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    Copyright 2008-2015Slow Food Fast. All writing and images on this blog unless otherwise attributed or set in quotes are the sole property of Slow Food Fast. Please contact DebbieN via the comments form for permissions before reprinting or reproducing any of the material on this blog.

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    SlowFoodFast sometimes addresses general public health topics related to nutrition, heart disease, blood pressure, and diabetes. Because this is a blog with a personal point of view, my health and food politics entries often include my opinions on the trends I see, and I try to be as blatant as possible about that. None of these articles should be construed as specific medical advice for an individual case. I do try to keep to findings from well-vetted research sources and large, well-controlled studies, and I try not to sensationalize the science (though if they actually come up with a real cure for Type I diabetes in the next couple of years, I'm gonna be dancing in the streets with a hat that would put Carmen Miranda to shame. Consider yourself warned).

Fifty, or “Sugar Shock, Part II”

I’m back, though a little bummed out. I didn’t post anything at all in September. There’s a reason for that. No, it’s not because I turned 50 last month (which I did). No, it’s not because I rebelled and declared against cooking anything ever again (which I almost wish I had, even though most of what I cooked was pretty good).

It’s because my routine physical showed up with a higher-than-normal-for-nondiabetics A1c even though my fasting blood glucose was under 100. The A1c measures the fraction of hemoglobins (the red blood cell proteins that include iron atoms and transport oxygen) with glucose molecules stuck to them. There’s always some level of glycosylated protein in the bloodstream, but above a certain threshold it means your average blood glucose for the previous 3 months or so has been over 100.  Not a good thing at 50. And when I borrowed my daughter’s old glucose meter and tested myself before breakfast a couple of days in a row, I saw why my A1c had been up–my fasting glucose was now hovering about 105, 110, even though it didn’t happen to be up on the day I tested at the lab.

Don’t that just figure, I thought. Happy birthday to me.

So I’ve been pretty PO’d and somewhat panicked. I do NOT want to become a full-blown diabetic. One in the family is more than plenty, thanks. Even though all the finest news outlets announced today that Tom Hanks is now diabetic. Not a huge comfort.

I think of myself as eating a generally healthy diet. I know full well how to count carbs, having had to for the past 4 years. My blood pressure’s good. I walk nearly every day. I know how to balance a meal.

But the Type II diabetes prevention and management advice I can find in the popular diabetes magazines and cookbooks (and online sites), even the ones endorsed by the American Diabetes Association, always seems to be ludicrously lax and useless compared with what we already have to do at home.

I’ve spent the past month reading up and seeing why the popular diabetes cookbooks and magazine recipe sections seem so useless–or even deceptive. Next post, coming up this week. You won’t believe what I found in most of them (other than all the pharmaceutical and sweetener ads, of course).

But for now, back to basics. Can I do the simple common-sense stuff they tell you (without actual instructions) at the doctor’s office to back away from diabetes risk?

Marion Nestle has pointed out that in large studies, the factors with the highest statistical correlation for preventing diabetes are weight loss and exercise.  They’re considerably more correlated than reducing dietary carb intake.

And on the other hand (how many other hands have I run through so far? more than three? I’m trying to cut down, really) I admit to knowing that eating less overall carb and much less in the way of sweets has worked in our own personal case…Please don’t ask me about the mysterious appearance of gestational diabetes some 13+ years ago. It lasted for exactly one week, complete with panicked call-backs for confirmatory tests from the doctor’s office, and then, just as suddenly, disappeared…in April. The nurse couldn’t understand it. I looked at the calendar and laughed (once my blood sugar snapped back down, anyway): that mystery week just happened to be the week of Passover, when macaroons and matzah seem to rule the menu in kosher households, especially when certain fathers-to-be are doing the shopping. Pretty much everything we’d eaten during Pesach had been laden with starches and sugars, and we hadn’t realized it. My husband and I had wondered why we were always starving for sweets even though we seemed to be eating plenty of them…never again, I decided.

But it’s the weight, stupid. I can face facts. I can. Really. Last year, which was pretty stressful overall, with some severe health scares in the family, I gained 10 pounds on top of what I already had. That doesn’t happen by itself. Even I know that.

So I thought, maybe I’m just ignoring something or fooling myself. Start keeping a total food diary and see what’s going on.

I discovered that while most of the stuff I eat is reasonably good healthwise, like most people who cook and eat actual food instead of box meals, I still do a number of things that aren’t so good for weight or for glucose management.

Like eating snacks at night after dinner, say, after 9:30 at night. Not a ton, usually, but often something involving bread or dried fruit. Sometimes it adds up, and sometimes it’s habit-forming. Like eating breakfast, and then, because I work from home, going back to the refrigerator for something small several times between mid-morning and early afternoon (and not thinking hard enough about the total because each thing is “small”) rather than eating a proper lunch that registers as lunch. If I’m out of the house most of the day, I don’t do this and I don’t feel hungry. So I know it’s just me being antsy and distracted about whatever I’m working on, but with food nearby. Bad combo.

There are other things–being a habitual night owl, for decades, means not necessarily getting enough sleep or enough daylight outside. Drinking more than one cup of coffee throughout the morning–some studies have shown that while drinking coffee seems to stave off insulin resistance, more than a cup’s worth of caffeine in a day seems to drive it forward. It’s a mixed bag.

For a while now, statistical and laboratory researchers have found correlations between lack of sleep and increased Type II diabetes risk. So more sleep, more daylight activity, and a little less caffeine are obviously on the docket for me.

But mostly, weight is a matter of calories vs. exercise, for everyone (or, everyone but Tom Hanks, who insists that his high school weight was mostly composed of big hair, ’70s style–but whose wasn’t?).

And for me, carbs matter a lot as a measure of calories. The last time I lost weight effectively, about two years after my daughter was born, I did it–and curbed my voracious, hormone-driven appetite at the same time, much quicker than I expected–by eating a lot less carbohydrate than I had been. I cut back to a cup of high-fiber cereal and one piece of bread or (not and) a cup of beans at lunch, and no carbs other than maybe a piece of fruit at dinner. No pasta, no rice, no potatoes, no cheese (for reasons of calories and salt, not carbs), no chocolate, and no sweets. Instead of “doing Atkins” and eating a bunch of high-fat, big meat as substitutes, which I couldn’t have stomached and didn’t make sense for a diet, I just ate more regular vegetables, like cauliflower and raw carrots, and drank water. And I did the stairs in our old townhouse 45 minutes a day (with book in hand for distraction).

Within four days–FOUR DAYS!–I stopped wanting to eat double meals–which I hadn’t even realized I’d been doing since the middle of my pregnancy (thank you leftover hormone swings)–and wondering how my husband could be full with just a single serving.  Once I stopped, I realized with a shock that I no longer felt anything at all, no yearning or twinges of hunger, when I passed the candy display at the supermarket checkout counter. It actually scared me how fast the instant-hunger signals turned off, because it means that most of those signals are just artificial cues provoked by snacking. And this was before David Kessler’s book came out and discussed them in a formal way.

I have no expectations, 10 years later, that it will be as easy for me now–50 brings its own hormone-laden complications, particularly for women. But it’s a start.

So far, after about 3-4 weeks, the diary has recorded the carb count without an actual attempt to cut all the carb out–and when it’s under 150 or so grams a day, I’m losing weight, and when it’s 180 or so I’m keeping it on. Those are the facts as I find them, and it means I have to cut carbs at least slightly, as well as walk a little more every day. My daughter needs at least 180 grams a day of carb because she’s young and growing fast and Type I diabetic. I can’t follow her diet and lose weight, even though it’s a reasonable amount for most adults who are maintaining weight.

But is it really that painful? No, to be honest. I’m vain enough that I’d like to get into some of the smaller pairs of jeans in my closet this year. Can I still cook something fun and interesting? Yes. Especially since I’m fond of odd vegetables (I’ve been threatening my husband that I’m going to bring home the okra any minute. Now he’s traumatized; his mother made it slimy and awful, even though it’s really no worse than slightly-chewy zucchini when you do it right, the way our best Indian restaurant does).

Can I get a belated birthday cake? Well…my husband and daughter were thoughtful of my woe this time around and pared it down to a single copy of my favorite bakery’s killer chocolate-on-chocolate cookie. Which we weighed out and split three ways after supper. The cookie was only about 3 or so inches in diameter, but my daughter weighed it out–60 grams in weight! heavy!–and figured it was about 75% carb or 45 grams of carb total. She’s the expert and she was right. And a third of that cookie, small as it looked, had enough chocolate power to be more than plenty. Even without candles on it. After eating my share, I don’t think I could really have handled the whole cookie at once without feeling it for the next 3 hours.

Now, all told, the above does not sound like a fabulous way to celebrate one’s 50th birthday. You know it, I know it. And I’m not exactly known for self-sacrifice. So I decided, screw the cake this year. We’re going to a play or two this fall instead, because although it’s more expensive, going to the theater has fewer calories and is actually a lot more fun. And you get to dress up.

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