Desperate Times Call for Critical Transformations…

After a series of (mostly) positive transitions in the past few months, my body was left feeling spent and terrible. Sugars were at an all-time high, my energy bottomed out, my carpal tunnel syndrome raging in both hands, joint aching, and my moods more variable than the Oregon spring weather. Even good change is hard.

But then I got some terrible news about my Dad.

Dad has been in heart failure for the past couple of years – he’s 58. Heart failure is a fatal condition in which the heart simply doesn’t have the capacity to keep up with the rigors of running a body. Also a type-1 diabetic, Dad spent years neglecting his self-care and that neglect had serious consequences: heart disease, eye disease, kidney disease, you name it. He is now biologically much older than his actual age and his quality of life sucks.

There was some (though not much) hope that his quality of life and longevity could be spared through either a heart transplant or a less-invasive procedure, a heart pump. However, a few weeks ago, Dad got rejected for both procedures. His weakened state and history of high blood sugars made it unlikely that he could withstand the anti-rejection drug regimen that follows a heart transplant. His high risk of infection made him a bad candidate for the pump because there are components of the pump that exist outside of the body (think open wound). Without either of these procedures, Dad is destined for few remaining years, which will be of poor quality.

What does this have to do with my diet? 

It is now more important than ever that I get my diabetes and general health in order for two reasons: First, Dad wants to see me healthy and happy before he goes. He has been an amazing (ah-mazing!) source of emotional and logistical support in both my move to Oregon and my transition into private practice (yeah, still working on that – anyone need a lawyer?). He needs to know I’ll be alright, and it’s my responsibility to get there. And although I absolutely want this for my own reasons, be it performance, aesthetics, and quality of life, Dad’s circumstances have slapped me back into the reality of doing the hard work. Ladies and gentlemen, we have exigency. 

Second, Dad’s poor prognosis has shined a spotlight on my own health and the potential consequences of continued diabetes mismanagement. For those of you who don’t know, diabetes effects everything. From your eyesight to your hydration to your circulation. Everything. Dad serves as an unfortunate bad example of how I may end up if I don’t get my act together and figure out this diabetes thing. So yeah – the bad family news and my own poor health resulting from crippling stress served as a pretty legit wake-up call. And getting my act together starts with the food I eat.

It Starts With Food

Let thy food be thy medicine, and let thy medicine be thy food.  

~ Hippocrates, 460-377 BC

It is no mystery that our quality of life is deeply associated with the quality of our food. When I am stressed, I go straight for low-nutrition convenience foods. Needless to say, I’ve been feeling terrible – my 14-day BG averages have been hovering between 185-200. Yikes.

I conducted a little experiment: I switched over to an almost exclusively plant-based lifestyle with an emphasis on whole foods for two weeks. I have been flirting with the idea of going vegan for a little while now and it wasn’t a hard thing to do, given that I have been an on-and-off-again vegetarian for the past decade.

Why Plant-based?

There is a litany of reasons why I am choosing a plant-based diet. In short: proven health benefits, nutrient efficiency, respect for my animal neighbors, and to protect the environment. It also limits my food choices – when you’re vegan, you’re not burdened with a sort of decision overload with food.

The Results

I have gone from a 14-day average of 200 down to 160 in two weeks. I have more energy. I feel lighter. My moods are evening out. My sleep has improved. Can I attribute all of this to a plant-based lifestyle? Not quite sure yet because a lot has been going on lately and I’m only just starting to carve out my new routine.

Of course, I’m wondering as much as you are,“can I even pull this off?” There are scores of diabetic athletes, including members of Team Novo Nordisk, diabetic vegans such as Adrian Kiger and Melissa from Type1Vegan, and vegan athletes such as Rich Roll and Matt Frazier, the No Meat Athlete, but where are the diabetic vegan athletes? Those sound like unicorns.

Can I be that unicorn? Let’s find out.

Goal-Setting: My Ideal Body in Pictures and Numbers

In his book “Thinner, Leaner, Stronger,” Michael Matthews recommends setting tangible goals before you even pick up a weight, drop a calorie, or hop on a treadmill. I wholly agree.

I did not do this in the first few weeks because I was extremely motivated to get started and I didn’t want to plan myself out of execution, which is consistent with my rather cerebral tendencies.  But goal-setting is just as important as knowing your baseline, and now that I’ve had a few weeks to really reflect, I’m ready to articulate those goals.

In setting up your goals, Matthews recommends assessing (1) what your ideal body looks like; (2) what your ideal state of health would be like; and (3) why you’re doing this in the first place. Today, I will focus on my ideal body.

A Picture of my Ideal Body

Matthews recommends not just using mere words to describe your ideal body, but pictures. So I found a few. Here is my favorite:
Fit Chick 1What a fox! She embodies a lot of qualities I am looking for: Strong, good lines, lean… but NOT “skinny fat.” I’ve been around this size before, so I’m confident this is an attainable goal (with time and effort). I want a body indicative of a healthy, happy lifestyle, in which I’m not engaging in negativity or self-punishment.

And most importantly, I want my thighs to still touch:

Fit Chick ThighsThe Thigh Gap is not welcome in this house.*

My Ideal Body in Numbers

I finally got my body fat percentage tested at 24-Hour Fitness, by Corey, my new trainer. Sadly, it’s at a whopping 35%. With a body weight of 150 lbs, this translates into 97.5 lbs of muscle, and 52.5 lbs of fat!

I’m carrying a spry tween’s worth of weight on my thighs, hips, ass, arms, and belly. YUCK. No wonder I’ve been feeling like crap.

My ultimate goal is to weigh approximately 135 lbs and have 20% body fat, which means I need to lose 25.5 lbs of fat and gain 10.5 lbs of muscle. I’m not ignorant to the fact that this is a fairly significant “body recomp,” so I set a first milestone to weigh approximately 140 lbs and have 25% body fat. Corey estimated that at a healthy rate of losing 2% of body fat each month, I can reach this goal in five months.

((whimper)) …wish me luck!

*I have A LOT of opinions on this Thigh Gap and Thinspo garbage circulating the internet and infiltrating the minds of young women out there. Stay tuned for more information on this dubious subject, and the all-out war to follow. It’s on, bitches.  

Sunday Stats: Week of March 16, 2014

Sunday, Bloody Sunday…. self-disclosure time!
Loudspeaker

There is a lot of anecdotal evidence showing that people who track their fitness see more progress, likely because they know how they measure up against their goals. Now that I am starting to develop a fairly regular health and fitness routine, I’ll be publishing my stats every Sunday to track my progress. They’ll be pretty basic to start – weight and BG stats for now. Next week, I’ll start tracking the inches ((shudder)) and RHR. Also, I’ll be posting about my goals in the near future…

I have a quarterly appointment with my endocrinologist in April, after which I’ll publish many of the same stats I posted in my Baseline Assessment. I would loooovvveee to see my a1c below 7. Fingers crossed.

WEIGHT: 152 ((sigh))

DIABETIC STATS:
     7-day BG average: 181
     14-day BG average: 190
     30-day BG average: 216

     Before Meal 7-day average: 131
     Before Meal 14-day average: 146
     Before Meal 30-day average: 178

     After Meal 7-day average: 241
     After Meal 14-day average: 254
     After Meal 30-day average: 282

     Lowest BG of the week: 40
     Highest BG of the week: 344

THOUGHTS
I’m liking the overall downward trend of my diabetic stats, particularly my pre-meal BGs. I’m down 15 points for my baseline 7-day average of 196. Unfortunately, this was the only stat I took down from my meter to establish my baseline – I’m excited to see what my 14-day and 30-day averages are going to look like next week!

I clearly need some improvement in the After Meal category, as this seems to be the major source of my high BGs. This could be an issue with carb-counting, my carb-to-unit ratio (currently 1 unit of insulin for every 12 grams of carbohydrates), or a little of both. I suspect the most likely culprit is carb counting. It is not even remotely an exact science, and I am in need of a major refresher. Luckily, my endocrinologist referred me to Kaiser Permanente’s nutrition department, and I will be setting up an appointment soon.

Nota bene: A lot of my lows are going unreported. When I was without health care, I had to severely cut back on my blood sugar testing to conserve test strips, so I was taught not to test for lows because I don’t need a meter to know when I’m low (hot neck, cranky, sweaty, disoriented, HANGRY).

hangry_banner_sm

I will be getting in the habit of testing for lows to show that trend to both my readers and my endocrinologist. While we’re on the topic of evil, evil lows, I’ve been having at least one hypo a day for the past four or five days, and I am not a fan of this trend. Lows feel like shit on a stick.

Anything else you guys think I should be tracking on a weekly basis? Chime in and leave a comment!

Photo Credits: ideasmile and http://efficientawesomeness.com/

Assessment: The Body Mass Index Revisited

In my inaugural post detailing my general health statistics, I made a short mention that the Body Mass Index is widely criticized as a flawed measurement and that it should not be the sole determinant of whether you are overweight.  For my own education and others, I’ve decided the explore the issue a little further. 

What is BMI?

The National Institute of Health (NIH) defines the Body Mass Index, or BMI, as a “measure of body fat based on height and weight that applies to adult men and women.”  The Index was derived in the 1830’s from a math formula conceived by Lambert Adolphe Jacques Quetelet, a Belgian astronomer, statistician, and sociologist.  Not a physiologist, nor kinesthetics guru… nope, a stars and numbers guy.

The formula is:  BMI = mass(lbs)/height(inches)2 x 703.  This formula yields a number that corresponds to the following categories: Underweight (Below 18.5), Normal (18.5 – 24.9), Overweight (25.0 – 29.9), and Obesity (30+).

Limitations of BMI

Nick Trefethen of Oxford University states that because the human body doesn’t scale equally as it grows, the current BMI formula only leads to confusion and misinformation. The height of short people is divided by the weight too much, and is divided by too little for tall people.  The result is that short people are being told they are thinner than they actually are, and tall people are fatter than they actually are.  Is this a boon for us miniature folks?  I don’t think so, there’s more…

NIH identifies two further limitations of the BMI:  First, it overestimates body fat in athletes and others who have a muscular build, and second, it underestimates body fat in older persons and others who have lost muscle. In other words, it does not consider the dimension and tissue composition of the individual.  Furthermore, many critics point out that BMI does not differentiate between gender, which is of note because women generally carry more body fat.

One size fits all. 

Based on the conventional BMI formula, two individuals of the same height, but with different dimensions and body density, could have comparable BMIs.  This sends the message that if you are X feet tall, you must be Y weight, no exceptions.  Yet, muscle weighs more than fatty tissue, and studies have shown that a greater proportion of muscle tissue to fat tissue improves your quality of life.

At-Home Alternatives to the BMI

Body Adiposity Index (BAI).  
This measure, created by Richard Bergman of the University of Southern California, calculates body fat using hip circumference and height, without the disadvantage of requiring a scale.  However, studies have concluded that this measurement no more accurate than the BMI, particularly among clinically severe obese women.

Waist Circumference Measurement.
NIH regards waist circumference as a particularly useful measurement for individuals who are categorized as normal or overweight on the BMI scale.  Furthermore, it is an independent prediction of health risks, such as type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease.  It should be noted that while waist circumference is optimal for predicting risk with the elderly, there are variations in predictability between ethnic and age groups. Generally, you are at high risk if your true waist is measured over 40 inches for men, and 35 inches for women.

Waist-to-Hip Ratio.
Similar to Waist Circumference, this measure is also great for predicting health risks, in addition to body fat. To calculate your ratio, use a tape measure to take a reading from both your natural waist line and the widest part of your hips, then divide the diameter of your waist by your hip measurement. If you measure below 0.95 for men, and 0.80 for women, you are considered low risk.

Body Fat Measuring.
If you have access to calipers, this measure is calculated by taking measurements from the waist, shoulder blade, biceps, and triceps.  Those measurements are added up to a single figure, plotted against a chart that takes your sex, age, and measurement into consideration to calculate a percentage.

The New BMI.
To account for the three-dimensional aspects of humans (errr, everything…), Trefethen came up with a “New BMI.”  A colleague came up with a simple New BMI Calculator here.

Et tu, Little Furr? 

As previously mentioned, I am almost 5 feet 4 inches tall, weigh approximately 150 lbs, with a waist and hips of 32 inches and 42 inches, respectively. So am I actually overweight as my BMI suggests, or a victim of bad math?

BAI:  33.3% – slightly overweight, similar to my BMI.
Waist Circumference:  32 inches > 35 inches – not overweight and not at risk.
Waist-to-Hip:  0.76 – regarded to be within a healthy range.
Body Fat %:  No calipers yet. Will update when they are in my possession and I’ve pinched myself.
New BMI:  This calculator compares my traditional BMI of 25.75 with a New BMI of 26.25.  Slightly more fat (harrumph).  It then states that my appropriate weight range is between 105.7 and 142.8 lbs.

My Take-away:  As you can see, my respective measurements plot me as normal to slightly overweight, but with low health risk.  While these calculators are good for getting a rough idea of where I stand, I recognize their limitations, particularly as I am on the cusp of many of the categories.  My goal moving forward will be to re-measure in three months, with a desire to get off the cusp.  I believe I sit squarely in the weight-loss goal category of most Americans – trying to lose that last chunk of weight.  As I previously stated, my specific goal is peak performance, even as a type-1 diabetic.   

And to try not to “lose that butt”: 

Sir Mix Alot

Assessment: Establishing My Baseline

“You can’t know where you’re going until you know where you’ve been….”  ~ Someone Marginally Intelligent 

Thus, I commence my journey back into being an athlete.

But, before I set my fitness and health goals, I think it’s important to establish a baseline for both health and fitness. This is the health portion of that assessment.  As I learn more about what it means to truly self-assess (read: not beat up on myself), I will incorporate more information (for example, a postural assessment).

Without further ado and in my science-y style, I give you my deplorable health stats:

General Physical Stats:
Overall Weight: ~150 lbs. ((sigh))
Height: 5 feet 3.75 inches
Body Mass Index: 25.7*

*Thoughts: Many people believe that BMI is a flawed measurement.  For example it does not account for the relative density of individuals with differing percentages of fat and lean tissue. I tend to agree. According to the BMI, I am technically overweight. I am not – I am a short woman with dense, muscular legs (for the record, I am a size 6, considered to be pretty average).  That being said, Furr.is.out.of.shape.  But Furr will win. 

Measurements:
Bust:  35.5 inches
Waist:  32 inches
Hips:  42 inches
Thighs:  25 inches ((thunder clap))
Arms:  12 inches

Thoughts: Nothing to see here, folks, move along ((thunder clap)).  I will be taking a “before” picture of myself – this is essentially that “before” on paper, so that I may track my progress in terms of shrinkage, of which I don’t plan on doing much of.  However, I will not be posting such a picture until I have made some visible progress, for insecurity’s sake. 

Aerobic Stats:
Resting Heart Rate (RHR):  84 bpm (beats per minute)
Maximum Heart Rate (MHR):  (220-age) 190 bpm
Lower Range of HR (50%):  0.50(MHR – RHR) + RHR = 137 bpm
Upper Range of HR (85%):  0.85(MHR – RHR) + RHR = 174.1 bpm

Thoughts: I don’t know much about the meaning of these numbers quite yet.  It does appear that my RHR is higher than most.  I’m not sure if this is a good or a bad thing. 

Diabetic, Metabolic, and other Medical Stats:
Hemoglobin a1c:  9.3
Average Blood Glucose (BG) This Week:  196 
Highest BG:  432
Lowest Recorded BG:  68

Thoughts:  Plain and simple, these numbers SUCK.  

Thyroid:  3.12
Cholesterol:  207
HDL Cholesterol:  65
LDL Cholesterol:  144
Triglycerides:  85

Thoughts:  One of the few happy revelations that came out of my [first] endocrinologist appointment [in four years] is that it appears I do not need to be on thyroid medication.  Good times!  Otherwise, all of these levels are normal, but on the higher end of the range.  My goal will be to reduce them generally.  Interestingly enough, my triglycerides are closely connected with BG levels, so I hope to see a quick reduction there. 

There you have it.  My health on paper.  These should be updated quarterly, and I’m excited to see what my new lifestyle will do change these numbers for the positive.

Namaste, suckas.