Diet dilemmas

I went for my quarterly hospital check-up today, and there was good and bad news.

Good news

The good news is that my cholesterol values total, LDL (bad cholesterol) and HDL (good cholesterol) as well as triglycerides are all well within the normal range, and the electrocardiogram also showed everything is fine. And my blood pressure remains normal.

Bad news

The bad news is that my HbA1c blood sugar value is way up again – back to almost where it was after I got out of the hospital. It’s really very high.

The doctor wanted to put me back on blood sugar medication, which I’ve been off of for almost 3 years now, but I know from multiple times in the past that medicine isn’t necessary. I can control it with diet if I can just lose the weight I’ve regained. So the doctor agreed, without much argument (I think he was just in a rush to see the next patient) and has given me 3 months, until my June 1 appointment, to get my blood sugar under control by myself.

I also had a meeting with the dietician, but she admitted that by now I know as much as she does about all the diets there are and the best advice at the end of our meeting she could give me was to try to drink green tea instead of eating between meals. Not a bad idea I guess.

What to do now?

The problem I’m left with right now is I don’t know what to eat to get my weight under control. I mean I know theoretically what to eat. I just don’t know how to stick with it. And weight control is the key to everything for me. If I lose weight my blood sugar goes down. If I’m too fat my blood sugar goes up. For me, it’s as simple as that. It always has been.

While on the Ornish “heart disease reversal program,” which is basically vegan, no-added-oil, no nuts or seeds I fairly quickly dropped 88 lb. That’s the program I went on after getting out of the hospital.

But after 700 days or so, as with every other diet I’ve been on my whole life, my will-power weakened and I started gaining weight. For a long time, I was able to restrain my weight gain to about 15 lbs or so. But since getting back from St. Louis my weight started creeping up again and I’ve regained a total of 35 lb so far – about 20 lb since getting back to Japan.

I’m still about 50 lb or so below from when I started, which  is a good thing. And I haven’t gone off the wagon to the extent that I’m eating fried chicken on skid row. So I’m somewhat relieved I’ve managed to prevent a total rebound this time. So far. But things are still in a precarious state, and I know things can go either way.

Things I know about diets, blood sugar, cholesterol, etc.

Here is what I know so far from my own experience with dieting, and also after monitoring of my blood test results every quarter since starting in May, 2012:

1. How long I can diet. I seem to have initial success on just about any diet I try, and I tell everybody about my success with great enthusiasm. But the success always only lasts for about 700 days, about two years. During those first two years I seem to have perfect will-power. I never ever go off my diet. I never have the urge to go off my diet – really! I can follow whatever the diet rules are, I can keep my calories under control, and I lose weight.

2. The 700 day effect. No matter what the diet is, “something” happens after about 700 days and my will-power weakens, and something (a combination of biology and psychology I think) causes me to start overeating again, and my weight creeps up, and I can’t stop it. I start flailing around from diet to diet trying to find a combination of eating tricks that works, but I can’t. Usually this ends up with me completely going off the wagon and a complete rebound.

3. Not a complete rebound so far but… So far I’ve been able to avoid a complete rebound this time. I’ve avoided fried foods for one thing, which I know is the worst of the worst for me. Yet my weight is still slow creeping up and I keep compromising about the limits I’ll accept: First I won’t allow my self to get above this weight. Then I won’t allow myself to get above that weight. Then I won’t allow myself to get above this other weight. These limits are getting dangerously high now, and it’s seriously depressing. I have to admit it has been weighing (as it were) too much on my mind lately.

4. What causes high cholesterol? As far as cholesterol goes, I just don’t don’t believe Ornish or Esselstyn or any of the vegan-no-fat people anymore. When I started my diet, my cholesterol was higher than normal. 6 months into the diet it was still high. It wasn’t until I started taking one statin each evening that my cholesterol dropped to the normal range. Since going to St. Louis in the summer, I haven’t really been vegan any more. During my two months in St. Louis I had some fish for lunch every day and some skinless chicken for dinner ever evening, and my weight stayed under control. And when I got back to Japan and had my next blood test a month later, my cholesterol was still low. And on December 1 my cholesterol was still low. And even today my cholesterol was still low (LDL of just 81 with a normal range of 70-139). So I think the recent U.S. government guidelines which now say the cholesterol you eat doesn’t affect your blood cholesterol are correct, at least for me. In other words, I don’t think it matters if I am vegan or not as far as cholesterol goes. I think probably eating olive oil in small amounts also doesn’t hurt either as far as heart health goes.

5. So should I eat more animal products? For me, there is a “feel good” limit in eating animal products since I went vegan. I can tolerate a little fish each day, or a little chicken. But beyond that I just don’t feel well at all. If I try eating beef or pork I get nauseous. So my sense is that no matter what I do going forward that it won’t involve a lot of animal products. But I see no reason in being fanatical about being 100% vegan. If there is a little chicken or fish in an otherwise low-calorie product, I don’t see any reason to let it bother me. The new guidelines also say eggs should be ok, but I’m a little hesitant about eating them again. If they are safe though, they are really great for weight loss since they are so low calorie, high in protein and satisfying.

6. Calories are key. I think it basically always comes back to weight and calories. I’m sure if I lose the weight I regained my blood sugar will go down again. From past experience with this, my blood sugar isn’t affected by the kinds of food I eat so long as my weight goes down. And to lose weight I have to restrict calories. There is no way around that basic fact.

7. And what about exercise? Exercise plays some role, but maybe not a big role in all of this. My exercise has slacked off lately I admit. I’m hoping as it gets warmer I will pick this up again. I haven’t been going often to that gym I joined, unfortunately. I was enthusiastic about it at first, but have not used it much since then.  I’m thinking instead of that gym I should just cycle over to the city sports center, which is along the river and only 3 km away, on the route I always take for bicycle runs. In other words, I’ve been cycling right past the city-run sports center for over two years now and not using it! I could use that gym for weight training exercises to help build muscle mass, and then cycle back. Maybe do that two or three times a week (i.e. setting a realistic goal). That would save money over the private sports club, and I would get in extra cycling by just getting there and coming back. Still, I don’t think this is the solution to my overall problem. The main thing is losing the weight I’ve gained. But I think I will cycle over the sports center and see how it is and maybe drop my membership in the nearby private club. I do sit at my desk way too much every day.

8. Addictions and what diet to follow. I’m still lost as to what diet to try to follow next. I’ve tried everything there is to try so far. There is nothing new that anybody can tell me about diet plans. I guess everybody has to find their own personal “bag of tricks” to psychologically control what they eat. Different people have different addictions. Some people can’t stop smoking. Others have alcohol or drug problems. Some people have gambling addictions. I’m fortunate to not fall into any of those categories. I smoke one cigarette every 10 years (next one in 2023), only drink alcohol 3 or 4 times a year and never have an “urge” to drink, and have never had any other addictions except for food. Unfortunately, unlike other addictions, food addiction is the only one where you can’t go “cold turkey” (as it were) and just stop eating altogether.

9. Depression. I have to admit this is bothering me excessively lately. People around me, like people in the neighborhood, have begun to notice. Even today, while walking back from the train station on my way home from the hospital, a neighbor I’ve never spoken with called out to me and said, “So what is happening with you? You used to be very fat. Then you got thin. But lately I think your weight is going up again, isn’t it?” (People in Japan can be surprisingly direct about saying things like this!) And so I talked to him for a while. He was very friendly and sympathetic about it, and said to keep on trying and we’ll talk again. People at Hibikinokai, where I do volunteer work on Sundays, also have noticed this for a while now, and have mentioned it to me.

Anyway, I’m just rambling at this point. I’m still not sure what to do, and I have to do something. I’m wary of grains – even whole grains – because I think they are all excessively high calorie, low protein and trigger hunger pangs. But I bought some brown rice at the supermarket today. I’m wary of legumes, because they just don’t sit well with me. But I bought some tofu today also. And some more non-oil salad dressing and some salad vegetables.

Ideally I would like to start a very calorie restricted diet (e.g. < 1500 calories a day), do some moderate exercise 3 times a week or so, avoid eating between meals if possible, and see how it goes for a few months. During this time I should avoid things with added sugars, simply to avoid hunger urges. Maybe I should restrict fruits? I am not sure.

I’m just talking out loud and not necessarily asking for advice. I think I’ve already tried every diet there is, including diets which won’t call themselves diets and instead call themselves “lifestyle changes” or whatever. Every diet works, and every diet doesn’t work. It’s easy to convince yourself something is working and get all caught up in it, then 700 days later find yourself rebounding.

I need to get back on a weight losing path somehow. It’s just difficult.



Diet dilemmas — 5 Comments

  1. Sympathy & best wishes. Obviously, I’ve never been as successful as you in even the first 700 days, but based on what you said, I would say, go for the small servings of lean chicken, fish and eggs. I think a bit of fat wouldn’t be bad, especially if you avoid trans fat. (ref Atkins diet about fat’s good effect on appetite). All the newest stuff I read seems to point the finger at sugar (and starch which soon turns into sugar). So I think sugar is the big one to avoid. Unfortunately, I have a sweet tooth, but I cut out the rice (especially white) and have dessert instead. It may not balance out, but I guess it’s better than both.
    I think exercise is great, the more the better, and I’m not very good at that either. I like your dietitian’s advice about the green tea to replace other sorts of snacking. I’d make mine coffee, but green tea is probably better for you. Anyway, don’t give up. And be careful about depression. That’s really nasty and has lots of bad effects on your physical health. I know it’s not enough to say avoid depression, but try to get some help if you can’t seem to talk yourself out of it. The caffeine in green tea may be good for that.

  2. The dietician first recommended black coffee, but I loathe coffee. Then she suggested green tea, which I like, but don’t often drink. I usually drink just water. But I think I’ll keep some green tea in the house going forward. I like “namacha” brand green tea. It isn’t bitter at all, like some brands are.

  3. I hear you, brother. My weight loss journey has been going on for 10 or 12 years now, and while I’m down substantially from my worst weight I still have a substantial distance to go. I’m on my third round with Weight Watchers and I’ve experimented with Atkins, South Beach, and various other approaches. Right now I’m doing reasonably well on WW but I can’t claim to be confident of reaching my goal. I’ve come to think of the whole deal as a successive approximation approach. My number is better now than it used to be, and perhaps the best I can do right now.

    On the exercise issue I’m squarely in your camp. I’m currently training for my next half marathon and I ran 10 miles yesterday. But even with a high level of activity I know that if I don’t count my WW points meticulously I will not lose weight, the work just doesn’t compensate for the extra calories. There are many good reasons to exercise but I flat don’t believe weight loss is one of them.

  4. Sorry you are having problems.

    I also am on a diet. No diets worked for me either. I want to be 140 lbs which is slightly higher than high school weight. I am also 5’7″.

    My highest weight was 232 after being 130 lbs. Over 100 lbs! I pigged myself over 10 years. I decided it was enough cause I could barely walk. Thank God I didn’t turn Diabetic or anything.

    4 years ago is when I started. I was so mad about how I looked I didn’t cheat on food. Then I got down to 175 and got “relaxed” about the weight. I got compliments from everyone. In stead of keepin on the diet, I let loose and ended back up at 215 lbs.

  5. Hi Michael. Yes, while exercise is probably healthy in general, you definitely can’t ignore diet. It takes a huge amount of exercise to overcome even one high calorie meal.

    Good luck with your marathon!

    Hi Nancy. Thanks for your note and followup email where you explained more about things you are doing to help you succeed with your diet. Maybe see you over at MyFitnessPal!

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