Saturday, February 8, 2020

Retrospective #357: Fourteen years ago, I had a relapse (Part 2).

As I started to tell in Retrospective #356, fourteen years ago, I had a relapse. I regained 12 of the 60 pounds I had lost over a 9-month period 4 years earlier. I had lost focus. So, I decided, for my health and longevity, that it was time to get serious again and rededicate myself to the principles and practice of Very Low Carb eating.
That summer of 2006, almost 14 years ago, I had also read Dr. Richard K. Bernstein’s book, “The Diabetes Diet.” So, with my renewed resolve, I decided to switch to Bernstein’s Diet Plan for Diabetics. Dr. Bernstein has been a Type 1 Diabetic for most of his 80-odd years and was an engineer before he became an MD, like his wife. As an MD, she had a big blood sugar testing machine in her office, so he used it to develop a strict regimen for “eating to the meter.” After all, he reasoned (as an engineer), if carbs make your blood sugar rise, the best treatment for regulating your blood sugar would be to restrict eating carbs. That makes sense doesn’t it? It’s just common sense!
Bernstein’s credo is that “everyone deserves a normal A1c.” His A1c’s are in the 4s. Being a Type 1, he achieves this by injecting insulin, both long acting (24-hour) and at mealtimes, on a 30g-of-carbs-a-day “diet”. He calls it 6-12-12: 6 grams at breakfast (lower due to the “Dawn Phenomenon”), 12g at lunch and 12g at supper. No snacks. These principles are all explained and well documented in the latest edition of his magnum opus, “The Diabetes Solution.”
Another difference from Atkins Induction (20g/day) is that Bernstein limits protein. When digested, protein breaks down into amino acids, some of which are made into glucose by the liver and thus raise blood sugar. So, to limit excess, unwanted glucose production (called gluconeogenesis), protein needs to be limited. But how much protein should a person eat? In 2006 I studied the question carefully and discovered that opinions vary widely, but the “correct” way is to use a number based on an estimate of “lean body weight.”
Lean Body Weight is the optimal weight for a person, and it is your lean body that needs protein. In 1998 the HHS/NIH adopted the Body Mass Index (BMI) Chart used by WHO, the World Health Organization. Your doctor is required to use this chart to “evaluate” your weight. It is a really gross metric that takes no account of gender, body type, age or cultural environment. It is also a pie-in-the-sky number for almost everyone who will read this post, i.e. people living in a part of the world where food is omnipresent and abundant and where processed food has replaced real food in our lives. Thus, according to the BMI, virtually all of us are now overweight or many of us are obese. Nevertheless, your BMI “normal” weight is what you should use to calculate the amount of protein to eat.
The middle of the “normal” range in the BMI chart for a 5’-10” person (me) is 150 pounds. I still weighed 300 pounds in 2006 – that’s morbidly obese – but 150 lbs still sounded totally ridiculous to me, so, by “mistake,” I chose instead a “goal” weight of 180 pounds for my calculation. And since I was pretty sedentary and did no exercises, I used 0.5 grams of protein per pound (1.1g/kg) of my goal body weight. So, 180 x 0.5 = 90 grams of protein a day. Honestly, though, the grams per pound is also a variable where opinions vary widely, so the number you settle on is up to you. That’s how I started. Note: I was soon able to reduce my protein budget further.
For fat, I followed Bernstein’s dictum: Eat enough to be satisfied. I didn’t avoid saturated fat or cholesterol. I had been convinced by Gary Taubes, and many others since, that the 1977 “Dietary Goals for the United States” and The Dietary Guidelines for Americans, first published in 1980 and then every five years, were A FAILED PUBLIC HEALTH EXPERIMENT. They were in fact THE CAUSE of our obesity and diabetes epidemic. And they certainly weren’t right for anyone who was diabetic, pre-diabetic, or was just a little overweight. It just didn’t make sense.
So, for breakfast, I usually ate 2 fried eggs and 2 strips of bacon, with coffee and whole cream. That’s all. No juice. No bread. No jelly. No fruit and No cereal. Period! No exceptions. I found this small meal very satiating. I was never hungry later in the morning or even at lunch. I usually eat lunch though, out of habit, I suppose. It was sometimes a can of kippered herring in brine, or an avocado with vinaigrette dressing in the cavity, or a can of sardines in EVOO and JalapeƱo peppers. Yum. Just protein and fat. And that’s the second meal of the day with virtually no carbs.

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