Wednesday, January 2, 2013

Un-resolutions and Some Thoughts About Food

Those of you who have been following this blog for a while may remember my post about not making New Years resolutions last year. While I haven't really made any resolutions for this year, except to continue my (un-)resolution from last year of being kinder to myself, I have spent the past few months thinking a lot about food, and sugar in particular. I read Gary Taubes' Why We Get Fat a few months ago, and it's really changed my thinking about nutrition. I'm going on vacation next week, and plan to be as indulgent as I like because, hey, it's vacation! But when I get back, I'm thinking about making some significant changes to my diet, though not for the reasons you might expect.

Except for two major exceptions, where I was taking medications that caused me to gain weight, I have been within the same 10-15 pound range. Right now, despite being on prednisone, I'm the thinnest I've been since college (thanks Arava!). I was vegetarian for almost ten years (ages 15-25), and even though I now consume meat and other animal products happily (particularly those that are from pastured or free-range animals), I still enjoy and frequently eat vegetarian staples like tofu, tempeh, and other beans and legumes along with lots of low-fat dairy products and mostly whole grains. My motto when it comes to food has been something along the lines of Michael Pollan's principles: "Eat food. Not too much. Mostly plants." So far, I think it's served me pretty well.

I remember first being aware of the Adkin's diet back in the early 2000s and thinking that it was a terrible idea. Growing up in the 80s and 90s, I had been fully indoctrinated into the "low-fat is better; saturated fat and meat are the enemy" ideology of the times and I still find myself returning to those ideas, even as I read about scientific and public health studies that point to its damagingly erroneous assumptions, namely that some foods (and food products) are better for us than others simply because they have fewer calories, when in fact, these foods (read: sugars and grains) may be destroying the hormonal equilibrium of our bodies.

A few friends of mine did the South Beach Diet briefly during 2003, and I joined in for a bit, mostly trying to reduce my reliance on pasta, bread, potatoes, and sugar, which often seem to form the center of a contemporary diet, vegetarian or not. I did cut back on my sugar consumption, and lost a tiny bit of weight, but then my interest in the whole idea of being on a "diet" waned, since I really didn't have any more weight to lose, and it wasn't having a noticeable effect on my autoimmune symptoms or energy. Since then, I've made an effort to swap whole grains for refined grains and to eat more vegetables, but other than the year when I was trying to lose the (massive, rapid, 30+ lbs) weight I gained from a combination of Lyrica, Cymbalta, and prednisone, I've never paid a significant amount of attention to the quantity of the the food I eat, preferring to focus on things that appeal to me and on making sure I'm getting enough vegetables and protein. Overall, I think I'm a pretty "clean" eater.

My experience with that trifecta of medications, and the sudden and uncontrollable weight gain that accompanied them, has made me much more sympathetic to people who have difficulty losing weight. It was like my body had turned against me, and no matter what I did (try running 4 miles 3 or 4 days a week and *still* gaining weight!) or how hard I tried to watch what I ate and drank, I was always hungry and never satisfied. (Plus I felt demented and lethargic much of the time, but that's another issue altogether.) Ultimately, there was no magic pill, diet plan, or exercise regimen that led me to lose all that weight (and then some). It was almost as though when I stopped the medications, and stopped focusing so hard on losing weight, after about 6 months my body began to shed the extra pounds and returned to its normal point of equilibrium.

But now I find myself facing the possibility of being on prednisone indefinitely. And though my weight is great and my lipid profile looks pretty good, I worry about the long-term effects of steroids, particularly the risk for high blood pressure, metabolic syndrome, and visceral (aka "skinny") fat accumulating around my internal organs (not to mention avascular necrosis, but that's another issue altogether). And I still grapple with daily fatigue and pain, even though my labs look pretty good, which makes it difficult to get the aerobic and weight-bearing exercise that might counteract some of these problems. The evidence, as presented by Taubes and many proponents of the so-called "Paleo" diet or lifestyle, seems to suggest that the best way to avoid these kinds of metabolic problems and conditions, and potentially to decrease inflammation and other symptoms of chronic and autoimmune disease, is to cut out grains and refined sugars as completely as possible.

But even as I'm persuaded by much of the scientific evidence, I find it difficult to stomach some of the quackery and bad science that comes along with the "lifestyle" aspects and the almost-religious passion that people have for these highly restrictive diets.  I also find it hard to shake my sense that whole grains are good for you. I suspect part of this is my preference for moderation (I've found Gretchen Rubin's take on "moderators" versus "abstainers" very helpful for making sense of my preferences and how other people operate in the world). But I wonder, if I cut out the grains and the sugars, and even the legumes and dairy, would I really feel better? Would these nagging aches in my hands, feet, elbows, and knees go away? Would I have more energy? Is this the panacea I've been looking for? Or would this just be another placebo, the kind that makes abstainers feel happy and in control and leaves moderators like me feeling deprived and frustrated? I'm thinking it may be worth a try, but I'll let you know how I feel next week when I get back from vacation. Some pain au chocolat is sounding mighty enticing at the moment...

Have you tried a diet or major nutritional interventions to help with chronic or autoimmune disease? What worked (or didn't work) for you?


  1. Hi Megan - I have two autoimmune diseases, Type 1 diabetes (insulin required) and hypothyroid. In 2012 I made a major change to my diet when I received two diagnoses, both complications on diabetes.

    I realize that my situation is different than yours but thought you might find some motivation for yourself in my story. I researched low carb eating for a long time before I actually decided to give it a try. My primary motivation was to moderate my blood sugar swings that typically characterize Type 1 diabetes.

    Basically, I limited my carb intake to about 50-70 grams per day. The results were dramatic and amazing. My blood sugar control, as measured by fingerstick blood samples and a continuous glucose monitor, markedly improved. My insulin intake was cut in half. The number of hypoglycemia incidents (low blood sugar, sometimes dangerous) diminished from 2-3 per day to 2-3 per week.

    As a side benefit and with little effort, I lost 23 pounds. My body mass index went from 27 to 24.5. My blood pressure went down and I stopped taking a blood pressure medication. Losing the weight felt good - I felt younger!

    I eat a low carb, medium protein and high fat diet. I am not hungry between meals. In fact I can easily skip a meal with little ill effects.

    I know your medical status is different than mine. But I think that the low carb way of eating is healthful. It will not harm your situation and may make you feel a little better.

    Good luck with whatever you decide to do! Your story reminds me of the power of the human spirit. Attitude is everything!

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