I will go from there.  Technically, my doctor wants me to weight 122 pounds with around 22% body fat.  At my age, I'm not sure that is possible, or even desirable.  It's fun to think about, but not if it means I have to live a life of deprivation.  I will be more than happy to reach my current goal.  Heck, if I stay where I am now, it will be a big health improvement from where I started, which, in case you forget, was here


This is a personal challenge just for me, but if anyone reading would like to join me, please talk to your doctor and make sure that it will not conflict with your current medical condition or medications.  If you are taking the challenge, please be sure to let me know how you are doing!  Thanks for reading!

Monday, April 25, 2016

BREAK TIME IS OVER - ON TO THE NEXT CHALLENGE!

My weight loss and blood glucose challenge came to an official end on April 1, 2016.  You can read the final results here if you haven't already.  Even though I came in a couple of pounds over my goal, it was so close that I consider the three-month challenge a rousing success!  I was able to lose a bunch of weight and, more importantly, I normalized my fasting blood glucose.

In case you are curious, for these past few weeks, I did some more fasting, lost some more weight, went on a mini vacation, gained some weight and saw one post-meal blood glucose reading get very high indeed, convincing me, once again, that I cannot eat sugar without damaging myself.

One of the things that I have been doing has been trying to follow the Optimal Ketogenic Living guidelines for the amount of protein, fat and carbs to eat each day.  If you join the Facebook group for OKL, you can learn more about how this way of eating works.

According to the OKL chart, shown here, a 5'3" woman like me should be eating between 91 and 136 grams of protein per day, no more than 23 grams of net carbs per day, and between 68 and 159 grams of fat per day.  This last guideline - for fat grams - is a sliding scale based on your weight goals.  If you want to lose weight, stay at or near the lower amount of fat grams.  If you want to maintain your current weight, stay around the middle.  If you want to gain weight, stay at or near the highest amount of fat grams.

Fasting, in many different forms, is encouraged in this group, and reading the many threads and research articles will give you a real education on nutrition.  The works of Drs. Phinney and Volek are highlighted and followed, and I highly recommend the folks at OKL!

I have also been spending a lot of time watching youtube videos on nutrition, fasting, protein needs and kittens.  (It would not be a good day if I did not watch at least one youtube video featuring kittens!)

One of the people I have been listening to is Jonathan Bailor.  I got his book from the library, but it may just end up being one that I need for my personal library.  I heard about Jonathan and his thoughts concerning the ridiculousness of counting calories last year.

I seriously considered trying his weight loss method, but when I found out that he is against counting calories, I was discouraged.  Each time I have tried a weight loss method that does not involve tracking every blankety-blank-blank bite of food I eat, I have always gained weight.

But, after listening to someone that I respect interviewing Jonathan, I decided to read his new book and see what I could glean from it.  I have to admit that I was impressed with what I read, which I did with a newly opened mind, and found that the vast majority of what he was suggesting was right in line with the OKL chart I have been following!

Jonathan's recommendations include eating plenty of nutrient-dense protein (about 1 gram per pound of body weight, which is at the high end of the OKL recommendation), LOTS of green vegetables, and other colors, too, and what he calls 'whole food fats'.  He is not a proponent of adding a lot of oils or butter to food, but rather, eating foods that have natural fats contained within them, such as avocados, olives, eggs, nuts, seeds, coconut, etc.

My fear was that, if I ate the amount of veggies he suggests, my blood glucose would spike up.  But, for the past few days, I have been stuffing myself with green veggies, mostly raw, and my blood glucose was only 95 mg/dl at the highest, which was two hours after eating.  So far, so good, so I am continuing on.

The basic premise of the nutrition portion of the book is to eat SANE food and avoid inSANE food.  Jonathan explains the difference quite clearly in the book, and on his website, and maintains that if you fill yourself up with (almost) unlimited amounts of SANE food, you will not have room for the inSANE food.   

I love Jonathan's take on exercise, too, possibly because he agrees with what I have already decided is the right way to exercise - lifting heavy weights very slowly, doing a little bit of High Intensity Interval Training (HIIT) now and then, and taking part in other activities that you enjoy, for stress relief, if for no other reason.  Waking, riding a bike, yoga, etc.

I have a new appreciation for the concepts outlined in "The Calorie Myth," so I have to give it a pretty sweeping recommendation.


Of course, Dr. Jason Fung is a particular favorite of mine as of late, and I am rather impatiently waiting for Amazon to deliver my copy of his long-awaited book, "The Obesity Code."  Dr. Fung has written extensively on diabetes treatment and prevention on his website, Intensive Dietary Management, and his videos, both on his website and on youtube, are thought-provoking, eye-opening and life-changing to thousands of people around the world.

Dr. Fung uses fasting, both short- and long-term, to manage blood glucose, insulin resistance and Metabolic Syndrome.  It was his factual reporting about the benefits of fasting that really pushed me over the edge into fasting to manage my Type 2 Diabetes.  Again, I highly recommend that all my readers look into what Dr. Jason Fung is uncovering.  His methods are really game-changing!

So, back to me and what I am doing next...

Encouraged by my recent challenge, and seeing that it is possible for me to lose weight and manage my blood glucose, I have decided that, after this past few weeks 'break' that I am going to jump back in and try to lose a few more pounds of body fat and gain a pound or so of lean mass.

Seeing a recent low weight of 133.4 pounds a couple of weeks ago, and a body fat percentage of 29.5, I have set my new goal at 130 pounds with body fat of 25%.  That translates to an additional loss of 11.1 pounds of body fat and an additional gain of 1.3 pounds of muscle.  Can I do it?  There is only one way to find out...

I have committed to one day per week of heavy, slow motion weight lifting, using Body By Science as my guide.  I have committed to HIIT twice per week on the treadmill at the gym.  I have committed to taking 3-mile walks as often as I can, maybe twice or three times per week, weather permitting.  The weight lifting should take care of the "gaining muscle" portion of my new challenge, and the HIIT and walking should continue to help with my insulin sensitivity.  Notice that I am not trying to "burn calories" with my exercise.  I'm done with that nonsense.  It's not a problem of too many calories that need to be "burned off".  It is a problem with hormonal imbalance that keeps body fat trapped and unable to be used for energy.  The solution for that is to balance hormones, not to eat less and move more!


 The chart to the left shows what my daily goals will be for my scale weight.  As you can see, the slope of the grey goal line is a little shallower now than it was for the first three months of this year.  My previous goal was to lose 0.2 pounds per day (on average), and, starting tomorrow, the new goal will be to lose only 0.12 pounds per day.  I am doing this to take a gentler approach to weight loss, to give my body a little break, and to give some loose skin a chance to firm up, which opportunity I certainly hope it will take advantage of!

From now until the end of June 2016, I will again be utilizing my Feast/Fast model, with one slight change - I will not be using fasting blood glucose as a determining factor of whether or not I fast on a particular day.  I really feel that I have increased my insulin sensitivity to the point where my blood glucose is stable, and although I will check it now and then, I will not routinely check it every morning to see whether or not I'm going to eat.

This time around, I will simply weigh first thing in the morning before I eat, and if my weight is equal to or less than my goal for that day, I will feast freely.  Even though I have been tracking my food intake for the past couple of weeks, just to get the hang of how much more protein and veggies to eat, and how much less fat to eat, I will stop tracking now and just eat in the amounts that I have become accustomed to.

And, speaking of fat, I do want to mention that I was eating a lot more fat in January, February and March than I have been eating lately.  (I am also eating a lot more protein, which has been shown in studies to aid in weight loss.)  I finally got it through my head that there is enough fat on my body to "eat" and I don't need Bullet Proof Coffee and Fat Bombs at this stage of my weight loss.  As I have heard said, all I need is Low Carb; I'm already High Fat!  The fat on my body will be utilized for energy until there is not an excess amount of it.  Each time I eat a bunch of fat, my body will burn that rather than the stores of fat already "on hand."  Eating less fat does not make this a low fat diet.  I am just eating the fat on my body instead of the fat on my plate.  And, even with the whole food fats that I am eating, around 50% or more of my calories are coming from fat, so even that is still considered a high fat diet.

When I get to the point were there is not a lot of excess fat on my body, I will get to increase fat to supply the energy I need to live.  I'm looking forward to that!  I do miss my BPC!


One more chart.  This is an extended Feast/Fast Heat Map, so that you can see at a glance how often I am fasting.  This chart starts on January 1, 2016 and ends on June 30, 2016.  One red block represents a 36-hour fast.  Two red blocks in a row represent a 60-hour fast.

As you can see, I have feasted for the past seven days in a row.  What a luxury!

All that will come to an end as I start my fasting again.  So I better get used to seeing a little more red and a little less green.

When I did my last challenge, I posted every day.  This time, I will probably post only once per week.  Even I get bored with mundane details every day!

My next post will be a week from now, and I will tell you how I am doing, and show you my charts.  I will be adding in an activity log that will show how my weight lifting is going and how many times I have done HIIT and how many walks I have gone on.

Oh, and I just want to give a personal thank you to my friend Lynn Weiler, who has been a real inspiration to me and gave me the little nudge I needed to start back up again.  And she is joining me in this challenge, so, with her permission, I may be sharing some of her results as well!  Thanks, Lynn!

This is a personal challenge just for me, but if anyone reading would like to join me, please talk to your doctor and make sure that it will not conflict with your current medical condition or medications.  If you are taking the challenge, please be sure to let me know how you are doing!  Thanks for reading!

Tuesday, April 12, 2016

HbA1c RESULTS CALLED INTO QUESTION.


IS THE HbA1c TEST A RELIABLE INDICATOR OF AVERAGE BLOOD GLUCOSE OVER THE PAST THREE MONTHS?

If you read my summary post from twelve days ago, you saw the picture I took of my test results from my home HbA1c test.  Watching what I ate and fasting a HECK of a lot of days in the first three months of the year, I still got a reading of 5.2%, which is equivalent to an average blood glucose of 103 mg/dl.

I was so upset when I saw that number!  How could it be true?  The answer is, it couldn't be true.


I went to the interwebs to check on the reliablility of this test and found several articles that showed that the results are skewed, either higher or lower, based on the patient's history of anemia and/or iron deficiency.

I have had anemia and/or iron deficiency since childhood. Even now, when blood tests are done, I am lacking in red blood cells.  Sometimes I take a supplement and that helps, and sometimes I just don't worry about it.

The article that I felt was the most clear was this one written by Dr. Chris Kesser.  In the article, he says this:

"Sugar has a tendency to stick to stuff. Anyone that has cooked with sugar can tell you that. In our bodies, sugar also sticks – especially to proteins. The theory behind the A1c test is that our red blood cells live an average of three months, so if we measure the amount of sugar stuck to these cells (which is what the hemoglobin A1c test does), it will give us an idea of how much sugar has been in the blood over the previous three months. The number reported in the A1c test result (i.e. 5.2) indicates the percentage of hemoglobin that has become glycated (stuck to sugar)."

However, people with low red blood cells get inaccurate results.  He continues:

"This confused me early in my practice. I was testing blood sugar in three different ways for all new patients: fasting blood glucose, post-meal blood sugar (with a glucometer) and A1c. And I was surprised to see people with completely normal fasting and post-meal blood sugars, and A1c levels of >5.4%."

You can read the rest of Dr. Kesser's article to learn how he changed his procedures and no longer uses the HbA1c as the determining factor when he checks the progress of his patients. For myself, I decided to check my blood glucose nine times per day over a one week time frame to see if it was true that my BG was rising so high after eating as to cause me to have an average blood glucose of 103 mg/dl, or 5.2%.

I tested my blood glucose right before each of my three daily meals.  I also tested one hour after beginning each meal, and again two hours after beginning each meal.  Of the seven days, I fasted only twice, from dinner one day until breakfast two days later, which made the duration of those two fasts 36 hours each.  On the first day that I fasted, I did check my BG nine times.  The second day that I fasted, I only checked it twice, because I could see from the last fasting day that there is barely any fluctuation when you are not eating at all.  On that second fasting day, I filled in estimates of what I considered to be reasonable numbers.

Here is a chart (click to enlarge it if necessary) that shows my results for this past week:




My TRUE average blood glucose over these 63 readings was 80 mg/dl or 4.4%.  And this is with me eating the same way that I was during my challenge, and even with me only fasting twice that week, when I was fasting three, four, or five times per week in the last half of the challenge, which would probably mean that my HbA1c should have been even lower than 4.4%.

My highest reading was 98 mg/dl or 5.0% (two hours after eating a meal) and my lowest reading was 68 mg/dl or 4.0% (the morning after a 36-hour fast).

My conclusion is that, had the HbA1c test been accurate, I would have gotten a reading somewhere in the neighborhood of 4.4%, not 5.2%.

Now that I have proved this to myself, I am going to go back to not checking my blood glucose as often.  I will check it now and then, and possibly when I eat a food I am not sure of to see if I can tolerate it.

In one of the diabetes Facebook groups that I belonged to last summer, I mentioned that I did not often check my BG.  The other diabetics were outraged and told me I had to test nine times per day or more every day for the rest of my life!  When I explained that I am perfectly controlled with diet and that I am on no diabetic drugs or insulin, they didn't care.  They felt that I was taking my disease lightly and it was an insult to all the diabetics that test multiple times per day.  They threatened me with blindness, nerve damage and amputations if I did not test every day.

At one point, I had made the mistake of saying that it was too expensive to do all that testing.  That's when the you-know-what really hit the fan!  They wondered what I cared most about, my disease or my money.

Well, since my diabetes is perfectly controlled with diet (and exercise), I care about the money.  If it ever becomes evident that I am no longer controlled, then I will spend the money.  For now, I will use that money to buy a nice steak!

Keep an eye out for my next personal challenge, which will center around body composition.

Onward and Downward!

Tuesday, April 5, 2016

FINAL RESULTS - 2016 WEIGHT LOSS AND BLOOD GLUCOSE CHALLENGE

Christmas Eve 2015
Today I am posting the final results for my 91-day challenge. I waited several days to post the results so that I would have a chance to do an HbA1c test, put together final photos and think about what I wanted to say about my findings, my feelings, and where I want to go from here in my quest to maintain my new weight and lowered fasting blood glucose.


THE WAY I WILL EAT

One thing is for certain, and that is that I will continue to eat a ketogenic diet - high fat, moderate protein and very low carb. This really seems like the only way to keep on track.  In the past, every time I have tried to increase carbs, I have gained weight.  I really don't want to do that this time.  More about exactly how I will proceed from here at the end of this post...


MY HbA1c TEST RESULTS 

I have taken an HbA1c test to see what my average blood glucose has been for the past three months.  The last time I took one was around a year ago, and I got a reading of 5.4%, which means that my average blood glucose for the prior three months had been 108 mg/dl.  And that is not an average of just the morning reading (FBG), but all the levels at all times of the day.  The ideal HbA1c is around 4.5% which is equal to 83 mg/dl.  You can see a chart of how that works here.

 
My test gave me a result of 5.2%, which is equivalent to an average blood glucose of 103 mg/dl.  This is an improvement over my last test, but I would be lying if I did not say how extremely disappointed I am.  What this means is that although my fasting blood glucose has come down into very good levels, my non-fasting blood glucose levels are still elevated.  As much as I hate the idea, I am going to have to start testing my postprandial (after meals) blood glucose to see what is causing this problem.  If my average is 103, that means that my post-meal readings must still be in diabetic ranges, possibly in the 120s and higher.


But, wait a minute!  It is very hard for me to believe that my average BG is this high when I have been doing all this fasting.  I went to the interwebs and found many articles that show the inaccuracy of the HgA1c test.  This article by Chris Kresser is a good example and is very easy to understand.  In short, Dr. Kresser believes that home monitoring before and after meals is a much better indicator of average blood glucose than the HbA1c test.  He found that his patients who had stellar BG readings before and after meals at home would test artificially high on a standard A1c test.  In the article, he mentions that people with anemia and/or iron-deficiency have incorrect results with the test.  I have been anemic and/or iron deficient since childhood, so a standard home test for BG will be accurate when an HbA1c test may not.  We'll get to the bottom of this!

Over this next week, I am going to check my BG at home nine times per day and find out what my true average is.  I will check fasting when I get up in the morning, one hour after starting to eat breakfast, two hours after starting to eat breakfast, then right before starting to eat lunch, then one and two hours after that, and the same for dinner.  The average of these nine readings should be very close to a true average.  I'm very sure that my result will not show that I have an average BG of 103 mg/dl.  I started doing this this morning, and so far my average over the three readings was 87 mg/dl.  When this week is over, I will post my results. 

The chart below is the final chart that shows my fasting blood glucose test results.  The grey lines are my long term goals. The blue lines are my actual results.  The orange lines are my 7-day averages.  As you can see, I did make progress toward normalizing my FBG.




MY OFFICIAL BEFORE AND AFTER PHOTOS

Although I have posted a few casual photos in this past three months, I wanted to wait until the challenge to post my official before and after photos, so here they are:




As I always do when I take these type of photos, I took special care to stand normally, neither pushing out my stomach in the before photos nor sucking it in in the after photos.  I also crop the photos so that they are the same size and can be compared side by side.  Also, if you click on the photo above, you will be able to see that I have been left with loose skin.  I hope you will not judge me too harshly for this, remembering that I am over 60 years old, and that is part of the reason why.  I remember my father telling me that it would be better to be somewhat overweight in order to have tighter skin and therefor a younger appearance, but I would much rather look a little bit older and have a proper body size for my height!























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Hypoglycemia (Low Blood Glucose)

Hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels, usually less than 70 mg/dl. However, it is important to talk to your health care provider about your individual blood glucose targets, and what level is too low for you.
Hypoglycemia may also be referred to as an insulin reaction, or insulin shock.
Hypoglycemic symptoms are important clues that you have low blood glucose. Each person's reaction to hypoglycemia is different, so it's important that you learn your own signs and symptoms when your blood glucose is low.
The only sure way to know whether you are experiencing hypoglycemia is to check your blood glucose, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia. Severe hypoglycemia has the potential to cause accidents, injuries, coma, and death.

Signs and Symptoms of Hypoglycemia (happen quickly)

  • Shakiness
  • Nervousness or anxiety
  • Sweating, chills and clamminess
  • Irritability or impatience
  • Confusion, including delirium
  • Rapid/fast heartbeat
  • Lightheadedness or dizziness
  • Hunger and nausea
  • Sleepiness
  • Blurred/impaired vision
  • Tingling or numbness in the lips or tongue
  • Headaches
  • Weakness or fatigue
  • Anger, stubbornness, or sadness
  • Lack of coordination
  • Nightmares or crying out during sleep
  • Seizures
  • Unconsciousness
- See more at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html#sthash.99Em6ldy.dpuf
As I always do when I take these kind of photos, I take special care to stand normally, neither pushing my stomach out in the before photo, nor sucking it in in the after photo.  I also crop them in such a way so that they are equal in actual size and a true comparison can be seen.
I had a bad incision during my c-section in 1977, and my stomach muscles were cut in such a way that I will never really be able to use them to hold my stomach in.  Because of that, I will probably always have a little bit of a "pooch" no matter how slim I am, but I can live with that.  Some tummy-control undies go a long way to giving me the impression of a flat stomach.  By the way, I am not wearing anything like that in either of these photos.  I am wearing regular, non-slimming leggings.


MY BODY MEASUREMENTS

Another thing that I have been doing in the background during the challenge is tracking my body measurements.  Here are the results for those:

NECK
12 3/8"  -  11 3/4"
LOST 5/8"

BUST
36 3/4"  -  35"
LOST 1 3/4"

WAIST
33 3/4"  -  29"
LOST 4 3/4"

BELLY
41 1/2"  -  37 1/8"
LOST 4 3/8"

HIPS
41 1/4"  -  38 1/4"
LOST 3"

THIGH
22 7/8"  -  21 1/4"
LOST 1 5/8"

CALF
14 3/8"  -  13 5/8"
LOST 3/4"

TOTAL INCHES LOST - 19 1/4"

When I do the math for the total inches lost, I count each measurement as one unit with the exception of my thighs and calves, which I count as two units each.  Because I have two of each of those.  That might not be the right way to do it, but it is the way I do it.


SCALE WEIGHT AND BODY COMPOSITION

 Before I talk about my weight loss, I want to explain how I determine my body fat and lean body mass percentages.

In the past few years, I have had DEXA scans and Bod Pod testing done to determine my body composition.  These are very accurate, but are expensive, usually costing around $100, depending where you get it done.

Several years ago, I found an online calculator that is used by the US Navy and is based on neck, waist and hip measurements.  I tried it out and found that the results, at least for me, were so similar to the expensive tests that I decided to start using the free online calculator to get an estimate of my body composition.  In my experience, I have found the free results to be within a few tenths of a percentage point of the other tests.  For my purposes, this is close enough.

My goal for the past several years has been to reach my goal of 136 pounds with 30% body fat. When trying to lose weight, the goal should be to lose body fat and not lean mass.  So knowing what your body composition is starting and ending is very useful.  Here are the results for those:

January 1, 2016
60.1 pounds of body fat - 39%
93.9 pounds of lean body mass - 61%
154 pounds of total scale weight

April 1, 2016
41.7 pounds of body fat - 30.3%
95.9 pounds of lean body mass - 69.7%
137.6 pounds of total scale weight

LOST 18.4 POUNDS OF BODY FAT
GAINED 2 POUNDS OF LEAN BODY MASS

The way I see it, I have come close enough to my weight loss goals to declare this part of the challenge a victory.  Technically, I still need to lose 0.9 pounds of body fat and I am actually over my goal for lean body mass by 0.7 pounds.

Because my lean body mass is over my goal, I need to make a shift in my goals.  Now, the new goal is to achieve 30% body fat regardless of my scale weight.  To reach this goal, all I need to do is lose another 1/4" from my waist.

By the way, according to my measurements, I am the smallest I have been since starting low carb in 2009, and also the smallest I have been in around twenty years.  Before now, the lowest body fat percentage I achieved was around 32% and that was three years ago, but I gained the weight back.  This time, I am bound and determined not to do that, no matter what it takes.

One thing that I want to be sure to mention is that I purposely did not do any kind of exercise during the challenge.  I did not want there to be any confounding factors pertaining to my results.

The chart below is the final chart that shows my scale weight results.  The grey lines are my long term goals. The blue lines are my actual results.  The orange lines are my 7-day averages.  As you can see, I came very close to reaching my goal.




FEASTING AND FASTING

 When I started this challenge, I really had no idea that I would end up fasting as often as I did!  I even said that I was going to fast at least once a week, even if I was meeting my goals for weight loss and FBG.  Little did I know that I would end up fasting three, four and even five times per week to reach my goals!  Here is my little heat map to show how often I needed to fast to achieve my goals:


I have said it before, but it bears repeating, that if I had known this going in, I wouldn't have started.  I probably would have just started micromanaging my food intake again, lost some weight, gotten sick of it, quit tracking and then gained all the weight back again.

I have fasted in the past, and I knew I could do it, but it is still hard to start doing it again once you haven't done it in a while.  I went in with a lot of commitment and drive and made it to the end, even when it was difficult.  But how often was it difficult?  Surprisingly seldom, to tell the truth.  For me, once I started and my body adjusted to it, I rarely got truly hungry, and I could even be around other people (most notably, my husband) when they were eating and I would not feel anything.  

In the evening, after a full day or two of fasting, I would start thinking about how wonderful it would be to eat in the morning.  Then I would get up in the morning and not be hungry at all.  This is one of the blessings/curses of fasting and being in deep nutritional ketosis.  Running on ketones instead of glucose is a big appetite suppressant!  Very often, I would have to force myself to eat something when I was not hungry.  If there was one downside to having a suppressed appetite, it was the concern that I was not going to be getting the nutrition I need.

Obviously, though, I was able to maintain my muscle mass while losing body fat, even though I was eating only every few days for the last half of the challenge.  I even gained some lean mass!

WHERE I AM GOING FROM HERE

As I mentioned at the beginning of this post, I intend to keep eating a ketogenic diet.  But will I continue to feast and fast, or will I go back to caloric restriction, which is eating a smaller amount each day and tracking my food?  I would like to look at the pros and cons of each.

FEASTING AND FASTING

Pro - On a feast day, I never have to count calories or grams of anything or weigh food.
Con - On a feast day, I sometimes don't want to eat and worry about getting nutrition.
  
Pro - On a fast day, I don't even have to think about food.  Or pay for it!
Con - On a fast day, I don't get to eat if I want to, and I have to watch others eat.

Pro - On either day, my metabolism stays strong and does not slow down.
Pro - This way of eating seems to be sustainable.  I may not feel like I need to give up.

CALORIC RESTRICTION

Pro - I get to eat every day.
Con - I have to measure everything I eat and track it on a spreadsheet.
Con - I have to stop eating when I am not satisfied.
Con - I have to pay for food every day.
Con - This is not a sustainable way for me to live.  I hate it and I always give up.

And the biggest con of all - Caloric restriction has been shown to slow the metabolism, meaning that the longer you restrict calories, the slower the metabolism and the less food you get to eat to try to maintain your weight.

I found this to be true for myself.  In the past, even when eating low carb, I had to continually reduce the amount of food I was allowed to eat in order to keep losing weight.  I'll leave it to others to get into the science of why that is true, but I know it is and I have read many articles about the subject.

So, as nice as it seems to be able to eat every day, I think that the preponderance of the evidence in my case is that I need to continue to feast and fast to maintain a healthy body composition and normal blood glucose.  This is what I have decided to do, and I can only hope that it will be sustainable over time.  I have done it for three months without too much drama, so it is sustainable so far.

From here on out, I will not be using the bathroom scale as the measure of my success.  Starting next week, I am going back to the gym once a week to do my weight training and I will also be starting a walking regimen to help with insulin resistance. 

Because I intend to gain more muscle (and hopefully tighten up my loose skin!), I know that the number on the scale may start increasing.  However, even as I gain muscle, my body size should not increase.  For that reason, I will be using my body fat percentage as a guide of whether or not to eat on a given day.  Using the free online calculator mentioned in this post, I will check my neck, waist and hip measurement each day and use those numbers in my decision for feast or fast.  If the scale is over 136 pounds, but the calculator says that I am still 30% body fat, I'm feasting.  If it is 30.1% or higher, I'm fasting.

The only drawback of this is that I am basically going by my waist measurement, and the day after I feast, I always feel a little bloated, which may be due to water weight and not true body fat gain.  Also, like I mentioned earlier, my stomach muscles don't work very well, and just having food in my stomach, even the right kind of food, makes my tummy stick out.  But, I figure that if I am fasting each time my waist measurement goes up a little, it will be good for me.  Fasting is good for me.  I need to keep telling myself that!  

Throughout this challenge, as I was needing to fast more and more often, I have been concerned that I would need to keep up only eating a few times a week in order to maintain my health.  But I'm thinking that it may not be the case, because I am now no longer needing to lose weight.  When the challenge was in full swing, and I gained weight after a feast day, I would not only have to "fast off" that weight, but also an additional 0.2 pounds to keep up with my weight loss schedule.  Now, if I gain weight (and by that, I mean body fat) on a feast day, all I need to lose the next day is that same weight and no more.  

I fully expect that I will be transitioning into a regular pattern of Alternate Day Fasting.  I hope that it will go well enough that there may be times that I eat two days in a row, but if not, so be it.

Rebecca on April 2, 2016
Well, I guess that's about all there is to my summary.  It's been a great three months!  I learned a lot, and I lost a lot.  I hope there has been enough content here that my challenge has been food for thought for those that feel like they are stuck and don't know what to try next or where to turn.

Thanks so much for reading and for sticking it out with me for the full challenge!

Oh, and just in an effort at full disclosure, I must admit to my faithful readers that I went out to a restaurant and to the mall on April 1st, the first day being off the challenge, and I ate things I should have not eaten.  It's all a blur now, but I have vague memories of a few French fries, some popcorn and a Dark Chocolate Pixie from Fannie May.

I gained weight.  I fasted on April 3rd and 4th.  Today I am eating and checking my blood glucose before and after eating.  Onward and downward!

This is a personal challenge just for me, but if anyone reading would like to join me, please talk to your doctor and make sure that it will not conflict with your current medical condition or medications.  If you are taking the challenge, please be sure to let me know how you are doing!  Thanks for reading!

To find out more about this challenge - the rules and how it started - click here.