So, you finally got the nerve to go to your doctor. You’ve been avoiding it because you have gained some weight, okay, like 50 pounds, since the last time you saw him 5 years ago. You feel okay, a little sluggish maybe, you get sleepy after meals but you know you aren’t sleeping well, and you’ve been kind of thirsty lately. Also, you’ve been more achy and had some increasing joint pain over the past few months. You get the news – you are pre-diabetic…UGH! Now what? Here are my top 5 innovative strategies for diabetes recovery.
You may be thinking, what is so new about your way, Dr. Kris? There are so many articles and blogs about weight loss and diabetes or the internet, is there really anything new under the sun?
Yes, come with me on this new adventure. Come on…it will be fun, REALLY! Instead of diving into the “miracle fad diet diet of the day”, let’s take a look at the big picture. So you understand where I’m coming from…I have a family history of diabetes. I also struggled for years to keep my weight in a normal range. I could have just as easily been the person in the first paragraph. Taking a look at my habits, emotions and what I choose day in and day out, helped me dodge that bullet.
Consider this innovative path for creating a lasting change in your lifestyle:
- Do you understand the lab information? It’s important to really know your lab info going forward as data. Not a judgement of good and bad, just data. It can tell you how you are doing…healing takes time…a month isn’t long enough, six months is a good start. Time comes and goes…
- Figure out how you got here. What habits allowed your body to de-compensate to the point of illness?
- You need to answer the most important question ever… is it important to you to change it? Is this about willpower or something more? The answer may surprise you!
- Start by making some obvious small changes in what you are eating, then make bigger changes in a few weeks as you get a handle on your new life.
- Along the way, figure out what new habits you can create in your mind? Also, who you need on your team to get and maintain your new healthy lifestyle.
First, what do my diabetes labs mean? Let’s get a handle on the information your doctor told you.
- Were you fasting when you went for your blood draw? Is this important?
- Was your glucose and Hemoglobin A1C high? What does that mean?
- What do your cholesterol, triglycerides and HDL numbers tell us about the status of your pre-diabetes?
You need to be fasting for your blood draw to get true glucose (blood sugar), cholesterol, triglyceride, LDL and HDL numbers. Eating will effect these numbers. Yes, even coffee! So you may want to get some new numbers if you weren’t fasting.
The glucose number is the amount of sugar actually in your blood stream when the blood was taken. The Hemoglobin A1C measures an average of your blood sugar over the previous 120 days or so.
Geek alert! Hemoglobin is a molecule in your red blood cells that carries oxygen. Red blood cells have a 120 day life span. So, when the red blood cell and hemoglobin are exposed to lots of sugar in the blood, they get “sticky” and that “stickiness” is measured. As your blood sugar comes down over time, there is less sugar to “stick” to the hemoglobin and the A1C number will come down, as well.
This also gives the doctor and nutrition coach a way to know if you have been compliant with your lifestyle changes over the previous 120 days. A1C is a “tattle-tale!”.
Cholesterol, triglycerides and LDL, lousy cholesterol, will generally go up as your glucose goes up over time. HDL, the healthy cholesterol, will go down. Even if you have a normal glucose number, all four of these numbers may be foreshadowing what is going on in your body. Elevated cholesterol is not a disease in and of itself. It is a sign of stress in your body. You may even be on a cholesterol lowering drug as your glucose climbs. The incidence of diabetes increases when you are on a statin because you are ignoring the root cause of the cholesterol elevation – your diet and lifestyle. Cholesterol doesn’t cause diseases alone. It has helpers – like glucose and homocysteine – both can cause your vessels to have inflammation. This is what creates the heart and cardiovascular disease in the long run.
That said, cholesterol will rise if your blood sugar is running higher than normal, but your body is still compensating.
Eating processed, high carbohydrate and high sugar foods causes stress on the body. The body responds to excess calories and carbs by turning them into triglycerides and cholesterol. This process happens in the liver. Our liver makes about 75% of the cholesterol in our body. Higher cholesterol numbers generally correlate with higher carb and sugar diets. Our Standard American Diet or Modern Urban Diet – SAD MUD – is responsible…Well, truth be told, you are responsible for making those choices – UMMM..sorry – I tell it like it is…
The other important labs to consider that are rarely considered are High sensitivity or Cardiac C-reactive protein and Homocysteine. C-reactive protein is an inflammatory marker that can tell you about your risk of cardio-vascular disease like plaques and inflammation inside your vessels that leads to heart disease.
Homocysteine is an inflammatory molecule that can directly cause injury and inflammation to the inside of your blood vessels. This is often the cause of heart disease and heart attacks in people who are young – like less than 50 years old. It can be easily eliminated through proper B-Complex supplementation. It’s important to know if the B-complex you are taking is keeping this molecule at or below 7, to reduce the cardiovascular inflammation it may cause.
Now that you understand the data, how did you end up becoming pre-diabetic?
- SAD MUD
- Unconscious eating and self sabotage
- Lack of movement
SAD MUD, the Standard American or Modern Urban Diet. Here it is again, highly processed junk contains too many carbohydrates, bad fats and calories. It is devoid of the nutrients your body needs and actually requires more nutrients than it delivers to be processed by the body. This kind of diet leaves you basically, malnourished.
You may be thinking, I am overweight and far from malnourished! I can tell you, most of the patients I see, even ones who eat more real food, are malnourished in some of the basic nutrients. Dr Jeffery Bland coined this “Over-consumptive Malnutrition”. Consuming too many calories, but not any real nutrition.
This over-consuming pushes the body’s limits of ability to handle the amount of carbohydrates consumed at any given time. Let’s assume, for the average female, 80-100 carbohydrates per day is a healthy amount. The SAD MUD starts with 40 grams in the morning bagel or oatmeal; another 20 in the medium non-fat latte, before sugar; the sandwich is another 25, soda 40; afternoon regular candy bar 30 or granola bar 25…you haven’t had dinner and are already at a grand total of 150! Add some fries and a burger with the bun or pizza and you are topping out at or over 200!
As females, unless you are training for an event, we can only process 20-30g of carbs at any one sitting. Every time we over-eat our carbs, our blood sugar goes up high, the body responds with a hormone called insulin. Insulin is a good thing as it allows sugar into cells to be made into energy, however, too much insulin, over time creates inflammation. Cholesterol and other markers start to rise.
When glucose is high, insulin surges. It helps the body shuttle the sugar into the cells – this is a good thing but only to a point. When we continue to eat more and more carbs/sugar, more insulin gets produced, then the damage that create diabetes begins to happen.
- Our body makes triglycerides out of the excess sugar, creating a fatty liver
- Our body starts ignoring our insulin. The cells just say “enough!” And stop responding. This leaves you with high blood sugar and constant cravings. This is known as insulin resistance and is part of the pre-diabetic state.
- Cholesterol and other markers rise, as a response to the high insulin and sugar levels which leads to inflammatory chemistry being produced
- The inflammatory molecules create symptoms – joint pain, brain fog, PMS, swelling and bloating, digestive issues, fatigue and more!
- Your body no longer handles the carb/sugar onslaught and eventually your glucose will rise – you have insulin resistance and are pre-diabetic – if this continues you will manifest full blown diabetes in time.
The good news is this can be completely turned around! You do not have to “become” diabetic or wear a victim label of “I am a pre-diabetic.” You can acknowledge it, take charge of it and change it. You may not have a clue what to eat. Marketing is makes it difficult to really discern what is healthy. So, ignore marketing and go with what you instinctively know is healthy. Vegetables, low glycemic fruit, lean proteins and healthy fats. I will discuss this more later…
Unconscious and habitual eating has, more than likely, taken over! Regaining a handle on what you are eating day in and day out is critical. There are many apps that will help you track your food. All the research says that tracking your food is one of the keys to taking control of your food, instead of you becoming a victim of the food monster that lives in your brain. That food monster will negotiate with you to eat anything and everything that is not healthy for you. Telling it no, just invites louder pleas. Becoming aware of these negotiations is one of the best ways to overcome those habits.
One way to overcome the food monster negotiations is to move. When the monster starts in – first, change venues -get out of the kitchen – I know you’re in there…!! Get out of the house! Nope, don’t care if it’s -20 degrees F, bundle up and move. Even if you are outside for less than 5 minutes you have broken the pattern.
Move your body. Movement creates a new chemistry in your brain. It also burns more calories and creates high metabolism muscle tissue. Down the driveway or hallway and back is more than you may be currently doing. And you need to start there! Every day for the first week, then increase it every week until you are walking 30 minutes a day.
I like My Fitness Pal because it will also keep track of your movement and calories expended. It connects to many watches as well. Getting a cheap pedometer or FitBit is helpful. Making step goals is one of the easiest ways to stay on track and keep yourself motivated.
That’s fine Dr Kris…and I have tried to start the movement thing and do the tracking thing before but I just fall off the truck in a week or two… then what! Or you say, “I have tried everything and I can’t lose weight.” But the truth is, you haven’t tried the thing long enough or you aren’t willing to change some key things… keep reading…
This next step is really the most important step of all…
Before you really implement anything, you must really dig in and figure out IF and WHY you want to be healthy again. Think about the following and then answer the questions…Maybe you want to be able to hike, run, bike or swim. Maybe there is a vacation you would love to take but…What about your grandkids – whether you have them or not – will you see them get married?
The answers to those and the following key questions are vital to your success:
- What is your current health status? Define it, write it out…the good the bad and the ugly…This is your current reality…get clear!
- How is your current health effecting you day in and day out? Do you have all the energy you need? Do you sleep well? PMS or menopause symptoms? If you are male, erectile dysfunction? (yes!! This is a symptom) Can you do everything you want to do?
- How are your clothes fitting and how is your self esteem? Is weight an issue?
- What would be different if you could get a handle on your health? This is where you want to go…
- What could you do or see if your health was improved?
- How would your relationships change? This can be scary because we fear loss.
- Would you be able to seek support in your life?
- Why do you want to shift from pre-diabetic to not diabetic?
Then make a decision:
- What is “hard” about your current life and and what will be “hard” to change? Which is worse? Do you feel the tension between where you are and where you want to be?
The first three questions tells you where you are right now, the next five help you understand where you want to be or dream to be. There is a “tension” established between the two pictures. This is what Robert Fritz defines as “structural tension”. You can feel the tension within yourself. You can feel the pull of the future…where you want to go. Use that pull as part of your motivation.
When you finish this blog, take time to make a vision board about your new life. Ignore those around you who may think its silly or whatever…This is what you need to do for yourself. I copy and paste pics from the internet onto a word doc then print them, cut them out and paste them on a piece of cardboard. You can do it on Pinterest or other apps, but I like the feel of the paper and actually making the board. I hung mine in the bathroom so I see it every morning.
There is a difference between being internally and externally motivated – a blog for another day. But, suffice it to say, when you look into yourself, take the time to question yourself, stop blaming everything outside of yourself – this holiday and that friend – for the health mess of your body – you will find the real key to long term health, mindset!
Congratulations, you have discovered a deeper reason or reasons for shifting your life and lifestyle, not just going on another diet. This will make it so much easier to stick to your plan.It’s no longer about will power.
This is the most important part because you create a vision of where you want to go and a way to overcome our own resistance, then you will have the lasting success you crave. These deeper reasons will carry you through the rough spots because the reasons for getting healthy actually touch your soul. The reasons are based in your value system now. Not just some vague wish to be healthy.
Fourth…now we can start to address the actual changes in lifestyle. Begin making some obvious small changes. Trying to change everything in your lifestyle, all at once, is going to leave you frustrated in a couple weeks. First things first. Clean up your food. High carbohydrate, processed foods and soda are generally the culprits, and it doesn’t have to mean zero – okay maybe for a while – but cleaning up your diet doesn’t have to leave you sentenced to a life of plain chicken breasts and broccoli. EEWWW…
How can I get started with better eating habits?
6 weeks to healthier food choices:
- Make a commitment to yourself to become aware of what your choices are – for the first week, you don’t even have to change anything. Just becoming aware and tracking what you eat on My Fitness Pal or notebook will make a difference. Precision Nutrition has found that this will actually create a small weight drop in most of their clients.
- Week two…start with some protein at breakfast. Eggs, a cup of vanilla Greek yogurt and 1/2 c berries. Skip the oatmeal for now. You will want to add a snack around 10am. How about some peanut butter and part of an apple? Or some peanut butter and 8 crackers – instead of the whole box…Can you make a different choice at lunch?
- Week three…notice I have not said anything about chicken breast or broccoli!! Let’s focus on lunch this week. What choices could you make if you are eating a burger and fries or if you entertain clients, a pasta choice or a very large meal? Alcohol involved? Just shift a little – skip the fries or the high carbohydrate pasta and shift to more protein and veggies. Then grab a cheese stick and a piece of fruit… I still haven’t said a thing about soda or desserts…
- Week four…What’s going on at dinner? Do you entertain clients? Do you really think they care what you are eating? If you are with your family, you don’t have to make a separate meal for yourself. Let’s say pizza is standard fare at your house. What if you opened a bag of lettuce and had a salad, then ate less of the pizza or only the cheese and the toppings from the pizza? Can you find an hour to plan meals for the next week?
- Week five…Find an hour or two to plan your meals. Find another hour to go to the grocery store…Again, eating chicken and broccoli has not been mentioned, so unless that is your favorite meal…make food you like. Think about your protein first! Then add veggies, then find yourself 1/2C of complex carbs.
- Week six…you are in a healthier groove. What else can you tweak? How about the soda or cookies that are still being consumed? Not that I think “diet” soda is a good choice, because it can cause some of the same issues as sugar soda, but let’s move that direction. There are sodas and water enhancers sweetened with stevia. Have you tried a flavored sparkling water – don’t expect the sweetness, but it will give you your fizz fix.
We are really just getting started and I will have another blog to finish my thoughts on this kind of slow, simple shifting. I think you will find this a new way to approach your food. Awareness through change is key!
If you have a more driven, change it all at once personality, humor me. How have all the fad diets worked for you in the past? How is your current plan working for you? Maybe, just maybe, this more awareness driven approach will enable you to have the lasting change you are seeking…
Or if you are looking for a fast start, structured program, safe for a 10-200+ pound weight loss to type 2 Diabetes or other chronic diseases – if you are that far along – with coaching included, check out www.DrKris.optavia.com. It’s just a different option and not everyone is a good fit.
To recap…Eggs or some Greek yogurt for breakfast. Skip the toast and add a cup of raspberries. Grab some favorite nuts, about 20, for a mid morning snack. Skip the bun and fries with that burger for lunch and a club soda, diet soda or water instead of the soda. Before that afternoon candy bar can call your name – grab some nut butter and an apple, or cheese stick and fruit and make something sensible for dinner. Dinner can be a protein – beef, chicken, fish, pork, lamb etc. some vegetables, and about 1/2 sweet potato.
Finally, something I eluded to early…who do you need on your team? Many of us hide in the shame of what we choose to eat, when we binge, binge and purge, etc. I have been know to eat chips in the pantry…AND using some of these techniques and others, I no longer eat the whole bag or even half. I am not perfect just because I am blogging about the solutions. I have a safety net in my life now. I have figured out what works for me.
This is an important point, you have have to figure out what is going to work for you. You can read a million things on the internet, even my blogs! Find what resonates with you and what makes sense in your life. Be resolved that things are going to have to look different and those changes feel and seem new and weird! New and weird is good, that means you are out of your comfort zone and in the change zone! That’s okay! You will be okay!
Four resources for support out of your comfort zone and to win over the food monster:
- Know that support in this process is necessary. Whether its a spouse, friend, therapist, pastor, or coach. Being able to have someone to text or call when you want to want to “eat the refrigerator” as one of my clients confided recently, is crucial to long term success. Even Facebook groups have been helpful when you find a like minded community. Be aware of those people in your life who are not supportive. Eventually, you will have to deal with them, one way or another. Picking fights with them will not be productive.
- Mel Robbins talks about the 5 Second Rule. She suggests to count backwards from 5 when you find yourself about to go elbow deep in the quart of ice cream or bag of chips. This gives you a moment to realize how you will feel when you have completed the less than healthy choice, which is just a habit or reaction. Dealing with whatever is going on in your life may be temporarily painful (this is the “hard”part of change), but is it as painful as continuing in your current reality? Avoidance behavior is more than likely what created the issue.
- Dr Wayne Scott Andersen cofounder of Medifast (MED), created Stop! Challenge! Choose! As another way to look at your weak spots where lifestyle changes are concerned. Stop first. When you are faced with a situation where you may make a poor for your health choice, whether its not going to the gym because it’s still dark outside (yes, I have heard every excuse in the book) or choosing to stay on your plan through your vacation. Just stoop and look at your Challenge, and challenge yourself…is this the choice I want to make? Is this going to move me closer to my goal or further away? Then, make a fully informed choice. This will also cut down on the reactionary habits you have created over time.
- I also use delay of gratification or the “just not right now” strategy. This is my combo version of the other two mentioned…My favorite junk/binge food is popcorn. Buttery, salty, crunchy…mmmmm…okay enough fantasizing…When I find myself with a full on popcorn crave, I tell myself I can have it next weekend. Even on a weekend, I promise myself I can have it next weekend. Then, I go about my business. I have given myself permission, just not right now! It changes the reactionary habit of getting into the pantry. One of two things will happen. I will forget that I have planned the binge. OR I will choose carefully, the time and place for a smaller amount than I would have eaten. Oh, yes, still with butter, etc but I will plan the portion. And then it’s over. And usually not that satisfying anyway, but sometimes it is…and its okay…Having the choice, is having power over the food instead of giving in to the power of the crave.
Dealing with any lifestyle change is more than just starting a diet. Most of us have done that with mixed results. The statistics are actually abysmal for those who have stuck with their changes and regained their health. Like I said, I have a safety net that has helped me for most of the past few years. It has allowed me to lose weight and decrease my risk for diabetes that runs it in my family.
If you find yourself in a place where you do not like the results of your labs and are ready to take control of your health, these steps will get you there. Reach out to me anytime for your 15 Minute Consultation, on me, let’s see if we are a good fit!