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.

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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.

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.

Have you got ‘a bit of’…? Yeah, so have I …

You know the drill. You see someone you have not seen for some time and one of the first questions they ask is always “And so how have you been since we saw you last?” or “How’s life treating you?”

How often we South Africans would answer something along the lines of –
“No,man, I’m fine thanks. My quack says I’ve got a bit of cholesterol – (here substitute with blood pressure or weight or sugar or bad indigestion or any other lifestyle related condition you have) – but, hey, I’m lekker. And you?”

I am here today to tell you that there is no such thing as ‘a bit of’. The ‘bit of’ that you have has already started on its destructive trail in your body. There will probably be no other indications (yet) of this destruction other than the ‘bit of’ that has manifested itself as glibly stated above.

The more astute of you will realise that writing on this forum is a huge motivation for me personally to stay the course and I truly hope that my scribblings do the same for you.

I should already be at my day job next door, so I will leave you to ponder your own ‘bits of’ and I will try to clock in again later today!