Sunday, August 13, 2017

Type 2 Diabetes, a Dietary Disease #393, My 2nd 30-lb Challenge (Amended): Final Report

Followers may recall that a few months back, in my 1st 30-lb Challenge, I lost 31 pounds in 10 weeks. They may also remember that I then embarked on a 2nd 30-pound challenge, this one of 16-weeks duration. After 12 weeks, I reported a less than stellar performance and amended the 16-week goal from 30 to 15 pounds. This is the 4thQ/Final report on the amended goal. I started the 4th quarter at 215 lbs. The goal is to return to 202 in 4 weeks, then 197 two weeks later. That’ll be over 50 pounds lost with full-day “fasting.”
Week 13: Attended Keto Fest, a festival in New London, CT, organized by 2 Keto Dudes. It was educational and fun, and I ate too much: Eggs/bacon breakfasts (in a hotel), ketogenic lunches (at the festival) and half-priced cherrystones and white wine (dinner on my own), but too much food/wine. I gained 5 pounds. FBG aver: 103!
Week 14: Fasting Mon-Wed-Fri. I dropped 10 pounds from 220 to 210. Amazing! Including an amazing buffet lunch at the Otesaga Hotel in Cooperstown before seeing “Porgy and Bess.” And I cheated a little each fasting day, but only with a protein/fat snack (bought at Keto Fest) with my happy hour spritzer. FBG aver: 99mg/dl.
Week 15: Fasting Mon-Wed-Thurs this week. Tuesday we’ll again have lunch at the Otesaga Hotel before seeing “Oklahoma” at Glimmerglass, and then a light “all protein” supper at home. All went well ‘till Saturday, the annual neighborhood association picnic. I had just one plate of protein and fat, plus 3 cups of my keto clam chowder, and 3 cups of white wine. Virtually no carbs (except in the wine) and no dessert! Alas, I gained 2 pounds for a net 4 pound loss for the week. Next morning: FBS up 29 points. FBG weekly average: 86mg/dl.
Week 16: Need to lose 4-6 pounds this week to reach my target. Glimmerglass (“Xerxes”) on Tuesday, so I will try “IF” Mon+Wed-Thu and maybe Fri. I have a gallon of leftover keto clam chowder: ergo, I will do a modified OMAD (one ‘mug’ a day) fast this week: for ‘supper’ I’ll substitute 12oz of chowder, plus iced tea, for my usual spritzer (6oz red wine + 8oz seltzer): fewer carbs, more fat, no wine. By week’s end I had lost 3 pounds, down to 203 (1 shy of my target). 26 week total: 45 pounds. FBG average this week: 90mg/dl.
Conclusion
Multiple, consecutive day “fasting” is easy, if you’re “fat adapted.” No hunger. Never was any at “breakfast.” Just coffee with cream. No hunger at “lunchtime.” I usually forget about it if I’m busy in the yard, etc. Supper has proved to be a little harder. In recent years I “snacked” before supper. (I say “supper” to suggest a smaller meal than “dinner.”) It’s usually been solid food, recently plain celery; before that radishes with salt and sometimes butter). Since beginning full-day “fasting,” I have substituted a red wine spritzer (6oz wine + 8oz seltzer) for solid food, to wash down my evening pills. In week 16, for 3 days I replaced the spritzer with iced tea, to save 150 calories while I used up leftover, calorie-rich keto chowder. It worked out okay. No cooking.
Other Related Thoughts
The brain is so facile at rationalizing. I have quickly come to accept that losing less than half the weight I wanted to lose in my 2nd 30-lb Challenge was still a good outcome. After all, a pound-a-week-loss really is respectable. Many healthcare professionals would even describe it as commendable. But I consider it a big disappointment. Not exactly a failure, but then I have high expectations for myself (and others, my wife says).
Going Forward
I have, however, gained another insight from this less-than-desired outcome. I have reasoned that to maintain each weight loss, the challenge must continue. And the best way to do that is to continue to set goals – albeit incrementally smaller goals – in successive weight loss campaigns. There are just two variables: elapsed time and weight. Time was the variable in the two original plans: 30 pounds in 10 weeks and then 30 pounds in 16 weeks. When I faltered in the 2nd plan, I cut the goal to 15 pounds in 16 weeks. Going forward, beyond this 16-week challenge, with 15 more pounds to lose, I will propose to lose 5 pounds in the 1st 2 weeks. And then, the “final” 10 in the last 6. Or something like that. We’ll see how it goes. And then? Another challenge?  Of course.

Sunday, August 6, 2017

Type 2 Diabetes, a Dietary Disease #392: “Broccoli May Help Fight Diabetes”

When I read this headline in Medscape Medical News, in a write-up by an MD, of a real research project, my hopes soared. I thought, doctors were adopting the precept that Hippocrates, “Father of Western Medicine,” had made famous: “Let food be thy medicine and medicine be thy food.” Finally, we had come full circle!
The full title of the Medscape précis of the study, which was published in Science Translational Medicine, was “Antioxidant in Broccoli May Help Fight Diabetes.” Nevertheless, I still believed that these medical doctors – the study authors and the Medscape writer – were advocating that we eat a diet of healthy, whole foods. And that there was a dietary fix for those among us who had already developed a lesser or greater degree of Carbohydrate Intolerance, i.e., were overweight, obese, or had been diagnosed pre-diabetic or type 2 diabetic.
And the first sentence of the Medscape piece did not disabuse me of this vision on the horizon – a mirage or hallucination it turns out. It described the antioxidant as “a new option for treating type 2 diabetes.” The second sentence went on to describe the mechanism that the antioxident used, that it “reduces exaggerated glucose production by the liver in type 2 diabetes,” in much the same way that Metformin does.
Unfortunately, in the sixth paragraph, the full story – and the sad truth – emerged: “The study used highly concentrated broccoli extract, which would be equivalent to eating about 5kg [11 pounds!] of broccoli per day.” “Because it’s almost impossible to eat such large amounts of broccoli [diya think?], [the antioxidant] needs to be taken as an extract or concentrate.” Okay. Now, where does this revelation take us?
“We think broccoli extract could be a very exciting addition to treatments that we already have,” the lead researcher said. “When we gave it to patients and measured their glucose control before and 12 weeks after treatment, we saw significant improvement in fasting blood glucose and HbA1c in obese patients with dysregulated type 2 diabetes,” he averred. The results were ‘very encouraging,’ he added.
So, where does this well designed research in basic science lead? Medscape explained: “Currently, they [the researchers] are working with a farmer-owned organization in Sweden…to make the extract available as a functional food preparation.” Aha! A collaboration: Basic Science → Applied Science + Farmer → $$$$ for all.
Diya think I am being cynical? Just read the accompanying Conflict of Interest Disclosure:
“The study was sponsored by Lund University. Lantmännen [the local farmer-owned organization] provided the broccoli extract and placebo for the study, and Lantmännen Research Fund financed part of the study. Lantmännen reports no influence on the study procedures, data analysis, or data interpretation. Rosengren [the lead researcher] had no relevant financial relationships. Two coauthors are inventors on patent applications submitted by Lund University that cover the use of sulforaphane [the antioxidant] to treat exaggerated hepatic glucose production. The rights to use this patent have been licensed to Lantmännen.”
Okay. I wasted my time reading this piece of garbage from the usually reliable Medscape Medical News. But it is medical business news in the sense that universities, even the best of them like Lund, are not above pecuniary interests. They need “research funds” to survive and prosper, just as “local farmer-owned organizations” need money. But this story is not about eating in a healthy way to avoid developing Insulin Resistance (Carbohydrate Intolerance) or even to treat “obese patients with dysregulated type 2 diabetes.”
But, I got to write another curmudgeonly piece to offset my usual lecture about eating Very Low Carb (VLC), losing weight without hunger, and lowering your blood glucose AND blood insulin levels. That’s a saving grace.
So, have doctors come full circle with respect to eating real food? Not in my lifetime, a friend quipped.