Wednesday, 16 October 2019

Personal Update on Pre-Diabetes

(Photo is of Sunflower Vegetable Paté, which I made for Thanksgiving with minor adjustments to use as a dressing/stuffing substitute.)

Last week I had my blood sugar measured again (A1C, I believe it is called). It came in at 5.8 compared to the last time 6 months ago, when it was 6.2.

What does that mean? It means I've done well! I gather that ideally it should probably come in between 5.0 and 5.5, but this is a considerable improvement and I am no longer quite on the edge of the precipice. I've also lost about 9 to 10 kg (20 to 22 pounds) in the last year. Obviously, I am not going to celebrate by going out and eating* all those things that I gave up to achieve this. It's a long term project. However, it's nice to see that the changes I've made are on the right track and that I am, for the most part, finding them reasonably do-able.

There is still some fine tuning to be done, and I expect to find things a bit easier once the gardening season is over and I'm spending more time inside. It turned out summer was a bit difficult of a time to start a new diet plan - there isn't a lot of time or energy to cook, and I don't necessarily want much hot food anyway. Unfortunately, that traditionally has  meant that we eat a lot of sandwiches and pasta in the summer (well, year round really, but summer is particularly bad). I'm still working on finding things to replace them with that don't require a lot of advance preparation and cooking.

I'm trying to come up with a plan that takes a number of factors into consideration. I don't tend to worry about calories too much. My feeling, though, is that I am eating more (calories, not volume) than I was and yet losing weight, albeit fairly slowly and still with the assistance of the 5-2 diet. Sugars, carbs, and fibre levels of ingredients are the main things that I am now checking, but they don't tell the whole story. Really low-carb days make me feel frantically horrible, so I'm aiming for "right carb" days. I try to check on glycemic index and glycemic load information, when I can find it. My nutritional counsellor through the local hospital gave me a blood glucose meter, and the proof of the blood sugar pudding can now be measured.

Here are some of the things I've been doing:

1.) Pasta: it's now whole wheat nearly always, and once a week only.

2.) Rice: it's now brown basmati or brown converted (which is a bit odd, but better than the white converted. More about converted rice lower down.) In theory it's on the menu once a week as well, but in practice we seem to having it about half that often.

3.) Quinoa: I have been making Quinoa Pilaf (without the rutabaga in it) quite often. One half gets eaten hot at dinner then in the next day or two the other half gets made into a salad. I do this about every second week, so on average, again, about once a week. It's a bit carb-y but better than rice or pasta.

4.) Sweet potatoes and squash: get served often as the "carb" portion of a meal. In the winter rutabaga will show up here too. Unfortunately, corn, beets and parsnips are going to be very occasional treats. I'm eating a certain amount of carrots, peas, and onions, about the same as I ever was.

5.) Dried beans, lentils, peas, etc are going to be eaten a lot. Two meals based on them per week is the rock bottom minimum, and I'm aiming for at least four. I have not eaten a lot of barley over the summer, but as we head into the fall I'd like it to appear on the menu once or twice a week. I'm also aiming to eat more wild rice and buckwheat.

6.) Bread: I was very frustrated by the selection of bread in local grocery stores, and by local I mean from Owen Sound to Thornbury. Owen Sound and Thornbury have, in theory, a much better selection than the local store, but in practice it was annoyingly common to drive 15 minutes or half an hour and discover they were sold out of what I wanted. Thanks to the arcane and frankly extortionate system of getting products onto the shelves of grocery stores, I was not able to place a standing order for bread either. However, I'm happy to report the problem has been solved: you can order directly from Dimplfmeier's on line and they mail it to you! It means we will be stuffing our freezer full of bread every 2 or 3 months, but it will be the bread I actually want. I'm selecting bread with fewer than 20 net carbs per slice, mostly rye flour, and no calcium propionate or other propionates. Dimpflmeier's is about the only widely available bread line that has some types to fit this profile.

7.) Natural sugars and artificial sweeteners: I've always avoided artificial sweeteners just because they all seemed to have a nasty, tinny aftertaste that spoiled whatever they were in. The good news is that there are now some that are not too bad. The even better news is that these are some of the ones with what appears to be the best health profiles. In particular, I find myself using stevia with erythritol or stevia with monkfruit. These are not the most artificial of artificial sweeteners - erythritol is a sugar alcohol and stevia and monkfruit are both sourced from plants - but they are highly processed and I am still treating them with a lot of caution. If calorie-free sweeteners prevented diabetes and weight gain, they've been around long enough and widely available enough that we ought to be seeing them making a difference. Instead, levels of weight gain and diabetes are higher than ever. They all contain carbohydrates even if they register as non caloric, and if I use them I am careful to treat the carbohydrates they contain as part of my daily allotment. That makes them only somewhat better than sugar, honey, maple syrup, etc. I find myself using natural sweeteners in combination with an artificial one, and neither in large quantities nor often.

8.) Potatoes and resistant starches: Well, here is an interesting thing. Potatoes are terrible for blood sugar! Except, if you cook them in advance, cool and chill them, then reheat them, they're not! Same with pasta, and I guess, a number of other starchy foods. We did an experiment where I ate freshly cooked potatoes, chicken and vegetables at a meal, and then ate the same thing except with reheated (pan fried) potatoes the next day. I measured my blood sugar both times and there really was a significant difference (lower) after the reheated potatoes. We did the same with a pasta meal. The difference wasn't quite as pronounced, and re-heated pasta isn't as pleasant as fried potatoes. Still, it means things like fried potatoes, pasta salad, and fried rice are going to have a place in the diet. Also doing a little cooking with potato starch is more reasonable than it might look at first glance. (Those Cocoa Crepes, for instance!) This creation of resistant starches by heating and cooling starchy foods explains why converted rice has a much better glycemic index than untreated rice. It's a bit annoying, because like re-heated pasta, converted rice isn't all that great. Still, it's better than no rice, I guess.

So now what? I'll continue to fine-tune the diet over the winter. I need to get more exercise - that's a big factor in avoiding diabetes and I haven't managed to maintain a good level of it yet. But the diet seems to be mostly under control so it's time to turn some attention there. I have a few recipes that I am still refining but which are turning into regular diet items and will probably get posted over the winter. I have added a "Diabetic Friendly" tag to the list on the side, and over the winter I will go through my recipes and add the ones I think are good for that. And so, onward and bon appétit to us all. 

* I reserve the right to make a big chocolate cake and eat it too, if and when Donald Trump is evicted from power.


Anne said...

Great update, I'm so glad to hear that you're progressing so well, however that chocolate cake can't come soon enough!

Ferdzy said...

Thanks Anne, and yes! There are so many of us waiting for that cake. As long we don't go and do something stupid here in Canada...

Ted Whittaker said...

Neat to read this. 20 years ago, I was doing the same meticulous stuff when I got the diagnosis. It took me a year with pretty stringent dieting and plenty of walking, but I lost 60-70 pounds and have kept most of it off. In Toronto, I had the opportunity of going through several years worth of dietary experiments at Saint Mike's Hospital that helped keep my A1C in line and left me with a sharpened sense of what foods to avoid. The foods they prescribed were really dull, unlike those I have been reading in this blog for the last 20 years. Twenty years of diabetes does wear one down, and the A1C is hard to keep in check. My best advice is just to eat less (the only way to lose weight, imho) and smarter, all the time, exercise like a hot damn, and treat all donuts and their relatives as a treat. I am 76, and I got my latest 3-month A1C draw this morning. I guess hope it will be around 7.2 (diabetes is progressive, and coping with it is REALLY boring and not easy). Courage, Ferdzy, and thanks for all the splendid recipes down the years!

Ferdzy said...

Thanks for the encouragement, Ted, and also the kind words about the blog! I am working on the eating less and moving more, as well as everything else.

I hope your test brings you some nice, low numbers.

Marnie said...

Good work! (And pan fried potatoes for the win!)

Ferdzy said...

Thanks! And yeah, when I first found out about cooled and reheated potatoes being better for blood sugar, I said, "So that means... frozen french fried are HEALTH FOOD!"

Yeah, probably not. But it's good for a giggle.

MMeadows said...

All the best Ferdzy! Nice to see you're doing well :)

Ferdzy said...

Thanks, MMeadows!