Sunday, May 21, 2017

Type 2 Diabetes, a Dietary Disease #381: My Next 30-lb Challenge: 4 weeks in…

After losing 31 pounds in 10 weeks this winter, and learning how easy it is to do a full-day (300 kcal/d) “fast,” without hunger, I relaxed a bit, and I immediately regained 4 pounds in the first week. So, I decided the best way to preserve the weight loss (and A1c benefit: -0.5% from 5.8% to 5.3%), was to start a new challenge: to lose 34 pounds (30 + 4) over 16 weeks, leading up to my next doctor’s visit. For the Design Protocol, see #378.
Week 1: That “first week,” in which I regained 4 pounds after my doctor visit, I let my guard down a bit – not much really – okay, I had a milk shake after seeing the doctor. I deserved it, right? But I paid for it. Even my fasting blood sugars (FBG) were elevated (93 average) with a couple as high as 105mg/dl (5.9mmol/L). Gone were the days of the 60s and 70s. My body stubbornly refuses to take up sugar after such transgressions. I lose insulin sensitivity; my insulin resistance is elevated, at times for many days, even with Metformin. Go figure.
Week 2: I started Week 2 behind the 8-ball. Besides the 4 pound gain in Week 1, my Sunday main meal was a shrimp cocktail and a large bowl of salted peanuts, plus 2 cocktails. See, my body shouldn’t trust me. I gained another 2 pounds (from the salt). The next day I dropped the water weight but was still deep in the hole. And then on Tuesday we ate out before theatre…which didn’t go well. You don’t want to know the details; suffice to say my FBG on Wednesday was 111. So, to start both a FBG drop and weight loss, I began a 2-consecutive day fast. The result: after 1 day, while forgetting my spritzer and my pills (including Metformin and a diuretic), my FBG on Thursday was 94 and I dropped 4 pounds! By Friday, I’d lost 3 more and my FBG was 82. I ended the week with a 5 pound weight loss and a 91mg/dl FBG average. Back on track!
Week 3: Two weeks into this new 30 (34 really) pound challenge, I was down 1, leaving 33 more to lose in 14 weeks. I knew that was doable, so long as I continued with at least 2 days of fasting a week, with perhaps a boost from a 3-consecutive-day fast, or two, if required “by circumstances.” Well, “circumstances” happened. (I love the passive voice; it’s so useful at times.) Monday night we went out to dinner, and I had 3 slices of really good crusty bread, slathered in butter, while waiting for my entrée…and I paid for it. After 4 days in the low 80s, next morning my FBG jumped to 102mg/dl. So, I decided that instead of alternate day fasting this week (Tuesday and Thursday), I would do a 3-consecutive-day fast. I need to protect that new 5.3% A1c!!! Result: The 3-day fast was easy. For the week I lost 4 pounds and posted an 83mg/dl FBG average. Not bad.
Week 4: This week I’m just doing alternate day (Tuesday +Thursday) 300kcal “fasting.” I’m on track to achieve my 4-wek goal, and Wednesday is my birthday. Oops, a premature expectation. I cheated on Tuesday (some junk food in the pantry), and well, Wednesday was my birthday. Okay, so I’m human. My weekly FBG average climbed to 91mg/dl with no day over 100…but the trend line was not good. I also gained 4 pounds (largely water), putting me 6 pounds behind schedule. Clearly, I’m off-message, and I need to do another 3-day fast.
Discussion: My 4-Week goal was to get to 210 (8 weeks to 202, 16 weeks to 187), and I missed it big time. At my August doctor’s appointment, my goal is to rack up another 5.3% A1c and reach 187 lbs. So, I will soon be entering “new territory” here, and we’ll see what’s possible. I remember writing several years ago ("My Goal Weight and the BMI Table") and ("How much Protein Should I Eat?"), that “goal” or “ideal” weights were subjective and basically unattainable for people who have been eating the Standard American or Western Diet for their entire lives. “Lean Body Weight,” on the other hand, was the weight that should be used to compute the body’s protein requirement because overeating protein just puts amino acid stores in the liver which become the building blocks for glucose via gluconeogenesis. That’s a major reason we take Metformin, to suppress this gluconeogenesis. I am now trying to eat just 60 grams of protein a day, and a “lean body weight” of 187 for me, while still “overweight,” now seems achievable:  BMI of 27, vs. BMI of 54, 15 years ago.

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