I would like to start this blog post by first thanking Kelley,  AKA the "Low Carb RN" for sharing this incredibly eye opening experience with us, so that we may share it with the world.

You see, most of us who are afflicted with diabetes (and know it) already know this truth. It is the rest of the population out there who do not seem to realize this, and this blog post is written for you. 

You may be fit and slender. Some of you are at the gym every day. Some of you think that you can eat loads of carbs and that that is possibly even helping your metabolism and your physique. Some of you run marathons. Some of you are bodybuilders. Some of you power lift. Some of you compete in spartan races and "tough mudder" events. Some of you work in the healthcare field. Some of you are personal trainers, coaches and like the woman in the story… maybe you are even a even certified nutrition professional.

No matter. Diabetes is insidious and misunderstood by laypeople and healthcare professionals alike. 

Listen up. 

Did you catch that the photo caption? A thin, fit dietitian.  

Like most of the rest of the world, we use the metric system in Canada… so henceforth I will talk about these numbers in metric terms. The conversion factor is 18 for those of you who are still using the old imperial system. 158 mg/dL equates to about 8.8 mmol/l. This is well beyond the level at which damage to the heart, kidneys, eyes and extremities such as the feet is thought to occur. 

Just in case this is not gelling for you… this woman ate less than 30 g worth of carbs. This is much, MUCH less than the positively outrageous "not less than 130 g" of carbs (26 tsp) that the Canadian Diabetes Association is recommending that a diabetic eat.
 
I have seen fitness buffs who eat hundreds of grams of carbohydrates in a day and then justify it by running their asses off on stairs or on the treadmill or whatever hamster wheel piece of equipment that they choose. Yikes. 

A normal healthy blood sugar to strive for all day, every day is approximately 4.6 mmol/liter (83 mg/dL). This equates to just a little bit less than 1 teaspoon (5 grams). Recall that in the previous paragraph I mentioned that the CDA recommends that a diabetic eat "no less than 130 g (26 tsp) of carbs in a day". No LESS than. All hope abandon, ye who enter here.

Anything more than this 1 tsp of sugar (carbs), and your body will have a strong hormonal response in an attempt to return your blood sugar levels to normal. Your life depends on your body's ability to do this. And, I really hate to tell you this… but, this rule holds true whether you are a first re-CrossFit athlete or an overweight couch surfer (insert pin into balloon here). 

One of the most important investments that you can make in terms of your health is a blood glucose monitor. Currently, the Freestyle Freedom Lite is thought to be the most accurate. They are available for FREE at any pharmacy across Canada with the purchase of a bottle of strips. Bonus – most insurance companies will reimburse almost 100% of the the cost of the strips, even without a prescription.

Once you have the meter, what should you do? When should you be testing and what do the numbers mean? 

To get a good grasp on what your blood sugar is actually doing, you should be testing it first thing in the morning upon arising (fasting) and before you eat or drink anything. You should then test at one hour and two hours after a meal or snack. If you really enjoy poking yourself, you can go one step further and test right before each meal as well.

Truly normal fasting blood sugar should be between 3.9 and 5 mmol/liter. That's right – those of you with blood sugars of 5.5 with doctors who are telling you that you are "okay" should be sitting up and taking a little bit of notice here.  

Regardless of what they eat, the blood sugar of a truly normal person should be under 6.6 mmol/liter one or two hours after a meal, with most normal people being under 5.5 mmol/liter two hours after eating. Personally, I am a diabetic and I would not be at all pleased with a blood sugar of 6.6 two hours after a meal. I would consider it way too high and an indication that I ate something that caused it to spike.

If you are outside of those ranges then you have a choice to make. You can bury your head in the sand and wait for the inevitable, or you can be proactive. Speak to a knowledgeable healthcare professional or nutritionist (caveat emptor on this front… drop me a note and I will do my best to help you find someone in your area) about what you can do to bring your blood sugar numbers into the truly normal ranges. And please believe me… the numbers that are recommended by both the Canadian and the American Diabetes Associations are anything BUT optimal or healthy ranges.

Remember – there are thought to be 1 million UNDIAGNOSED diabetics in Canada (http://www.diabetes.ca/newsroom/search-news/canadians-urged-to-check-their-risk-of-diabetes). 

Don't be one of them.

Over the past few few weeks I have noticed that people seem to be confused about their Dr. Bernsteins. But have no fear... I am here to help you out.

Most Canadians have probably heard of "Dr. Bernstein's Diet Clinics". A few Canadians may have heard of a book titled "Dr. Bernstein's Diabetes Solution".

They are not the same person,  but do share the same middle initial as well as the same last name. Let's begin with Dr. Stanley K. Bernstein of "Bernstein Diet Clinic" fame.

Dr. Bernstein's Diet Clinics are: 

- the brainchild of Stanley K. Bernstein of Toronto, ON - who was born in 1951
- a chain of diet clinics operating in Canada, 
- reviewers and former staffers describe them as "expensive, very low calorie diets, requiring clients to attend the clinic up to 3 times a week to receive injections of B vitamins.",
- Dr. STANLEY K. Bernstein appears to have had some run-in's with 'John Q. Law' of a pretty serious nature. You can Google around for that info yourself. 

And now for the other, totally unrelated Dr. Bernstein...

Dr. Bernstein's Diabetes Solution is:

- a best selling book, and a simple nutrition plan for T1 and T2 diabetics to be used with or without insulin or meds,
- was authored by RICHARD K. Bernstein, who was born in NYC in 1934. See? Not the same guy at all...
- he is an engineer, physician and lifetime T1 diabetic
- his work is probably the BEST advice available for both T1 and T2 diabetics, and should be front and centre in the reference library of all diabetics and of ANYONE who counsels them on matters of nutrition.
- as an aside, Dr. RICHARD K. Bernstein is still working at age 80, and still offers free tele seminars and workshops. Incredible.

So, as you can see - there is a world of difference between these two men, what they do and how they do it. Now you now the difference.

You're welcome.

November 16th. Christmas is still 5-1/2 weeks away and the photos of Christmas goodies are beginning to surface. The stores are fully stocked with baking supplies and some folks are already beginning to create their holiday specialties. And it's still 5-1/2 weeks away. Let the (over) eating and poor food choices roll. 

Depending on their metabolic status, people have been known to gain anywhere from 2 to 15 pounds over the Christmas season. Remember... 5-1/2 weeks out and it's already here. A person with good insulin sensitivity can deck the food halls and gain very little weight, while someone on the other end of the spectrum, (such as an insulin resistant person) can easily eat far less but gain a significant amount of weight during the same time frame.

Physical activity appears to have no real bearing on this, so thinking that you will nosh out on 1200 calories of nog and cookies (which is VERY easy to do) then hit the gym and work it off is not a viable option. The expression "you can't out-train a bad diet" is never more true than at this time of the year. However, maintaining your workout schedule DOES have several other plusses, and may keep you mindful of your food intake among other benefits. Schedule time to work out, just realize that you cannot burn off what you can eat. 

You can see this illustrated wonderfully by
Craig Ballantyne and friends. As you watch these short videos, keep in mind that some Christmas goodies are even MORE calorie dense than the foods that they show. Watch all 4 of the episodes... pretty hilarious and pretty mind blowing.

http://www.youtube.com/watch?v=UQbuzsY_34Q


So, how will you handle it this year? Will you:

1. Throw caution to the wind and eat it, just eat it (Thanks for the visual, Weird Al)? Hide the scale for the next 6-ish weeks and just plan on trying to do some damage control in the new year? 

2. Plan a moderate intake? Load up on shrimp and raw veg at the staff Christmas party? Only scoop one or two cookies from the plate in the lunch room? Flee from egg nog? CAUTION - often, this strategy ends up turning into strategy #1.

3. Hide in your house and not attend parties and functions? Yes... some people do this, and it's sad.


4. Try to create holiday foods that are NOT sugar and white flour based and completely devoid of nutrition? 


Personally, I like a combination of numbers 2 and 4. Use the old raw veggie and shrimp trick (and possibly some old fashioned willpower) when the situation is beyond your control, such as a catered party. But, when entertaining at home, or when you can bring a dish to a party or function, you can take the opportunity to slide a healthier option in.


Remember, natural foods such as fruits, nuts, meat and vegetables ARE colourful on their own and can be delicious, nutritious, filling and will not cause a health damaging blood sugar spike nor likely lead to a food binge.  Decorated cookies are no match for a spinach dip stuffed tomato when it comes to being pretty and festive.


Please share your recipes with me. As long as they conform to a paleo/primal regimen (no grain, soy or sugar) I will share them on my website.

This is an extremely sad day for Jimmy Moore, of Livin La Vida Low Carb. Today is the fourth anniversary of the loss of his brother, Kevin Moore. Jimmy has dedicated today's post to writing about that difficult time and the events leading up to it, and has given me permission to re-post it here.

To quote Jimmy himself, "the loss of Kevin has given me a renewed purpose and mission to help prevent others from succumbing to the same fate of my beloved brother. If I can help save just one person from becoming a victim of conventional dietary wisdom, then all the time and energy will have been worth it all."

Please connect to Jimmy's page here to read Kevin's story.

Akrasia. What the heck is that? It sounds like some sort of contagious illness or parasite... “Don’t get too close to Robb. His akrasia is flaring up again.”

By definition, akrasia is derived from ancient Greek ἀκρασία, meaning "lacking command (over oneself)", or the state of acting against one's better judgement.


Mark Sisson, of Primal Blueprint fame, sums it up the best.

“Akrasia encompasses that irrational, confounding state of mind in which we wittingly throw caution, reason, and consequences to the wind in order to pursue a choice we understand will be bad for us. In other words, we know better. In fact, we know pretty much exactly what repercussions will befall us. That chocolate donut in our hand, for example, will undoubtedly cause our IBS to flare up – or have us bemoaning the paunch look later. Staying up late to watch one more episode of Breaking Bad will leave us comatose in tomorrow’s big meeting. Skipping yet another workout keeps us on track to lose all the gains we’ve built up the last few months. Stewing over the day’s stresses and playing out angry scenarios in our heads will keep our kids and partner at arm’s length and us up half the night with stomach pain.

But damned if we don’t make the choice anyway. Why? What’s wrong with us that we go down these roads when we clearly understand the fallout? Is it temporary insanity? Delusion? Just human nature?”


Certainly, we have all likely experienced akrasia on a personal level. As a consulting nutritionist, I see people tripping themselves up on a regular basis. I see diabetics who will not (notice that I am saying WILL not, rather than CAN not) give up candy bars and sugary junk food. I see others who appear almost proud of their unhealthy lifestyles. 

But, I digress. Now that we know what akrasia is, why am I writing about it in terms of whether or not we will succeed or fail in our weight loss or health improvement pursuits? Is akrasia something that comes completely from within, or is it something that can be given to us by others? Can we be encouraged to act in an akratic way? I say, yes we can.

Over the years, I have personally battled and won my own war on obesity and will struggle to keep that monster at bay for the rest of my life. I am also faced with a very strong genetic predisposition to develop metabolic disorders such as insulin resistance and Type 2 Diabetes. So, it is obviously in my own best interest to be very proactive when it comes to my diet and lifestyle choices if I want to live a long, productive, happy and healthy life. 

However, over the years and more recently it has become more and more evident to me that we (or at least, I ) seem to live in a society in which we are surrounded by apathetic, ignorant people. I recall an incident several years ago where I ended up at an ice cream stand (hey, I wasn’t driving) with a very obese acquaintance. I declined the sweet treat, and this resulted in me being subjected to sarcastic comments and eye rolling as my corpulent counterpart sat licking away at their ice cream. What the .....??

More recently, I ended up in a dining situation with a group of friends. Quick bio... Wheat based carbs affect me very badly. They cause blood sugar spikes, bloating, weight gain and lasting lethargy. End bio. 

I sat perusing the food in front of me, scanning for sugars and processed wheat based starches. My refusal to give in to my own akrasia seemed to annoy one of my table mates enough to prompt them to loudly exclaim, “Heaven forbid she should eat a carb.”

So, that brings me back to the question, can we be encouraged to act in an akratic way? In this case, as well as the previous example, yes, it would have been very easy to buckle under the sarcasm, eye rolling and obvious distain for my personal choices. Peer pressure. It isn’t just for teenagers anymore.

What would compel someone to engage in sarcasm intended to single out and belittle someone who is trying to get healthy or stay healthy? Or, someone who is striving for a fitness or condition goal? Why would someone feel led to make loud and disparaging comments about what someone else was eating or not eating, particularly in a public setting? 

Guilt? Jealousy? A subconscious awareness of their own akrasia, or lack of “self command”? I tend to think that it is the latter. 

Heaven forbid that I am attempting to divert my future away from diabetes and the heart disease, kidney disease, blindness, nerve damage, lesser life quality and shortened life span that can accompany it. I’m sorry if that bothers some people.


Heaven forbid that I want to live a long, healthy and productive life. I know that is asking for a lot.

Heaven forbid that I do not wish to be a financial or emotional burden on my family, my friends and on our already stretched thin social medicine system. How selfish of me.


And, heaven forbid that I refuse to be ignorant and apathetic about my own health and well being, but rather choose to be the captain of my own destiny as much as I possibly can. Call me an iconoclast, I guess.

Heaven forbid, indeed!!

I make no apologies. We have very little control over so many things in our lives. But, the one thing that we do have control over is what we put into our mouths. I choose to exercise that control. How about you?