I am a bit of a science freak. I play experiments with myself to see which things work, and get rid of things that don’t. For example, since becoming diabetic I’ve tested the following things:
- The effect on my favorite breakfasts on my post meal blood sugar level. It turns out that I can only have minute quantities of any form of sugar, whether fructose from a slice of banana (!) to heaped tablespoons of white sugar on lemon pancakes (not good!). So I’m essentially stuck eating unrefined oat meal for breakfast, with no added sugar or salt.
- The effect of my favorite drinks. I can’t have OJ any more - it puts me in near-hospitalization blood sugar levels. I’ve settled on drinking essentially nothing but plain old filtered water, mineral (sparkling spring) water, and black coffee. Alcohol was already somewhat denied to me, so I am currently having a dry spell. Pretty bland, but good blood sugar control
- The effect of my previous day’s food on my fasting blood sugar level. No noticeable effect, so that value comes from my liver’s overnight excess production of blood sugars from probably a decade or more of excess insulin production
- The effect of exercise on my blood sugars. Excellent results - generally pulls me under 100 in the first hour of exercise, and stays that way for some time.
- In an on-going experiment, I am currently working on how to avoid my personal hypoglycemia in the late afternoon. For those of you who don’t have diabetes, anything under around 50-60 will give you the shakes. I get that when I’m under about 90-95 as my body is sugar tolerant. The effects of low blood sugar are terrible, and I need to fix it. I am settling on a low GI pick-me-up of a serve of oatmeal with some fruit as chocolate and sugars give me temporary (and fast) relief but a worse low, yoghurt and nuts seem to do nothing, and not doing anything just makes it worse.
From these ongoing experiments, I now have a relatively stable set of things that work, that don’t suck too much, and I have a bit of wiggle room when I must have something like a carrot cake or ice cream.
I am starting to get this thing under control - my fasting blood sugars are starting to get closer to the high end of “normal”, and my post-breakfast reading is usually not too bad. For my efforts, I am losing weight even though I am not doing anything in particular but constraining my carbohydrate intake to low GI type foods (salads, meat and other proteins, wheat (brown) breads, oatmeal, and wraps).
This brings me to my main point - the uselessness of well advised but crap advice. Being seriously overweight (nearly 75 kg - equivalent to the weight of a healthy man of my height) means following a diabetic path along with weight loss is actually incredibly hard. I look at all the things that work for others, and try them out. But I need to find my own special thing that will work for me, for I am in a race with my body to get rid of diabetic symptoms before I get insulin dependent and the host of bad things that can happen, like kidney failure, body parts amputated, and permanent eye damage.
I expect evidence based medicine to have sorted out what is necessary by now. However, the same old, same old mantra of “eat less, exercise more” is given. And as recently as this last Saturday when the nutritionist balanced a neurotic path telling us to not eat high GI foods, and then said don’t eat things heavy in protein or fat. Folks sticking to this same old same old adage of “eat less and exercise more, you fat lazy b…” have a less than 10% success rate. Placebo is better than that. Everyone loses a little bit and then they gain it all back and then some in no time. I certainly did and no less than 20 times.
Last week’s New Scientist had a nice little commentary on this exact thing. The author argues that the above mantra to “eat less, exercise more” alone has failed, and was the given received wisdom during a time of massive obesity growth. He calls for more research into things which will do better than placebo and to discard the current approach unless it is part of something that actually works for the majority of folks. I don’t think that is unreasonable at all, especially as I have a 100% failure rate at losing weight.
Eat less and exercise more works - if you’re a machine. The folks on Biggest Loser do exactly this, and you know what, they really do lose the weight. But under the relentless eye of sadistic personal trainers, doctors, and nutritionists with gobs of daily exercise and essentially no outside food challenges. You and I can’t do “Biggest Loser” style weight loss without entering full time medical care. The human factor must be included in any solution as well as better nutrition advice beyond “eat less”. Exercise will always be a part of losing weight - there is no escaping it.
I am surprised that given all the research, the sheer profits that big pharma could make if they had a wonder drug, and that every weight loss program, even Weight Watchers, has “Results Not Typical“ disclaimers, that science has yet to come up with answers for folks like me who need to lose more than the average bear. It turns they have, but they don’t enjoy widespread support:
- Bariatric surgery. This forces you to eat less. It works, but you can still undermine it. There’s no “Results Not Typical” disclaimers with this path. Often seen as the easy way out as you have no choice but to eat less or you’ll throw up. The author beings up “lack of fortitude” in dieters, and obviously this is a failing of more than 90% of us. Bariatric surgery gives you fortitude - you have no choice.
- Low fat, high protein carb diets, such as CSIRO Total Well Being Diet are looked down upon by nutritionists. The nutritionist I showed the actual scientific research to essentially dismissed the diet with saying that I should investigate the American Diabetes Organization’s website. Sure enough, they’re still in low fat, low carb land, recommending against the satiety that protein can bring.
- High fat, high protein diets, like Atkins. Atkins is the only diet I’ve done where I lost more than 15 kg, essentially through not eating any carbs. I hated the diet as it was a bit monotonous and difficult to do. Worse, it made me feel weird. I now know that this was most likely due to hypoglycemia and if I had been able to measure my blood sugars at that time, I think I would have succeeded.
As I am not keen on undergoing surgery, I have to keep going on the CSIRO diet. So far, I’ve lost seven kilograms on it since November, and despite really hurting my foot to the extent that I could not go to the gym. This weight loss is approaching the half way point that I lost using Atkins. Unlike Atkins, it’s keeping my blood sugars okay as I’ve been able to work out through experimentation what works and what doesn’t. But I know in my heart of hearts than unless I lose enough to keep diabetes’ ravages at bay, I probably will have no alternative than to go for option number one. I’d rather have a little bit of surgery than to lose my kidneys, eyes or parts of my body. It’s incredibly motivating to keep on going either way.
I just wish that scientists researching in the field would really get their fingers out of their rectums and work out a way to get better than the placebo effect. Giving advice that provably does not work and will not work for the overwhelming majority of folks, whilst squishing and dismissing alternatives which may work better is simply not evidence based medicine. Nutrition is not pseudo science, like homeopathy - it’s actual science. Nutritionists should have figured out what needed to be done and stopped giving advice that clearly has failed. We deserve better, and before everyone becomes fat and ends up dying of preventable diseases all the while following their stupid and useless advice.
vanderaj on January 28th 2008 in Weight Loss
