Archive for July, 2011

Is It All About Processing?

July 15th, 2011

Did you hear about the guy who lost 27 pounds in 8 weeks by eating the majority of his calories in the form of Ho Hos, Little Debbie cakes, and Twinkies?

Holy cow.

Somewhat reminiscent of the guy from SuperSize Me, this researcher wanted to prove that a calorie is a calorie, no matter what form it takes.

In fact he was correct: he lost the weight by cutting his normal 2,600 calories per day down to 1,800 calories per day.

It should seem like he lost some good health in there along the way!

Bless the researchers; someone else was trying to figure out what else mattered when it comes to processed food versus whole food.  THEY found some interesting things happening after each type of meal.

The study was conducted with the attention focused on the biological processes that occur in our bodies after we eat: the postprandial thermogenic response.  (My dad taught thermodynamics so I know that thermogenic has to do with the production of heat.  I tried Symlin for a few months so I know that postprandial means after eating.)

A calorie is in our world today a measurement we most commonly use to apply to food and exercise, but it comes from science and means, in thermodynamic terms, an amount of heat equal to 4.1840 joules.  (I have no recollection what that is or why it matters.  My last chemistry class was 18 years ago and I wasn’t very good at it at the time.)

ANYWAY, sorry for that tangent, but it matters for this study.  The researchers discovered that, 5-6 hours after the participants ate their cheese and bread sandwiches, the amount of heat/energy
produced was very different if the sandwiches were made of whole food or of processed food.

Fifty percent kind of different.

The average energy expenditure after the whole food meal was nearly 20% of the calories in the sandwich; the average for the processed food was 10.7%.

The wise researchers concluded that: “this reduction in daily energy expenditure has potential implications for diets comprised heavily of processed foods and their associations with obesity.”  I would say that potential implication is none other than that bugger Obesity.

It seems to me (an entirely unscientific person) that no matter what, food needs to be processed before our bodies can use it.  The potential outcome of that usage is calculated in terms of heat: the calorie.

I think we have outsourced those required processes to manufacturers instead of getting our food from farmers and processing it ourselves.

And look what has happened: rising obesity rates.

Think how fast that guy could have lost his 27 pounds if he had been
processing longer after he ate by eating whole food instead of processed snack cakes.

Yow.

Finding What You Enjoy

July 14th, 2011

I hear a lot of people tell me they hate to exercise, or they hate running, or they “can’t” run, or they used to exercise before their knees started to complain, or they aren’t coordinated enough to play sports, or any number of excuses.

It makes me sad, because I think exercise is fantastic and I think that all the excuses serve only to build a wall between “exercisers” and “non-exercisers” for no good reason.

When I meet someone and they learn I run marathons, some eventually come around to saying “I should run a marathon.”  My response to that never changes: “you have to WANT to do it; don’t even try if you don’t want it or you will be miserable every [literal and figurative] step of the way.”

And when someone says they don’t like to exercise, I think to myself that they just haven’t found an activity they enjoy.  Like the saying goes: “love your work and you’ll never work a day in your life;” so goes exercise.

Make it fun.

On the off chance that you might be inspired by some visuals, I took a gander through the Power Systems catalog that came in my mail today.  The catalog is designed for athletic trainers, gym owners, personal trainers and the home exerciser and they have more equipment and gadgets than you can even imagine.

Some look like a ton of fun.

Suction cup ski poles?! Love!!

Someday I'll get one of these slider things.

Some not so much.

I find yoga challenging enough without the weight balls, thank you.

Weighted Pants

Some look downright dangerous.

Be careful if you're prone to vertigo!

There isn't much to say here.

Some look like I should start saving up to purchase for bootcamp.

Power Jumper

I wonder if actors use these training for spy movies.

How FUN would this be?!

Each one shows someone exercising for a different purpose, and yet the goals are the same: improving their lives through exercise.

Which ones strike YOUR fancy?

Strengthening Your Self Control

July 13th, 2011

A little exercise can go a long way when it comes to resisting damaging behavior.

Take this study performed at the University of Exeter, England: 25 chocolate lovers were asked to avoid chocolate for three days prior to the mini stress test performed.  (I really hope they got paid for their participation!)

When the participants arrived at the lab, half of them were asked to walk briskly on a treadmill for 15 minutes while the other half simply waited for the tests to begin.

If abstaining from chocolate weren’t enough, the researchers then put all of the participants through a challenging mental test designed to stress them out.  (Sounds mean!) As if that weren’t enough, at
the end of the test another researcher walked into the room and lets you choose your favorite chocolate bar from the samples he carries.  Then you are asked to unwrap the chocolate BUT NOT EAT IT.

Yow.   How difficult do you imagine that was for the participants?!

The exercising participants showed a smaller increase in blood pressure during the mental tests and had a smaller increase in blood pressure when asked to unwrap but not eat the chocolate.

Researchers concluded that the 15 minutes of exercise helped the participants cope better with both challenges. 

(And it isn’t only chocolate: the same researchers have performed similar tests with smokers and on the subject of basic concentration in the face of distractions.)

It looks like the advice of “if you feel hungry, take a walk around the block” or “do 20 pushups” first before you reach for an unhealthy snack has some research to back it up!

If you are dealing with any number of temptations, use exercise to help you resist temptation and improve your self control!  Use your physiology to your advantage, and start to see exercise as a source of mental and physical strength!

Say it Loud

July 12th, 2011

I think some people are afraid of their blood glucose meters.  I think that fear needs to be eliminated because it makes diabetes too big and powerful—you have given it permission to dictate your emotions.

If you were trying to lose weight, you would emotionally not fare as well by stepping on the scale every day as you would by stepping on it only once a week.

Yet blood glucose readings need to be taken several times a day, without fail.

The more we can do to minimize emotions with the task, the better off we will be when it comes to the emotional side of life with diabetes.

So try this on for size.  You can do it with someone else in the room or not—you can say it under your breath.  But speak loud enough that YOU CAN HEAR YOURSELF say it.  Heck, you can be in a closet in the dark for all it matters—you just need to be able to read the screen.

Start the sentence when your meter has 2 seconds left.  That way you’ll have already started before any BG number appears on the screen and you’ll be more likely to finish the sentence.

It has two parts.  Each recognizes the PURPOSE behind checking blood glucose levels.  You need to (a) know the reading because it (b) helps you decide what to do next.

So, with 2 seconds left before the meter is finished, start saying MY METER SAYS MY BLOOD GLUCOSE LEVEL IS [fill in the reading].  THAT MEANS I NEED TO [complete the sentence].

For example, when I got back from my run yesterday I checked and said aloud: My meter says my blood glucose is 158.  That
means I need to enter the number into my pump and have the bolus wizard tell me if I need to bolus to bring down the number.

It’s kind of funky to hear it out loud.  But very good training for keeping things in perspective about why we do what we do when it comes to blood glucose management.

Rock on.

Hanz and Franz vs. Harriet and Francine

July 11th, 2011

Do you remember these two guys from SNL in the early 90s?  They were SO FUN.  I just had a fun moment with my husband when I went to him and said “what were their names?” as I hunched forward, said “PUMP [clap] YOU UP!”  He said “Hanz and Franz” right away.

I guess we’ve been together a long time.

Anyway, I thought of these two and their stuffed sweatshirts as I thought about what to write about today.  I also thought about the roughly seven thousand and three conversations I have each year with women who say their husbands can lose weight just by thinking about it for an afternoon.

It begs the question: are men and women different when it comes to muscle mass?

The first and most obvious answer to that question is to say “yes” that men and women differ.  The various reasons for that number in the thousands; the critical differences when it comes to exercise are body size and composition.

When scientists look closer at muscle tissue itself, though, the differences between men and women do not exist! 

While men in general have more muscle MASS, the makeup and strength in muscle tissues of men and of women are equal. (Women’s values in muscle strength, pulmonary ventilation, and cardiac output are generally 60-75% of those values recorded in men due to the variances in body size, body composition, and levels of testosterone.)

So are there exercises that men should do and women shouldn’t do?  NOPE.

Are there “female” exercises and “male” exercises?  NOPE.

Is there a biological reason for “boy pushups” and “girl pushups”?  NOT ON MY WATCH.  EVER. (This is one of the very few things I will actually yell at you for saying during a workout.)

Seriously; your body isn’t as different from your brother or sister’s body as you may want to believe.  You can both train the same and both perform the same exercises and achieve most of the same results.  Sure, the improvements by the numbers will never be identical due to the basic differences above in size, composition, and testosterone, but that doesn’t mean you shouldn’t go after what you want.

Male or female, muscle is muscle.  Use it or lose it.

I vote “USE IT!”

One of the Best Ways to Improve Your Life

July 8th, 2011

I really really don’t want this one to sound preachy.  So if it feels that way
to you, please accept my apologies.  I just really believe in this one.

I think one of the most important ways we can improve our lives with diabetes (type one or type two or one of the other four unnumbered types) is by taking charge of our medical care.

From the mental side of things to the physical side, there are about three kazillion things we think about all day and night every day when we live with diabetes.

So why do we allow things we CAN do something about to languish and fester and eat at us?  One thing I try and do all the time is to identify my biggest stressor and do what I can to get rid of it.

If that includes my medical care, you can bet I’m going to make some changes. It is so much easier to fix something like that than it is to work to lower my A1c it just makes sense to do the easy stuff first.

 

Deal With Your Doctor/CDE Situation

If you feel your doctor or CDE is judging you, there are hundreds of other doctors out there who might not.  Check with your insurance, Yelp the covered people, ask around.  Find someone you can be comfortable with most of the time. 

If you are incredibly anxious when you have an upcoming appointment, when you next see your doctor or CDE, tell them that.  Talk about how it feels for you to sit there for an hour and nitpick what you’ve done every day for the past few weeks.  Maybe they need a wakeup call, too, about what it’s like.

If you aren’t sure why your doctor is suggesting a treatment or drug or avoiding it with you, find out why they are making the choices they make for your body.

Heck, they ask us why we go high and low and what we eat and yaddah yah; it’s perfectly appropriate for YOU to ask THEM why they are doing something with your health.

It’s a responsibility you have when you inhabit your body: you need to know what’s going on when someone else is making changes (or not). 

The thing about living with diabetes: you are the expert on YOUR BODY and YOUR DISEASE.  Sure, they went to medical school and see a
lot of people with diabetes and they know a lot about the science involved… but the one thing they don’t know is one of the most crucial when it comes to life with diabetes: they don’t know YOUR body
like you do (from the inside!)
.

And that’s as it should be: if it were something simple enough like a broken bone, you’d see them, they’d fix it, and you’d go on your way.  But
with diabetes, there isn’t anything you can point to.  It involves a lot more communication and a lot more thought and a lot more trial and error.

So if your medical team isn’t up to snuff, take charge. 

You owe it to yourself.

Got a Spare $8,000?

July 7th, 2011

The George Washington University School of Public Health and Health Services’ Department of Health Policy released a study last year that reported the individual cost of obesity in the United States.

Not the cost in macroeconomic terms, the costs individuals pay for being obese.

Women pay an average of $4,879 and men pay $2,646 each year for obesity-related medical expenses and lost productivity.

Yikes.

Beyond that, the authors added in the value of each individual’s loss of life due to their obesity.  THAT took the toll up to $8,365 for women and $6,518 for men. Each year.

Yikes again.

We aren’t even counting what it costs to live with (presumably) type two diabetes.

Nor what the non-monetary costs are.

I suggest those non-monetary costs are much higher.

Do you travel less than you would if you weren’t concerned about fitting in a seat?  Do you attend fewer functions because you only have one or two “nice”outfits that fit?  Do you feel as though you can’t be yourself because you’re busy worrying about how big you are?

Do you think people aren’t your friend, don’t invite you to get-togethers, or talk behind your back about how much you weigh?  Do you take an awfully long time to climb a flight of stairs or walk to your destination?

If the answer is “yes” to any of these, I’m willing to bet you’d pay more than $8,000 to get it to stop.

_____

I’m not going to say that if I can do it, anyone can do it.  Anyone can do it regardless of my own success losing a lot of weight.

And it takes work, and not everyone is willing to work at it for as long as it takes.

But it IS possible, and you CAN do it.  But you absolutely must believe that you can; that’s I think where a lot of the trouble lies.  It isn’t about the monetary costs, and it isn’t about the non-monetary costs, and it isn’t about knowing or not knowing what to eat and not eat.  It isn’t about how long you’ll live or in what condition.

Most of it is about your belief in yourself. 

If you’ve got that, you can do anything.

So if you need to, take some time and have some honest conversations with yourself about what your body needs you to do.  Speak to your doctor, speak to me, speak with someone in your family, speak with a therapist.  Do what you need to do to get yourself to recognize your own needs and believe in yourself.

You (and your bank account) deserve it.

AAWPP

July 6th, 2011

No; that title isn’t the cry of an angry bird.  (That’s “ca-caw!” or “squawk!”)  It’s the official acronym from the United States Coast Guard and the Department of Homeland Security for the Assumed Average Weight Per Person.

Why would they have such a thing?  Well, just like elevators, I guess, ships and boats need maximum loads posted and obeyed so people have a better shot of staying afloat (or suspended, in the case of elevators).

Why would I know that such a thing as an AAWPP exists?  Because it matters in a professional sense for a fitness professional to know that the AAWPP is changing December first.

It’s changing from 160 pounds to 185 pounds.

It feels somehow more official when the Coast Guard says it, doesn’t it?  We are, on average, gaining weight and staying heavier than our bodies were designed to weigh. I don’t like this trend.

I automatically translate this from boats to elevators simply because I have been on far more elevators (and stared at the maximum capacity signs) than I have boats. This means that when 10 people used to fit on a boat together, now the Coast Guard says only 8 people can fit safely.

That’s a LOT of difference when it’s ten people; imagine how many fit on a cruise ship!  This is going to make our vacations MORE EXPENSIVE!!  It isn’t just the Coast Guard, either.  The airlines are doing it too, I’ve heard.  (That one is much harder to find through the FAA.)

Being shorter than average, I am curious how tall the Assumed Average Height Per Person is, if it exists. But being shorter than average, it feels strange that I’ve been both AAWPPs in my past.  Eek.

I myself need to weigh less than the AAWPP.  What about you?

I know how it is a lot of the time: we feel like we have to pay SO MUCH ATTENTION to our blood sugars, and now you’re supposed to manage your WEIGHT, too?  AND exercise??!

Well, yes.

It’s the hand we’ve been dealt.  So we can either be sad and fold early, or we can play the best game possible with that hand.  You just never know what’s going to happen.

Our job is to do our best to stay afloat.

My Latest (and Perhaps Greatest) Rant

July 1st, 2011

If you’ve read my blog for any length of time, you probably know I don’t hold back when it comes to sharing my opinion on nearly anything.

(We all have them, what’s the big deal with sharing them? If you wanted all Technicolor rainbows and butterflies you’d probably be picnicking in a meadow anyway, instead of reading this.)

But here’s the thing.

I think it should be considered medical malpractice for a general or internal medicine doctor to diagnose and/or medicate someone with diabetes.

It simply happens too often. I’ve heard too many stories (that I consider horror stories) of a GP or IM diagnosing a patient with type 2 diabetes and prescribing whatever popular drug and both doctor and patient carrying on without further changes or appointments.

ARE. YOU. KIDDING. ME.???

Diabetes requires accurate diagnosis. It requires a knowledgeable prescriber and correct dosage and medication.

Heck, for a lot of people, it requires a hospital stay.

And everyone needs fantastic education, guidance, and support.

So what are they teaching these doctors in medical school and reinforcing in the medical community?? That diabetes is a “try this drug and come back in three months” kind of disease?!

The whole thing simply frightens me.

It frightens me because I hear about people who were incorrectly diagnosed as type 2 who, upon seeing an endocrinologist after months or years with deteriorating health, are correctly diagnosed with LADA, MODY, or in some cases, type 1 diabetes.

If you live with diabetes of any kind, you know what it takes to manage the disease. You know how intricate the work can be, and how helpful (and not as helpful) doctors can be when it comes to the ways in which you need their help.

So when I see these stories it amazes me that there are so many general practitioners who think they can diagnose and treat a patient’s diabetes without help from an endocrinologist.

It concerns me what they do with other diagnoses. I can’t see them thinking they can diagnose and treat cancer—or at least I HOPE they don’t.

Let me assure anyone who has been treated exclusively by their general doctor for diabetes: you need an expert’s help with this disease. You can’t get it online; you can’t find what you need in the Diabetes Online Community. You can’t find it on WebMD or from a friend.

You need to do this TODAY. Start by making a phone call. This is your health and no one cares about it in the same way as you care.

But you need to take charge. You need to make sure you understand enough about the disease to evaluate whether your diagnosis feels correct. If it doesn’t, make another phone call, get another lab test, see another expert.

YOU AND YOUR HEALTH ARE WORTH IT.

No matter what your general doctor might say.