Weight loss : a mini-breakthrough

Well, it was a damn long time coming. What a battle! As of this morning, I have edged past the 25kg mark for the first time – 25.2kg down to be exact. As I said, a mini breakthrough but a breakthrough it is.

My weight loss has fluctuated between 24 –24.8kg for the last 2 months. I know the reasons for this very well. Lax portion control, little exercise, insufficient water and occasional mini-binges all contributed to the patchy downward progress.

June was a month of bi-annual medical checks I have which form part of the diabetic care protocol. At the beginning of the year and at mid-year, I have various tests done to check my health status.  Doctor, pathologists, ophthalmologist, podiatrist and dietician all had the dubious pleasure of my company last month. I will talk about it in a later post.

Diabetes really is a dread disease in that uncontrolled – or even just poorly controlled glucose levels wreak havoc with virtually every body system. Unseen and undetected until too late. That’s fact and not just me becoming neurotic or a hypochondriac! While I am very aware of my health diagnoses/challenges and am doing (action!) all I reasonably can to reverse the situation, I have no time to sit around contemplating my ‘health navel’!

Between health, business and personal challenges, I seldom have time to scratch myself! I do not schedule enough ‘me time’.  I call it down time or time out. I am looking at that quite seriously and would recommend it for everybody.

As part of my mid-year checks, I consulted a dietician about the prolonged weight plateau. Yeah. Another one. Another dietician I mean. Did I learn anything new? No. Didn’t expect to. What I did get was a slightly revised eating plan which cuts kJ to 5200 per day. (About 1222 calories). Rather strict plan for sure. Cuts carbs and leaves protein/fats much the same. Am I following the recommendations to the letter? Not quite but I have had a shift in weight and that’s the bottom line isn’t it?!

The other perennial recommendation is to increase exercise. Any regular physical activity is crucial for overall health improvement – any physical activity at all.

So get that fat dog out on a leash and get out into the neighbourhood so that he can pick up his pee-mail!

I am really upset … 3 Poor self care and diabetes complications

Those of you following this blog will know the story about my friend T who works for a friend/client of mine. At Christmas time he scraped his foot while swimming and by March his foot had been amputated.  He is still getting around on crutches while he awaits a prosthetic foot.

I was upset once again yesterday when I was told that T was admitted to hospital last Thursday with deep vein thrombosis in the remaining ‘good’ leg. He remains hospitalised at this time and I will contact his son later this morning to get the latest update. The grave danger and possible consequences in this situation do not have to be spelled out.

What really, really gets to me is that this whole unfolding crisis could quite probably have been avoided completely. It need never have happened.

T really needs to supplement his pension income, his employer wants to accommodate this but also has to deal with T’s lengthy  absences from work. It has placed my client in a  difficult situation which will have to resolved one way or another.

When we blithely ignore the warning signs that our lifestyle is causing our bodies to deteriorate, we are literally toying with our  lives. There are thousands of medical conditions that can befall us over which we have no control whatsoever. Surely it makes sense to take charge of what we can control and influence? But we just don’t do it.

I am relentlessly driven by a number of things to continue on my odyssey back to optimal (optimum?!) wellness. I cannot just let it go. I cannot just let things slide – much as I am so often tempted to do. I deviate from the path – badly sometimes – and yet I cannot throw in the towel.

  • I value my financial independence and the lifestyle that this affords me.
  • I dread the day my children have to step up to the plate and provide for me financially.
  • I fear being dependant on others to care for me physically. I cared for my dying mom-in-law for over a year before she died and it was a harrowing experience for both of us. Well do I remember the two of us crying bitterly in each other’s arms as I changed her filthy disposable nappy yet again. The anguish she suffered from the pain and loss of dignity is something that still lives with me  26 years later.
  • I am angry at myself for the stupidity I exhibited over many years in not looking after my health and lifestyle.  I still exhibit this same stupidity ; work and stressful deadlines still predominate in my life.

One small consolation is that sanity has now prevailed long enough for me to appoint a temporary office assistant. After only 3 mornings with us, the ‘advent of Nicky’ is changing my office landscape and I will talk more about this in a later post.

Weight Loss : I’ve got to up the ante

It’s now exactly two weeks since we returned from our wonderful break at Pinnacle Point. A fading memory I am afraid. 😦  We had to jump right back into the fray and catch up on time lost while we chilled out.

There’s something fundamentally wrong with the whole scenario; with the way that we live our lives in our house. This work, work, work is not a good place to be. We should be relaxing and I suppose I should be relaxing doing crochet or something or maybe gossiping with the other tannies in our quiet apartment block. Nah, just can’t see that ever happening.

I, for one, am right up there with my kids checking out the latest Blackberry, muttering about what in the cloud data backups are costing me, taking on new payroll work for small businesses. I would just like to have a more rounded life and in truth am striving towards that goal; without any notable success at this time!

What has happened since returning to Cape Town two weeks ago? Well, on the weight front nothing much at all and therein lies the problem. Having lost 23kg, my metabolism has settled down and decided that this weight is quite OK, thank you very much. So, another dreaded plateau. I have 7kg to go to the W-L goal set for me and I still want to go at least another 5kg down after that!

I feel good! I’m told I look good (but not when I am still working in my dressing gown mid-morning!) I am much smaller than I was, of course. I had the most amazing experience just before we left on holiday. I simply had to go to Woollies and find some denim pants to take on holiday – the old ones were all hanging like sacks on me. Great feeling actually! 🙂

Not having a clue what size to buy, I confidently took home two pairs of denim pants in size 18. Bearing in mind that I had been wearing size 22 stuff, this in itself was a major victory for me. Got home to find that the jeans as well as the pull on elasticised denim pants were both far too big!

As I hate trying on clothes in shop fitting rooms, I went back, changed the pants and came home with size 16’s. Tried them on. WOW!  The fitted jeans were fine – even a little loose. The elasticised pants were too big!  So back to the shop again to came home with size 14’s. Anyone who has worn size 22 clothes and now wears size 14 will know exactly how I felt!  I was and still am over the moon about this very tangible evidence of my progress so far.

SO FAR

Two very crucial little words for me. I have come so far and am justifiably chuffed with my efforts. But now the real test must begin. The last 7kg’s will be difficult to lose and hence the expression below :-

“ If you up the ante, you increase the importance or value of something, especially where there’s an element of risk as the term comes from gambling, where it means to increase the stake (the amount of money bet). “    Wikipedia

The element of risk for me is, of course, the real possibility of deteriorating health issues due to too slow intervention on my part. I must place a much greater emphasis on where I am heading and pick up the pace substantially.  I will have to worry about all the loose, wrinkled, floppy bits that will only get worse once I have arrived at my destination! The value of goal weight as the basis for optimum wellness has to be the most important element of my odyssey.

So, onward and downward again – are you joining me? You are most welcome!

BP – as in blood pressure, not petrol!

My valued readers may remember my post about ‘a bit of’.  A ‘bit of weight’; a ‘bit of cholesterol’; a ‘bit of diabetes; and so on. Looking back at older posts, I see that I wrote that post on 8th March.

What I said on that day is something I would like to repeat today and I will probably return to the subject time and again as I try to hammer home the crucial core message:-

There is no such thing as ‘a bit of’. You either have it or you don’t!  The ‘bits of’ have already started their destructive paths in your body and will continue to do so unless you take charge of your choices right now!

In my observations and personal experience, we typically see these (lifestyle induced) patterns manifesting around our 40th birthday. Very sadly, we are also seeing more of these conditions emerging in much younger people. I seem to recall reading that 19-year old Americans in the Vietnam war already showed signs of arteries clogging up; the trend has been growing for decades. Just look, really look around you in a shopping mall; particularly in the food courts. Obese parents loading all sorts of junk food onto their plates and ordering the same for their plump, chubby or already obese kids. I feel sick at heart as I observe it all.

I recently watched a 40-something man sitting at a small restaurant table with his knees spread wider than the table. He could not close his knees because his stomach was resting on the chair seat between his legs. He was simultaneously reading the morning paper, while shovelling bacon, sausage, eggs, toast etc down his throat as if there would be no tomorrow. His two obese kids of primary school age sat at the table with him also shovelling down… guess what?  Neither he nor his children were actually paying much attention to what they were so avidly consuming. It was a mindless, well practised exercise in gluttony.

Do not get me wrong, there is nothing more ‘lekker’ than an ‘English breakfast’ of bacon, eggs etc as an occasional treat to be savoured and enjoyed. My W-L  group leader says that she loves to prepare her own lunchtime version of the ultimate sandwich, cut it into 4 triangles and then really look at it with pleasure and anticipation before eating it!

One of the many lifestyle induced health dragons we usually face is hypertension -high blood pressure. My spouse W & I have to take our blood pressure readings on a very regular basis. W because of ischaemic heart disease – he now has two coronary stents – and me because of diabetes and the other other dragons of Metabolic Syndrome.

While on holiday this month, we took BG (blood glucose) as well as BP readings every day; our children were not even aware that this was part of our daily routine even on holiday. All readings are recorded and then transcribed into Benutriwise as data for our GP, Dr Anna.

I recently upgraded our BP cuff – we now have the type that takes the readings at the press of a button and gives digital readouts. It also averages the readings for the previous 30 days; all of which is crucial information for the GP as well as the cardiologist.

We have HARTMANN brand BP cuffs (a German make) which Dr Anna tells me are about the best on the market. Taking info from their user manual, I quote hereunder:

“The World Health Organisation (WHO) and the International Society of Hypertension (ISH) have developed the following classifications for blood pressure values:”

Assessment Systolic pressure Diastolic pressure
Optimal up to 120 mmHg up to 80mmHg
Normal up to 130 mmHg up to 85 mmHg
Normal limit values 130 – 139 mmHg 85 – 89 mmHg
Grade 1 hypertension 140 – 150 mmHg 90 – 99 mmHg
Grade 2 hypertension 160 – 179 mmHg 100 – 109 mmHg
Grade 3 hypertension over 180 mmHg over 110mmHg
     

“ Established hypertension is defined as repeated measurement of a systolic value greater than 140 mmHg and/or a diastolic value greater than 90 mmHg. Please note that this classification of blood pressure values is independent of age. Optimal blood pressure values have health benefits for all people. There is no generally recognised definition of too low blood pressure (hypotension). Readings of less than 100mmHg systolic and less than 70 mmHg diastolic are considered too low. Please note that, unlike too-high blood pressure values, too-low blood pressure values are not usually expected to be associated with health risks. However, if you are always feeling unwell, you should check with your doctor. “

“ Constantly elevated blood pressure multiplies the risk for other health problems.

Also according to HARTMANN, high blood pressure elevates the risk for thickening and/or weakness of the heart muscle 7 times and the risk of stroke 8 times.

Constant hypertension also leads to vascular damage. Additional increased risks are quoted as follows: Heart attack 3 times; shrunken kidney/kidney problems/kidney failure 6 times; impaired blood flow 2 times; and arteriosclerosis (hardening of the arteries) 8 times.

When W was admitted to a cath lab for the first stent, he commented to the theatre sister that she must see a lot of heart disease in her line of work. She looked at him, sighed and said, “ Yes and the sad part of it is that it is all self inflicted.”

My cardiologist showed me very carefully where my heart muscle has thickened due to poorly controlled hypertension. It’s sobering stuff I can tell you.

Is this post meant to scare you? No, it is not. It is meant to present the facts about the serious consequences of uncontrolled or poorly controlled hypertension. It is also intended to encourage those not yet medicated and monitored by a doctor to most urgently monitor their BP over a period of time and take corrective action – be that drastic lifestyle modification and/or medication.

Food labelling – we have often been misled

Over time, I have become a consumer addicted to reading nutrition information labels on foodstuffs in my favoured food markets. In the early years it was for fat content, then it became the (often vain) hope that the GI value was quoted on breakfast cereals and now, finally, I can assess the info with some degree of intelligence.

With the advent in my life of the despised Metabolic Syndrome, I will not put a grocery item into my trolley without having read the nutritional information. I was so pleasantly surprised to see recently that a very dear friend with health issues to manage will also not purchase any item that would be detrimental to his health.

I am not for one minute saying that I am a Joan of Arc martyr to my health challenges nor a Paragon of Virtue as headmistress Reverend Mother Maria used to call me. (Poor misguided woman – luckily for me she did not deem it necessary to open nor censor my schoolgirl correspondence with a certain young gentleman at Kearsney College! Some of my Holy Family Convent school friends were not so fortunate)!

What I am saying – with much rambling, sorry – is that we need to become informed in our health choices. I ate a slice of Black Forrest cake this week – yeah horrors! – with no consequences on the scale nor my glucose readings. (Back to the comment about not being a Joan of Arc on my odyssey to health). An occasional ‘sin’ is not going to kill me as long as the ‘sins’ do not become a regular habit. Been there, done that. Never again in my lifetime. The ‘sins’ are what got me into my MS predicament in the first place.

No food is ‘bad’. All food has its place. The trick is to know which foods we must strictly limit to occasional treats and what foods are needed for vibrant health and energy.

New regulations for food labelling become mandatory in RSA from March 2011. Some retailers already have pretty good labelling on their products – PnP and Woolworths to name two.

Misleading labels will not be permitted. For example to be labelled low in kJ, a food will have to have less than 170kJ per 100g (solids) or 80kJ per 100ml (liquids). “Low fat” must contain less than 3g per 100g (solids) or 1,5g of total fat per 100ml liquids).

Don’t wait until March 2011 to start really examining what you permit down your throat! I haven’t.

So, how did it go?

As we reluctantly ease back into work mode after a lazy Easter weekend, W & I are pleased to note that we both lost a little weight over the weekend. We did indulge in a few, small easter eggs and sundry other foods such as a lovely bacon/egg breakfast and a couple of takeaways and visits to food outlets in CW (Canal Walk Shopping Centre, Century City)

We realise that it’s not about ‘dieting’. It’s about consciously making choices (indulging our love of chocolate which we seldom do) and then simply re-focussing on what we know is the right eating regime for us.

In past years, I – for one – would have polished off lots  of marshmallow eggs and any/all hollow eggs that came my way! The huge Easter egg market set up in CW was a sight to behold and I did buy a box of Lindor 60% balls. I dished them out very quickly! I could have polished off the lot by myself without much trouble but in truth I had no real desire to do that.

My glucose levels did not go haywire and we will soon see if there were any real spikes this week. I was due to go for my bi-annual fasting HbA1c test this morning but am fighting a cold that I picked up yesterday. Got up at 2am and swallowed a mega dose of Vit C so have had to postpone the test until tomorrow morning.

I will also make sure we both have our bottles of ice water on our desks – something that we tend to forget. So vitally important!

I have not posted about what I drink – I will try to do that this evening. At boarding school in the village made world famous by Alan Paton, Ixopo, a huge treat was to be ‘let out of’ hostel on a Saturday morning. We girls would all troop down to the village and settle in the ‘tea room’ and check out the boys while consuming large helpings of slap chips, hamburgers and Coca Cola!

Old habits die hard and if I was unwise I would still happily consume greasy burgers, fries and coke all these years later. Such is the influence of childhood habits!

Would love to hear how your Easter weekend went?

This and that …… 1

” This and that “
These words bring back memories and a smile to my face. My only sibling C, my husband W and my children will remember so well that my Dad used to get a rise out of my Mom at least three times a day. She would get all huffy for a couple of seconds and he would grin in a self-satisfied way and stroll off.

How did he do this?
Every single time he stood up after breakfast he would say, ” Thanks Gog, what’s for lunch? “; after lunch he would do the same damn thing and say, “Thanks Gog, what’s for supper? “, and after … but you get my drift… My Mom would answer in an infuriated tone, ” This and That! ” and my Dad would smugly wander off to think of something else to draw attention to himself….

I really must invest in some new dictionaries. The Readers Digest Complete Word Finder and the Oxford Illustrated Dictionary – not surprisingly – do not have the word gogga listed but it does feature in the ” Tweetalige Skool-Woordeboek ” 1988 edition! An Afrikaans word meaning ” insect “, my Dad used the abbreviation “gog” as a pet name for my Mom – unusual in that neither my Mom nor Dad had any Afrikaans connections.

This is getting entirely off the point of this post – fiddling again!
Back to the matter in hand.

Succumbing to sheer laziness, I have had the following for breakfast, so far:
2 x Ouma Nutri Rusks (Intermediate GI)
1 x mug coffee (Jacobs Cronat Gold), with skim milk and 2 sweeteners (Equi-Sweet Blue)
   I also use Equi-Sweet Green but the green dispensers always seem to get jammed up.
   My all time favourite granulated sweetener Sweet Pea is only used on porridge and then only very sparingly.

Not too good hey? BUT not anything that I am not ” allowed ” to have. My point is that W & I work hard to have only ” legal ” foodstuffs in our home. I actually dislike calling food ” legal ” and ” illegal ” – comes from the days when Jean Nidetch founded Weight Watchers in New York yonks ago.

Even with my health challenges including DM II, there is no foodstuff forbidden to me – just have to know how to incorporate the item with other far better choices. Thus diluting/lowering  the glycemic effect of the (usually High GI ) item. We both like Checkers Decaff coffee and will tootle out later (when I can bestir myself to get showered and dressed) to get more.

What we will also do this morning is boil up 6 (Canola) eggs and I will chomp a hard-boiled egg with a teeny sprinkle of Low Salt and some freshly ground black pepper just now. Thus having 2 x carb + 1 x protein for my breakfast.

We keep to a maximum of 4 eggs each per week. These are often hard boiled. Sometimes we also spray a small non-stick frying pan with olive oil spray and fry ourselves an egg to have on low GI toast for breakfast. Once again, sprinkled with S + P as above, together with a dash of Worcestershire sauce.   A dash of  Light All Gold Tomato Sauce or Sweet Chilli sauce would be nice as well.  Note, I said a dash! 🙂 Once again, protein + carb = cool! We also sometimes use 1 x tsp olive oil heated in the non-stick pan and fry the eggs in that; giving an additional 1/2 fat to the day’s total. And yes, we do measure the oil.

Talking about toast – which I love to eat and my spouse does not – I am very particular about bread.
The simple rule is: If the label/packaging of the bread does not include the actual words ” Low GI “, I do not buy it. It’s just that simple.

My personal eating plan allows about 5 complex (starch) carbs per day. I have tried – oh how I have tried over the years – to like coarse bread that tastes like chipboard. OK, OK, as I imagine chipboard would taste! I know all about the linseed and soy loaves, the rye breads and the like. Just cannot get past one slice at the most. If I make my Ultimate Sandwich on rye, I tend to end up eating the protein and salad sandwich filling and not the bread!

We have settled on the following breads in our house:
Albany Brown Seed low GI (Yellow)
Albany White low GI (Lime green-do not confuse with ‘ ordinary ‘ green label one)
Sasko Low GI True Whole Wheat brown loaf
We buy the loaves and freeze them, taking out only what we require. Experiment with thawing times in the microwave and you will have lovely fresh, soft bread for the Ultimate Sandwich or whatever!

I would say that by changing your bread selections to only those specifically labelled ‘low GI’ you can reduce spiking of your glucose levels considerably. It is important to note that curbing spikes in glucose levels – in my experience – is as important for non-diabetics as it is for diabetics/pre-diabetics.

Do you get the munchies mid-afternoon? That’s low blood sugar folks!
My W-L plan lists two afternoon snacks – early afternoon (2-4pm) as well as a late afternoon snack (4-6 pm). I also have a mid-morning snack – making 3 snacks per day in all. This totally in keeping with lowGI/low GL eating guidelines.

Mid-morning is 1 x fruit + 1 x milk.
     I have a fruit (mostly a small crisp apple from the fridge) and 175 ml fat free fruit yoghurt.
Early afternoon is usually another fruit.
I love pears, grapes, kiwi, orange, all the berries. The peaches have been to die for this year and we have eaten a lot of them.
Late afternoon is 1 x Complex (starchy) carb + 1/2 protein.
possibly 3 Finn Crisps with PnP low fat hummus or cottage cheese or lower fat cheese.

Try it, it works!
Talk later, E

Chicks rule!!!

Right! Now I’m really getting somewhere!

Broken a plateau which really frustrated me for the much of February and this month to date.
Hovering between 21 and 22kg loss was not a joke and unfortunately my life is so crazy at this time that I had not posted here about it.

Stand by…….. drumroll…… 23.1kg down this morning!!! Whew what a great feeling – I’m on the downward path again. Decisively so.

Let me encourage you not to give up if you also experience no or minimal losses over an extended period – a few weeks in my case. Our bodies are not engines that we fuel and can then expect to perform to specification. Each and every one of us is very, very different and as we pay more attention to our health and bodies, we get to know what works and what does not.

I can honestly state that I did not panic and I did not think even for one split second about throwing in the towel. That option did not cross my mind.

So, what lead to the breakthrough? Two things only – portion control and eating right. In my case, as you know, ‘ eating right’ is a combination of my W-L plan, my plan devised by a dietician well versed in low GI/GL principles, ongoing discussions and shared info with my doctor Anna Hall and last but honestly not least my own research into the kind of nutrition best suited to slay the Metabolic Syndrome dragons.

Very bad grammar in the above paragraph but I am posting this nonetheless!! Or should I say I am nonetheless posting this? Eileen – get back to the subject at hand – you are fiddling again!

Please comment on this post or write to me personally if you are having similiar problems. A problem shared is a problem halved – most of the time anyway.

Chicks rule??
A real biggie is that I now weigh less than my husband – quite something that – as he is also now on his own journey which is a new development which I have yet to write about. That was another huge breakthrough in our little family.

Have a great day and a safe weekend.

BMR .. Basal Metabolic Rate .. what is it?

I’ve never really been a calorie (or kilojoule) counter. Over the years I have become used to simply eating the portions as prescribed for me by dieticians or by following the formula selected for me at Weigh-Less. So much easier in my view!

However, I have recently become curious and have swotted up about the balance of macronutrients (carbohydrate, protein and fat) in eating plans suitable for those of us with Metabolic Syndrome (Insulin Resistance Syndrome.)

Remember that according to the IDF (International Diabetes Federation), for a person to be defined as having metabolic syndrome, they must experience the following metabolic abnormalities:
– abdominal obesity (defined as a waist circumference beyond ethnic specific values (see elsewhere on this blog),
Plus any two of the following factors:
– raised triglycerides (above 1.7mmol/l);
– reduced HDL (good) cholesterol (below 1.03mmol/l in men or 1.29mmol/l in women);
– raised blood pressure (systolic >130mmHG; diastolic >85mmHg); or
– raised fasting plasma glucose (above 5.6mmol/l).
Ria Catsicas – The Complete Nutritional Solution to Diabetes. Publisher: Struik Lifestyle 2009.

According to Anne Till, another leading South African dietician, the balance of macronutrients could look like this:

Proteins 15%
Carbs 45-55%
Fat 30-40%
The Ultimate Diet Solution. Anne Till. Published by Struik 2006

Through membership of the GI Club run by GIFSA (Glycemic Foundation of South Africa), I have direct access to Liesbet Delport and Gabi Steenkamp authors of the bestselling Eating for Sustained Energy books. The books published by these two dieticians are the gold standard on low/lower GI/GL, lower fat eating in South Africa.

Liesbet Delport has advised me not to have more than 20% protein and 30% fat in my eating regime so I have tweaked my Benutriwise software to reflect the following breakdown:
Protein: 20%
Carbs: 50%
Fats: 30%

BMR / Calories Required Calculator

Basal Metabolic rate (BMR) is the amount of calories needed by your body at rest.

For the average sized body the BMR is extremely accurate. However, for larger bodies (both muscular and fat) it can be inaccurate in determining your caloric needs.

For the muscular body type, the BMR can underestimate the number of calories required, and for the
overweight body type it can overestimate the number of calories required.

What you eat and how much you exercise are both important for achieving health and the type of physique you want.

But, the basic equation remains the number of calories taken in minus the number of calories consumed equals what’s left over to be stored as fat.

The BMR is calculated according to the formula :
Women: BMR = 655 + ( 9.6 x weight in kilos ) + ( 1.8 x height in cm ) – (4.7 x age in years )
Men: BMR = 66 + ( 13.7 x weight in kilos ) + ( 5 x height in cm ) – ( 6.8 x age in years )

To calculate Calories Required, BMR is multiplied by a factor depending on your Activity Level:

Sedentary – 1.2
Lightly Active – 1.375
Moderately Active – 1.55
Very Active – 1.725
Extra Active – 1.9

Based on the above, a Lightly Active, 30 year old woman, 55 kgs, 155 centimetres will have a BMR of
BMR = 655 + (9.6 x 55) + (1.8 x 155) – (4.7 x 30) = 1 321
Calories Required = 1 321 x 1.375 = 1 816 (calories required to maintain weight)

Be in good health ”
http://www.benutriwise.co.za. Should you opt to download a trial version of this great nutrition software, please be good enough to quote agent code AG Hall. Thank you! More about how I use this resource in a future post.