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Category Archives: Diabetes

Categories Diabetes, Uncategorized

Case Study: Reversing Type 2 Diabetes

This is a synopsis of the journey of a 50 year old male client of The Balanced Nutritionist who presented with Type 2 Diabetes, hypertension and raised liver enzymes on July 5th 2019. This client wanted to release 25kg of body weight to return to a healthy weight range. In addition, he wanted to minimize his need for medication and better manage his conditions with nutrition and lifestyle. For privacy reasons, this client will be referred to simply as ‘D’ throughout this case study.

The purpose of this report is to draw attention to the power of individualized dietary interventions and professional support in the presence of chronic health conditions. Between the 5th of July and the 12th of October, D released 25kg of body weight, was taken off all diabetes medication (as directed by his GP), significantly lowered his blood pressure medication and improved his overall wellbeing. For the full journey, see below:

Initial consultation July 5th presenting concerns:

  • Type 2 Diabetes Mellitus, diagnosed more than 10 years ago. Oral medication (metformin) in use,. Most recent HbA1c* was 11.6
  • Blood pressure issues for close to 15 years.
  • Triglycerides were 3.2 on latest blood tests despite cholesterol medication.
  • Minor reflux
  • Occasional muscle cramping particularly in feet
  • Uncomfortable with current weight
  • Unable to exercise due to shoulder and hip issues
  • Energy not ideal particularly in the afternoon
  • Family history of blood pressure issues and diabetes type 2
  • Motivated to change nutrition and lifestyle to release weight and improve blood pressure and diabetes management.

Initial consultation July 5th Medications and stats:

  • Diabetic medication twice daily / blood pressure managed with 2 separate medications taken twice daily / cholesterol medication
  • Weight: 124.9kg / waist measurement 114cm

Initial consultation July 5th nutritional and lifestyle habits:

  • D was not a big drinker; a couple of nights per week
  • Rarely drank soft drink
  • Water intake was around 1L
  • Plenty of protein in the diet, but perhaps a little too much mindless snacking as a habit – this was most likely driving up blood sugar and making weight loss challenging.

Initial consultation July 5th Initial recommendations:

  • Advised to bring in some low impact exercise
  • Reduced size of breakfast and asked D to eliminate snacking altogether, focusing on just 3 quality meals
  • Increased hydration
  • D began logging BSLs* regularly
  • D began keeping a food diary which generally helps with more mindful eating by default

Second consultation 3rd August Medications and stats:

  • D had followed recommendations to a tee
  • BSLs had initially ranged from 8 to 11mmol/L in early July. By the middle of the month they were more often sitting between 5.5 and 7.5mmol/L (readings taken at various times through the day).
  • Diabetic mediation reduced and evening blood pressure medication reduced as directed by GP
  • Weight 118kg; a reduction of 6kg.
  • Waist circumference 110cm; a reduction of 4cm

Second consultation 3rd August Recommendations:

  • D embarked on structured Metabolic Balance® program*
  • Foods and quantities matched to D based on extensive blood work, medications, medical conditions and physical statistics.
  • GP aware and supportive of this dietary approach

Third consultation 23rd August Medications and stats:

  • Under direction of GP, metformin (oral diabetic medication) was stopped after 10 years of being mediated for diabetes.
  • Fasting BSLs consistently sitting between 4.8 and 5.
  • No issues with hypoglycaemia* although blood pressure dipping low at times hence further changes to blood pressure as per below
  • Evening BP medication no longer used (as directed by GP)
  • Weight reduced to and waist
  • Energy fairly consistent, rarely feeling hungry.
  • Hamstring pulled unfortunately so not much chance of introducing structured exercise into lifestyle at this point

Third consultation 23rd August Recommendations:

  • Continue with structured food plan, addition of more healthy fats
  • Keep consulting with GP and keep recording daily blood pressure to ensure medication adjusted accordingly to ensure no low blood pressure episodes.

Fourth consultation 14th September Medications and Stats:

  • Current medications consisting only of ½ dose of morning blood pressure pills plus cholesterol pill.
  • Still consistently releasing over 1kg of body weight a week, with minimal loss of lean body mass*
  • Had introduced a few meals off the plan and noted a fast response to ‘white carbs’ i.e. white rice – a good lesson to learn moving forward*

Fourth consultation 14th September Recommendations:

  • Advised to start trialling some foods outside of original plan and monitor blood sugar response particularly to other low GI carbohydrates
  • Avoid ‘white’ cabohydrates and high wheat carbs at all costs due to effect on BSL
  • Prescribed multi mineral formula to support nutrient status whilst still releasing weight

Fifth consultation 12th October Medications and stats:

  • Current weight is 100kg, and according to VLA, body fat is now ideal for frame size. An overall loss of 25kg.
  • Waist measurement down to 97cm*, an overall reduction of 17cm.
  • D wanting to discuss remaining BP medication and cholesterol medication with GP

Fifth consultation 12th October Recommendations

  • Relaxing some aspects of the program with a view of maintain wellbeing and blood sugar readings. Review again in 6 weeks.
  • Bring in some exercise with a view for this to become habitual once received the all clear on injuries.

This synopsis of D’s journey so far has been written based on the CARE case report guidelines to ensure the synopsis is as objective as possible. This summary was prepared in consultation with clinical notes taken during consultations. D has read this report in full and confirms it’s accuracy as well as providing consent for it to be published.

The take home points for the reader of this case study include:

  • Comprehensive and individualised nutritional prescriptions are a truly powerful solution to chronic and debilitating health conditions
  • Food groups don’t necessarily have to be excluded. Exclusions of any whole foods should be based on an individual’s reaction to them – not on a societal level.
  • Professional advice and support is critical particularly where medical conditions and medications are involved. D benefited from the support of Katie King, nutritionist as well as his General Practitioner to monitor his medications closely.
  • This is not individualised advice. Consult a professional if you want results like this.
  • These results are proportionate to effort. We can guide, support and advice but ultimately D had the right mindset to make changes to his nutrition and he deserves these results.

*The term ‘diabetes reversal’ is used in medical literature and the exact criteria for reversal is still debated. However, according to the World Health Organisation, most agree that a HbA1c under the diabetic threshold of 6.5% without the use of medication does qualify. More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/

*HbA1c: a test which gives an average of the previous 2-3 months blood sugar results)

*The specific instructions given to this client have been deliberately excluded from this case study as they suited this particular person. The same interventions applied to someone else may not have the same outcome. For safe and effective results, you should work with a suitably qualified practitioner. Book your consultation here.

*BSLs: blood sugar levels

*Metabolic Balance® program is a German medical program that we have received extensive training in and offer at The Balanced Nutritionist. The exact foods and quantities of foods ideal for a person (based on extensive blood work, medications, medical conditions and physical statistics) are prescribed to a person and a structured program follows. Meals are clean, but balanced. Each meal contains protein and fibre rich vegetables as well as fruits and even starch are generally included in a Metabolic Balance® program.

*Hypoglyaemia: low blood sugar (to the extent that it may lead to disturbing symptoms like dizziness, feeling faint, weak or shaky.)

*Lean body mass: the difference between total body weight and fat mass; ideally you always want to preserve lean body mass as it accounts for muscle mass.

*VLA: a scientifically validated test we use in clinic to accurately monitor changes in body fat, lean body mass, hydration and cellular health.

*White carbs: please note that each diabetic is unique. Some, for example may respond fine to fruit others may find it spikes blood sugar. Part of the journey of any diabetic who wants to manage their condition as best as they can through diet, is discovery which foods are most problematic for them. They should then be avoided at all costs.

*Waist measurement: according to the World Health Organisation and the Australian Heart Foundation (https://www.heartfoundation.org.au/your-heart/know-your-risks/healthy-weight/waist-measurement) , a waist measurement is an important measurement of overall risk of chronic disease, particularly cardiovascular disease. Men should strive for a waist measurement below 94cm and women under 80cm.

 

Categories Diabetes

2017: Reversing Australia’s Health Crisis

Happy New Year

And welcome to 2017.
I spent the holiday period decompressing and considering my pathway forward for 2017. Over the break, I was overwhelmed by the sheer volume of conflicting nutritional advice that popped up on my social media feed from others in the health industry ranging from personal trainers, weekender nutritionists and right through to PhD qualified industry leaders. If it was overwhelming for me, then I can only imagine what it’s like for the everyday person. In addition, the myriad of beautiful yet insanely complicated (not to mention expensive) recipes that pop up on Instagram these days…. Seriously. If it takes longer than 20 minutes in the kitchen (and it can’t be prepared in bulk), quite frankly, I’m really not interested. Plus bee pollen in smoothies, blue green algae, ‘detoxifying’ charcoal…. Hmmm, funky ingredients aren’t going to solve the global health crisis.

In order to get clear, I had to revisit my values and look where I was really needed to ascertain exactly where I am going to focus my energy this year. This is what I decided…..

We’re inaccessible.

The first thing that bothers me is that CAM (complementary medicine – the umbrella that I as a nutritional medicine practitioner falls under) is inaccessible. We might qualify for private health rebates, but Medicare doesn’t recognize us. Perhaps 2% of the population may book in to see a privately billed health practitioner when really, the other 98% need us far more.

Treatment and advice still needs to be individualized, so the face to face model is still important. Last year, I bought a clinic in Carindale where we also offer acupuncture, naturopathy, counselling kinesiology and massage. In order to reach more people who truly need us, we have come up with the concept of shared care consultations. Read more about that here.

N.B. 1 on 1 consultations still available, this is simply an additional service.

Chronic Disease

I’ll be shifting my focus more to chronic disease this year because the current epidemic isn’t acceptable. In particular, I’ll be focusing more on type 1 and type 2 Diabetes. Almost 2 million Australians are now living with diabetes and yet it’s a condition where diet is the single most effective management tool. Yet, diabetics aren’t getting the information that they need to stop the progression of their condition or reverse it. I’ll be tackling type 2 diabetes in a series of shared care consultations, face to face at my Carindale clinic beginning in February. You can read more about that here. Phone me (07 3398 1977) or email me to enquire / enrol.

Athletes

I haven’t forgotten about you guys, but again I’ll be offering additional options for consulting. I’ll have a series of small group consultations launching in the next 6 weeks aimed at answering these questions and more:

-what you should be eating on a daily basis for recovery, performance, longevity
-how to fuel to prevent running out of gas
-what sports nutrition products are good and when to consider supplementation

No dates are finalized at this point, but if you are after the facts delivered to you simplistically so you can implement this stuff right away, then let me know you are interested please by contacting me here. I’m taking 5 people at a time – no more. (1 on 1 still available).

No Fluff

In line with my values, I’ll be continuing to deliver the facts based on evidence, research and what gets results in a clinical setting.
Nutrition, lifestyle and complementary medicine can make a massively positive difference in the world, but the fluffy stuff isn’t really cutting it. In addition, you can forget about finding the perfect diet or that magic supplement to solve everyone’s ailments – we are all individuals, and many people now have serious health complications so the one size fits all model just isn’t going to work.
I look forward to working with more people in 2017 who are prepared to put the work in alongside me to restore health and start living.
Catch you on Facebook or here in a fortnight.

Categories Diabetes, SPORT NUTRITION

Jason’s Story-Type 1 Diabetic Marathon Runner

“The key to living with Diabetes lies in taking responsibility, owning the condition and being accountable. It’s not about blame and it’s not about excuses. It’s not something outside of your own body. You have to own it and be proud of it. Embrace it and live it. Diabetes is a reason to be healthy and fit; it’s a motivation not an excuse.” (Jason Lonergan)

Jason
Jason (right) during Noosa Half Marathon (24.5.2015)

This is the story of Jason. Husband, soon to be Father, 3 hour marathon runner and type 1 Diabetic. Jason came to see me about 2 months ago to fine tune his nutrition and his story is so exceptional I asked if I could share it with the world.

Let’s start at the beginning. Jason was not diagnosed until the age of 21, (1992) but his 2 brothers and Mother were diabetics so he was all too familiar with the condition. Growing up, Jason said his family would focus on eating 6 meals per day, all centred around carbohydrates, as instructed. His brothers and mother would eat a set portion of carbohydrates per meal and inject insulin accordingly. The main dietary advice outside of the standard dietary recommendations, was to avoid all sugar and sweets unless treating a low, in which case bread and honey with an iced coffee or cake were generally used. There was no preventative advice offered to Jason because 3 out of 5 members of the immediate family already had the condition and so Jason was deemed unlikely to develop it based on statistics.

Prior to diagnoses, Jason went off to boarding school and distinctly remembers eating a lot of filler foods like white bread with every meal and copious amounts of dairy. His school life was extremely active both mentally and physically, playing every sport known to man and doing well in class. In his early 20s, the habits of a typical bachelor began to set in. Although still very active, something was creeping up on him without his knowing. A weeklong skiing trip with mates turned into an unforgettable occasion for all the wrong reasons. By the end of the week, some tell-tale symptoms had set in including unquenchable thirst, the constant desire to pee, hunger and over the proceeding weeks, blurred vision, a mottle coloured tongue. After a few weeks of this, the penny dropped and Jason suspected diabetes. Unlike many people, Jason understood diabetes and the symptoms, which was lucky. Jason tested his own blood sugar levels using his Mum’s monitor and sure enough the levels were sky high (24mmol/ml). After a phone call to the family’s Endocrinologist Jason had his first shot of insulin, which has been an undeniable part of his life ever since. There was no face to face appointment at this time; simply a verbal diagnosis of type 1 Diabetes and a prescription for insulin.  The family Endocrinologist knew that Jason was in good hands with his Mum. An appointment was arranged a few weeks later and a trial of high carbohydrates with moderate insulin dosage was established. Jason was informed to stay safe and run the BG levels towards the higher spectrum of 8-12mmol/L without concern until he settled into a pattern and learnt how his body reacted to the so many facets of diabetes control. Jason says that everyone is different and all diabetics need to take their own initiative in understanding what works and doesn’t work for them.

Over the following years, Jason continued in much the same fashion. He followed what would have been considered a fairly healthy diet; low in fat, moderate protein and carbohydrates from wholegrains, dairy, fruits and cereals. The whole theme was focused on eating carbohydrates. ‘That’s what we counted at every meal’, Jason says. He felt healthy, looked healthy and was happy. There was never any suggestion to learn more about diabetes, there was no cure and treatment processes were slowly getting more efficient and mobile. That was about it. Just keep on doing what you’re doing is what Jason heard time and time again.

Early in his years of being a diabetic, Jason consulted a diabetes dietician to learn more about the disease and how to manage it better. He was given a basic explanation of what diabetes was and how a diabetic must eat carbohydrates and manage BG levels with injecting insulin. Most importantly avoid quick acting carbs like sugars etc. Recommendations were made to consume diet soft drinks or artificially sweetened foods to compliment the every day diet that was and still is the common way.  He was instructed to eat more carbohydrates before and after training to ‘top up’, keep his fat intake low and bolus with insulin accordingly for the carbohydrates on the plate. Besides ‘eat a slice of bread instead of a donut’ this was the extent of the nutrition advice Jason received and it didn’t help with diabetes management or his overall health. “Nutrition as I understand it now, was never suggested’, says Jason. At this point, his HbA1c* was sitting around 7.5 to 7.8, which is quite good and often meant his advisors didn’t consider providing him with any further assistance, considering Jason as doing everything right. There were far more challenging patients to work with, they felt, so he was advised to just keep on doing what he was doing.

In 2010 Jason’s Endocrinologist reviewed his long term HbA1C results to discover a marker indicating Coeliac Disease. At this point, Jason was unaware this was even being tested and was shocked to see that his Endocrinologist had never mentioned it before. Apparently long-term diabetics are very susceptible to developing Coeliac’s Disease. “I didn’t even know what it was, let alone, that Diabetics are very susceptible”, says Jason.

After a biopsy Jason was officially diagnosed Coeliac. Jason was now challenged with not being allowed to eat glutinous foods such as bread, pasta, cereals, and many, many other foods that contain gluten. Jason had NO SYMPTOMS, no noticeable irritable bowl, lack of energy, foggy brain, bloating or any noticeable deficiencies. But capturing this disease early meant that it was manageable and not health threatening. As long as all gluten was never consumed, Jason could live as well as he had been. “The question is, why wasn’t this ever mentioned before, why was I never told to reduce gluten and manage my diet to protect from developing this disease, when there is a known link between diabetes and coeliac disease?” There were no dietary recommendations given, except contact the Australian Coeliac Society and start learning from there. That’s it.

Jason was convinced that there was still a better way to manage diabetes, and now coeliac disease as well. So he took matters into his own hands. He consulted an open minded dietician specialising in improved athletic performance including aspects such as muscle development, fat loss, eating the right forms of fat, protein and carbohydrates for athletes. This dietician encouraged more balanced meals; including good fats and protein and less starchy carbohydrates. Portion sizes were also reduced and over a period of 18 months, Jason became leaner, dropping 8kg of body fat and gaining 5kg of lean muscle. At 70kg, his body composition was spot on for running fast.  By this stage Jason had competed in many triathlons, half marathons and 3 full marathons. His times were getting faster and faster and it wasn’t because of his training alone. The diet was helping him.

Alongside the work Jason did with this dietician, he began looking for other sources of information to better manage his condition. He stumbled across The Wellness Guys podcast (episode 27 with Mark Sisson to be precise) and a whole new world of wellness opened up. The constant stream of free information available astounded Jason and he began to truly understand complex issues including cholesterol, the impact of saturated fats, the importance of sleep and food quality.  He had an ‘ah hah’ moment, saying to himself that “it’s all got to be simple, life has to be simple, eating has to be simple, it’s got to be about ‘just real food’ and nothing processed, nothing man made.” That clarity has stuck with Jason every since. This was the catalyst for more changes including a switch to mostly organic foods including grass fed meats, more animal fat sources, high quality dairy and fermented foods and a complete shift away from processed foods including cereals.

From a numbers perspective, Jason’s results continued to improve. He found that his blood sugars were more stable with less ‘high’ highs and ‘low’ lows. His HbA1c dropped to range between 6.7 & 7.0 and his blood cholesterol continued to improve; HDL increased and LDL came down. With each visit to his Endocrinologist, he would ask (and continues to ask) ‘what can I do better?’ And despite improving with each visit the answer is always the same; ‘I’m not sure Jason, you are doing everything you can. You are doing better than everyone else. Just keep doing it’. ‘Why, when my results are getting better and better and I’m telling my Endocrinologist that its my diet helping me achieve these amazing results, that my Endocrinologist glazes over and is stumped as to what to say or do?’, asks Jason. ‘There’s no connection between nutrition and better health or better diabetes management it seems….but why?’

The next big ‘ah hah’ moment was when Jason began to consider fat as a potential fuel source for his running, instead of glucose. It made sense from a diabetic perspective and he began experimenting. In 2013 he ran a marathon on nothing but 4 salt tablets and water, finishing in 3 hours 8 minutes. His pre-race fuel was a combination of macadamia butter on Gluten Free toast plus a little salt. His blood glucose reading at the start of the race was the same at the end (around 5.7mmol/L). In 2014 Jason completed another marathon in 3 hours, 1 minute. This time Jason prepared his own gels to fuel himself during the race. His homemade gels were made of real foods like chia seeds, coconut milk and oil, blueberries, salt and a small amount of banana. This is when the idea of fuelling with fat was tested and Jason felt it was working. Jason began working with me in April 2015 and we are refining an LCHF nutrition approach (low carbohydrate high fat) to keep him well fuelled for his exercise and reduce his dependency on insulin. Last week, he ran a total of 100km and did 4 yoga classes. His longest run was 32.5km which he did using water alone. Here are Jason’s comments below:

“This was a big week running wise. In the past month I’ve increased my weekly Km dramatically from 50-55km to 70km up to 82km to 94km to 101km this week. I ran on Sat with very little fatigue and finished the last 8km at my marathon race pace of 4min 5sec to 4min 10sec/km and felt I could have kept running once finished. I felt no hunger, no weakness and still plenty of energy when completed. I tested by BG straight afterward at 7.8mmol/L, it was excellent. I had a simple coffee before another 1hr 15min of YOGA. I have not had as much energy in Yoga for a long time. I was more focused, more in tuned with the movements and held my positions with much better form than I feel I have done in the past few weeks. When I was finished I was not hungry but was looking forward to having something to eat. I had plenty of energy still and felt very clear minded with no soreness in the legs which I usually do after a long run. Particularly in the achilles tendon area. I spent the rest of the day on my feet at the shops and only felt tired from about 3pm onwards.”

Jason’s energy, vitality, mental clarity and running performance have been exceptional for some time and they only seem to improve with each step forward. With the recent tweaks to his diet, he feels calm and confident and well satiated. He hopes to further reduce inflammation, training stress, and his dependency on insulin. We hope that his HbA1c will continue to come down. Still hungry for more knowledge, this month Jason is really focusing on his gut health, aware that a healthy gut is imperative for wellness on all levels. Homemade kefir and sugar free kombuchi are on the brew as are sauerkraut and kimchi.

Jason said he cried when he was first diagnosed, back in 1992, but that was the only time he felt down about being Diabetic. The shock was overwhelming at first as he thought he was eating well, based on the standard diet recommendations, he was active in both work and sports, his weight was excellent and he had a healthy outlook. But ever since then, he has embraced his condition, using it to stoke the fire of desire to be as healthy and as fit as he possibly can be. Jason says some of his piers will comment that he is a little fitness fanatic and that they couldn’t do what he does. Jason simply says with a smile, that he has to, because he is a diabetic.  So rather than use his condition as an excuse to not get out there and do extraordinary things, he uses it as a reason! “That usually shuts them up. But in truth, I do it because I want to live for a very long time. Not only that, I want to live very well for a very long time. There’s too much good out there to miss by being sick and guided into early aging by ignoring the real benefits of eating, exercising, and living intelligently. Everyone can do it, it’s a choice we all have.”

He is disappointed that the information he has learnt in recent years wasn’t offered to him much earlier.  He’s had to find the information himself; no medical expert has ever mentioned that diet or nutrition can help you live well. Like so many of us, he wonders why nutrition and lifestyle are not an integral part of diabetes management. Diabetes is a condition directly affected by the food one eats… and yet a conversation about diet is often overlooked. Furthermore, why is carbohydrate reduction looked on with disdain by so many health professionals, when diabetics are incapable of processing carbohydrates effectively? These are some of the questions that we need to address and implement subsequent changes to achieve effective management of this condition. Managing diabetes is not about the foreseeable development of Coeliac Disease, amputating limbs or laser eye surgery; rather, these are the consequences that we can collectively work together to avoid in the first place.

Please know that this article is intended to inspire you as the reader and open your mind to some new possibilities.  This is not individual medical advice and you should always consult qualified health professionals before changing your diet, lifestyle or medications. This is not intended as a dig at modern medicine on any level; insulin is a lifesaver for diabetics and in some cases, so is surgery. However, it is time to acknowledge that diet and lifestyle education must become an integral part of the health care system. The management of chronic diseases, Diabetes and beyond, will benefit enormously and people’s quality of life can be improved immeasurably. Whether you are a Diabetic yourself or not, there is no doubt that Jason’s story is inspiring and I am sure you join me in thanking him for sharing it with us. As Jason has attested, knowledge is empowerment and will enable you to do some extraordinary things if you see opportunities as opposed to obstacles in your path.

*HbA1c levels are not influenced by daily fluctuations of blood sugar levels; they reflect the average glucose levels over the prior six to eight weeks and as such they are a key measurement for diabetics. Complications are lessened if HbA1c is below 7 and normal is considered to be below 6.

Categories Diabetes, SPORT NUTRITION, SUGAR

Metabolic Efficiency For Athletes… A New World, An Endless Fuel Supply…

My last article ‘I ran a Marathon on a Coffee Bean’ sparked quite a lot of interest. My approach is not exactly conventional and the article was absent of many key concepts in traditional sports nutrition namely carb loading, gels and that magic number of ‘grams per hour.’ In fact, if we have a closer look at the current conventional recommendations listed here, my suggested daily carbohydrate intake is 360g per day. I was interested to see what these recommendations would actually equate to on a plate.  Firstly, I established that in order to meet these kinds of numbers, I would have to include what I refer to as ‘dirty carbohydrates’ from cereals, highly refined grains, low fat dairy, sugary yoghurts and the dreaded sports drinks.

This is what it could look like:

Breakfast: 1 and a half serves of Nutri Grain (40.5g) with 1 and a half cups of low fat milk (20g). Total carbs=60.5 grams

Snack: Smoothie consisting of 1 and a half bananas (34g) plus a cup of low fat milk (12g) plus a tub of low fat yoghurt (25g) and some protein powder. Total carbs =71 grams

Lunch: 1 sandwich with 2 slices of bread (35g) plus an orange (12g). Total = 47gcarbs!

Afternoon snack: 4 x Rice cakes (30g) with nut butter. Total carbs = 30g

Post training drink: Gatorade (30g). Total carbs = 30g

Dinner: ½ a cup of cooked rice (30g) with 2 potatoes (34g) plus meat and other vegetables (negligible). Total carbs = 64g

Supper: Milo 1 serving (12g) with 1 cup of milk (12g). Total carbs = 24g

Daily total of carbs = 326.5 grams (please note that this is for example purposes only and the numbers listed are averages of major brands).

I still haven’t quite hit my daily quota but I am sure you get the idea. I’m honestly convinced that if I followed these kinds of recommendations for just a few short weeks, my fairly consistent 60kg would soon be approaching 70kg and so on. Not to mention the belly bloat from this much wheat and gluten. In addition to daily carbohydrate recommendations, traditional sports nutrition indicates that during an endurance event, I may require up to 90g of carbohydrates per hour. So hang on, whilst I’m out there, pumping blood around my body in order for my legs and arms to carry me to the finish as fast as possible, I am supposed to EAT?

I find this advice difficult to swallow… pardon the pun. Here are just 3 major reasons why I don’t agree with these recommendations:

  • Firstly: In order to come anywhere close to the recommended daily carbohydrate intake, you must include a lot of highly refined carbohydrates from heavily processed foods. These sources tend to be high in gluten, additives, preservatives, artificial flavours, colours, sugar and unfermented processed soy. Every single one of these ingredients is inflammatory to the body, damaging to the gut lining and may inhibit the immune system. Furthermore, I really can’t imagine having much room leftover for essential fats and proteins if I am required to ingest this many carbohydrates.
  • Secondly: When carbohydrates are the primary component of every meal, blood sugar and insulin levels rise and fall like a rollercoaster ride. The constant need for these insulin surges; meal after meal, day after day, year after year; may lead to insulin resistance down the track. This is the pathway to other far more serious conditions including metabolic syndrome, type 2 diabetes and obesity. Yes, even athletes develop these conditions.
  • Finally: when we exercise, our heart works harder to pump blood to the extremities of the body, including the muscles which require nutrients and oxygen in greater amounts. The blood vessels to these outer extremities actually dilate whilst the vessels around the stomach and kidney become narrower. This makes the whole process of digestion extremely difficult. Last time you had an energy gel or a snack during an event…. How did it go down? Did it hesitate half way? Feel like it might come back up again? Is it any wonder?

met_inefficiencyOverall, we know that running a marathon, or doing a triathlon or any type of athletic event is physically stressful – the very process causes a great deal of inflammation within the body. So why then do we turn to copious amounts of highly refined foods that further exacerbate these responses?

Well, traditional sports dietetics is built on the premise that we use glucose (sugar) as energy. Specifically, we use up the glucose that is stored as glycogen in the muscles and liver during endurance events. There is approximately 2500 calories worth of energy stored in the form of glycogen within our bodies and this is our ‘gas tank’ if you like during sporting events. The whole premise of ingesting carbohydrate as you move is to prevent the tank from running out of gas, otherwise known as bonking. But 2500 calories isn’t going to get you that far. Whilst we all burn calories at slightly different rates, a 70kg man running at 10km / hour will use up approximately 800 calories per hour. Do the math and this means that he’s got just over 3 hours of fuel in the tank…. Or 30km. Ever seen someone hit the wall in a marathon at 30km? I bet you have…. it’s an all too familiar state of affairs. And unless you have an iron gut chances are you aren’t going to keep up with your own refuelling requirements so there’s a high chance you’re going to bonkville too.

Good news – there’s an alternative. See, what we have been ignoring for such a very long time is that in addition to those 2500 calories of stored glycogen, we have another pretty nifty tool in (or around if you like!) our belt – literally –I am referring to stored body fat. And seriously, who is going to say no to burning off a bit of body fat during an endurance event? Not me. The cool thing is that even a lean athlete will have at least 100,000 calories worth of energy available within stored fat sources and we are able to train our bodies to tap into these reserves. It’s that simple!  Yes… THIS is what all the fuss is about!

fat v carbs for fuellingImagine the potential for athletes who have a continuous fuel source at their disposal? There are lots of athletes out there who are experiencing the benefits; Bevan McKinnon, Sami Inkinen, Bruce Fordyce, Jon Olsen, Zach Bitter and Karyn Hoffman are some of the big names living, breathing and succeeding with this method. But I believe that it is so much more than just performance. I believe that this approach is essential for athletic longevity. It promotes the inclusion of foods in their most unrefined state, with moderate amounts of protein and nourishing anti-inflammatory fats; both of which are essential for hormones, cells and life in general. Interestingly, these ‘real’ food sources are also the richest in nutrients including vitamins, minerals, antioxidants and phytonutrients. As athletes it is absolutely imperative that we are getting an abundance of good nutrition to promote fast recovery, support our immune systems and dampen down inflammation within the body.

Contrary to what critics may say, fat adaptation for athletes does not necessarily severely restrict carbohydrate intake. For some, nutritional ketosis may be worthwhile considering (more on that later, but this needs to be under the guidance of a qualified health practitioner), but for most people, fat adaptation is about retraining the body so that it becomes more metabolically efficient. In order to explain this effectively, let’s consider the Respiratory Quotient; a method of testing how much energy is coming from carbohydrates and how much is coming from fat, during an exercise session. An athlete with an RQ of 1.0 is solely relying on carbohydrates during exercise, whilst an athlete with an RQ of 0.7 is burning fat exclusively. Obviously intensity of output does play a part here, but can you see the benefits of sitting closer to the 0.7 score as opposed to 1.0 on this scale? An athlete who is able to tap into some of his or her existing fat stores is going to be capable of a higher output for a longer amount of time with less fuel. This is a win / win in my book. Achieving optimal metabolic efficiency for your own sport and your own individual body may make you ‘bonk proof’ and means that your nutrition is no longer left to chance.Tim Olsen

In addition, fat adapted athletes tend to experience advantageous body composition changes and may experience better recovery as a real food diet has superior nutrient density. The information in this article is just the beginning and serves as an introduction to fat adaption or metabolic efficiency for athletes. This is not a blanket approach to nutrition, it is simply a template. Just to reiterate, the absolute foundation of this approach is real food, as unrefined as possible. Once you switch to a real food diet, your carbohydrate intake will automatically lower and your fat intake will increase because this is how real food is designed… for a reason. Beyond that, there are many other concepts for you to consider such as the ‘train low, race high’ approach, nutritional ketosis, electrolytes and fluids and fasted training for adaptation. Start your research and see what you find. There is nothing scary about this approach to sports nutrition… unless you think throwing out the Nutri Grain and Ski D’Lite sugar laden yoghurt is a bad thing. Have you seen what I eat on my Instagram account? I’d take that food over processed, packaged stuff any day of the week.

This article is a thought provoker – I am prodding your mind and asking you to consider another way. If you want some more assistance you can Work with Me here. I can show you how simple real food living truly is.

Good luck on your quest for life long athletic longevity and your journey to bonk proof :).

Sami Inkinen
Sami Inkinen and his wife rowed from California to Hawaii in record time to raise awareness in the fight against excess sugar. Their quest was called the Fat Chance Row, and needless to say they are fat adapted athletes. Read about it here: http://www.fatchancerow.org/
Categories Diabetes, SPORT NUTRITION, SUGAR

I Ran My First Marathon… On Nothing But A Single Coffee Bean!

Before you commence reading, I would like to remind you that this is not individual advice and my own body and yours are very different machines. Please enjoy this post and realise that if your current sports nutrition approach is not working, there are other ways to explore and I can work with you to develop an approach tailored to you.

So Sunday morning the 12th of April arrived in cold, crisp but beautiful Canberra; it was the morning of the 40th Canberra Marathon to be precise! Now, those of you who follow me on Facebook and Instagram know that it had been an epic week. My partner Carl had succeeded in completing the 2015 Anzac Ultra – a distance of 300km over tough terrain on the outskirts of the city. Running; yes that is 300km of running. I will write about his story soon, but this blog is all about me! So the week before, Carl had commenced running on Wednesday morning at 8am and completed the race at 2:51pm Saturday afternoon the 11th of April. Now, obviously I did not physically run the race with him, but mentally I was there all the way. I was his one and only crew member and if you have ever crewed for someone in an ultramarathon you will know how critical this role is. For that time, however long it take your runner to finish, you are there. 100%. You are the coach, the chef, the mindset master, the boss, the physio, the masseuse, mother, partner, teacher, counsellor, hugger. True success in an ultra really does depend on the dedication of both runner and crew and how well they understand eachother. So for 78 hours I was all of these things for Carl and while it was an epic experience I was… tired. To be diplomatic about it. I had slept a total of 11 hours over 5 days. I had showered twice in that time. And to add to this already disastrous marathon lead in, my longest training run in the preceeding 8 weeks had been a total of…. 18.5km. Hmmmm. For anyone who has run a marathon, this is not exactly textbook prep. Despite all of this, when I climbed out of bed on that fateful day I was quietly confident. I simply knew that I could do it. My aim was to come in around 4 hours 30 minutes and this is how the day rolled out:

marathon start....First I ate some breakfast. 2 eggs, scrambled with a bit of strong, hard cheese and some organic butter on a single piece of toast. Probably, if I had been home, I may have had the eggs with a side of spinach on a slice of vegie bread but what I had was fine. A good mix of anti-inflammatory fats (from the butter and eggs, rich in omega 3 and loads of other goodies), protein (also from the eggs, as well as the cheese) and some complex carbohydrates (dense toast). Let’s fast forward now to the race itself where I started slow (6:25am) and conservatively. I sat on about 6:15min/km and was hanging around with the 4:30 pacing crowd. This was a great group to be with and the pacer was Bruce Hargreaves aka Digger – a fearless leader in my own running group in Brisbane. I felt good…. great actually. I cruised the pace up a knotch around the 7km mark and rounded the 10km timing point about 4 minutes ahead of the 4:30 group. At this point, I had drunk a cup of water from 1 of the aid stations and that was it. My second 10km stint passed rather unremarkably. I remained on about 6:15km/hr and power walked up a couple of hills at the 15km mark and the 18km mark. I knew that power walking strongly up the hills would work well for me as a strategy – my couple of experiences doing trail ultraruns (including the North Face 50 and The Most Beautiful Thing in Borneo) had taught me this strategy. Just before the 20km mark I noticed that I was sweating… more than I thought I would to be honest, considering the cold. As I had consumed some more water from the aid stations I had my first cup (about 100ml) of Hydralyte at this point. I was really impressed that the electrolyte provided at the Canberra Marathon was hospital grade and sugar free…. if you don’t know my stance on sugar then you can read my article from a few weeks ago here. 

By the 25km mark I was feeling tired. Not physically (surprisingly) just mentally. I could have happily drifted off the road into a bush and gone to sleep. Exhaustion was setting in. But I had just the thing to help me along in my race belt…. 1 little dark chocolate coated coffee bean! I put that little morsel of magnesium and caffeine on my tongue and let it do its thing. I seemed to perk up a bit after that – it may have been a bit of a placebo affect, but hey it worked. For the next 8km I continued my strategy quite happily; walking up the few big hills in the course and steadily running the rest of it. The only difference I employed at this point was I stopped looking at my pace. I was no longer interested in sitting on a particular speed as I was well inside unknown territory by this point and my goal was to finish comfortably not to finish fast. I had my second cup of Hydralyte during this section of the course as well as some more water as my body indicated it wanted both.

Between 34km and 36km a couple of things happened. Firstly, the 4:30 group passed me, with Digger wishing me his best on the way. IMid runhad no problems with this – my current strategy was working and I was not losing energy, merely remaining conservative for the final 5. Secondly, my stomach felt a little queasy. Now, this did stress me for a moment as it has never happened to me before. I am certain I know why this occurred; it was my first time using Hydralyte for an electrolyte source. Violation of racing rule number 1: Don’t try anything new on race day! Had the lead in been different I certainly would have had my own electrolyte source but I couldn’t change that now. For about 600m I walked briskly, also looking for a bathroom. However, after this brief stint of slowing the pace, my stomach recovered quickly and I was able to continue on my steady jog, with another powerful lesson under my belt. The third thing that happened at this point was by far the most interesting, albeit it upsetting. I began to witness the infamous ‘marathon bonk’ unfolding around me. This is the point in the marathon where runners have used up their stored glycogen sources (around 2000 – 2500 calories) and they start hitting walls. Brick walls. Hard. It was nasty. Some people were struggling to even walk with one foot in front of another, I saw another throwing up off to the side of the race and quite a lot of people stopped around this point to stretch out some painful cramps. I passed many and offered words of encouragement which, understandably, were met with grunts. Whilst I felt a gut wrenching disappointment for the people suffering around me I was really celebrating my own metabolic efficiency. I realised that I really had nailed my nutrition strategy and my body was comfortably cruising along drawing fuel from its own existing fat sources. My energy was remaining steady and I was not contending with the glucose / insulin rollercoaster. Remember that to this point I had consumed 1 single dark chocolate coffee bean only.

By 38km I was on fire. I was inside the 5km to go and I was still feeling strong. This was the time to start picking things up. From 38.5km I ran steadily into the finish, walking only for a stretch of 100m on a final ascent into the ring road near the finish. In the last 600m, I picked up the pace to hit 5:30km/hr and ‘sprinted’ in to the finish – catching the runner in front of me (pictured). A good friend of mine, Sam was just ahead of me and it was great to see her smiling face just after I crossed that line. As I headed through the finishes shoot I collected another full cup of Hydralyte and some water.

sprint finish

Fast forward to 24 hours later and I climbed out of bed on Monday morning. Well, I am being completely honest here, although I know that many people won’t believe me. I felt fantastic. About the same feeling I have the day after a long training run (about 20km). A little stiff through the hamstrings, but the head was clear and I even felt mentally rested. The evening before I had taken some extra Omega 3 anti-inflammatory supplements as well as some high strength magnesium which would have aided this recovery. In addition, I was able to get through the marathon easily and avoid inflammatory fuel sources (sugars, soft drinks, gels) that so many runners rely on. My final time, by the way was 4 hours 39 minutes – not far off my ultimate goal on quite a hilly course. I honestly can’t wait to run my next race. And I can guarantee 1 thing…. from now on, every race I run, I will be sure to carry 1 lucky coffee bean with me along the way!

Disclosures:

  • As stated above, this is my story, my approach and my fuelling strategy that works for me. Your body is not the same as mine. Please do not attempt to run a marathon in exactly the same way as I did. Please consult a health professional if you would like to work out a specific fuelling strategy to suit your own requirements. I would love to help you. You can work with mehere.
  • Please note that I did have other fuel sources in my running belt as well. I was carrying some almonds and a Cliff bar (in case things got really nasty) in my belt.
  • Please do not try new things on race day….. I made this mistake and I could have paid a far bigger price.
  • Feel free to leave any positive comments below and share this story if you enjoyed it.

inspiration

Categories Diabetes, SUGAR, WEIGHT LOSS

Thriving With Diabetes

Meet Ray. According to the statistics listed on the Diabetes Australia website, Ray is 1 of the 960,000 Australians living with type 2 Diabetes. With over 280 Australians being diagnosed with diabetes every day, its no wonder its being labelled as an ‘out of control pandemic’ requiring urgent and immediate attention.

Ray was diagnosed over 10 years ago by his GP and was prescribed a mixture of medication to control his blood pressure, cholesterol and blood sugar levels. For the next few years, things generally remained stable; the symptoms were managed, but their were no real improvements to his overall health. About 3 years ago, it seemed that things were starting to deteriorate. Ray’s weight and blood pressure were gradually but steadily increasing and so were his blood sugar readings. A stern warning from his GP that a more sustainable approach was required, prompted Ray to take matters into his own hands and do something to really address the underlying cause of his conditions. The alternative was pretty grim; if his health did not improve then he would be become insulin dependent.

Over the next 6 months, we began addressing Ray’s diet and exercise habits. Remember that Type 2 diabetes is characterized by insulin resistance. In simple terms, this means the body can not control blood sugar levels and has major problems metabolizing glucose normally. Despite being directly related to diet, we don’t seem to focus on this aspect enough; many diabetics unfortunately don’t understand how to eat for their condition. The first switch was to a real food diet, with less starchy and sugary carbohydrates and some more protein and good fats to stabilize blood sugar levels. In addition, Ray began exercising consistently; walking every single day, sometimes up to 12km at a time. 6 months on, back in his GP’s office, he was bar  ely recognizable and needless to say, his Doctor was impressed. His medication was reduced as all of his health markers had improved.

The journey continued for another 18 months and still continues today. Ray has learnt through close self monitoring which foods he is able to enjoy abundantly and what he really needs to stay away from. We have more recently adopted a ‘low carbohydrate, higher healthy fat’ diet and all health markers continue to improve. With the use of some concentrated nutritional medicine supplements alongside his current medication his blood sugar readings are still coming down. His Doctor fully supports his desire to come off Metformin as he is now managing his condition with diet and lifestyle. His current dosages of Metformin are at the absolute minimum and in coming weeks he will be off this altogether.  His weight loss to date is over 30kg, he engages in hot yoga, brisk walking and some strength training for exercise and in June he will summit Mt Kenya in Africa.

The point of this post is to show you that a diagnosis of diabetes (or similar) is not a sentence. Its an indication that something isn’t working right and its time to re-evaluate. Medication has its place of course and is critically important. However, one must absolutely look beyond managing symptoms and also address the underlying cause. According to the Diabetes Australia website, “up to 58% of cases of type 2 can be prevented and we know that good blood glucose control and maintaining a healthy lifestyle can significantly improve the complications associated with diabetes.” If you or someone you know suffers from this condition and they are in need of some assistance to manage it long term, take a look at my Work with Me page because I’m committed to reversing the statistics. The risk factors for diabetes should also be noted: impaired glucose tolerance, high fasting blood glucose, overweight, belly fat, high blood pressure, lack of exercise, smoking, PCOS or PCO (females), high cholesterol and a poor diet in general. Prevention is better than cure in my view and its never to late to improve your health.