Still in ketosis, and observations about metabolism and starvation

I’m not sure if I ever went completely out of ketosis the other night with the rice crackers, but if I did, I didn’t stay out of it for very long. I use ketone testing strips (Ketostix brand) to check, and they’ve been at least a very light pink every time I’ve tested. Today they are more back to normal, probably around 80mg/dl or slightly less.

I suddenly have this insight on why you don’t give candy bars to starving prisoners you’ve just released from Auschwitz. They’ve been in ketosis all that time, and the candy bar is sugar city. Not good.

In fact, given that benign dietary ketosis has a good bit in common with fasting, I suddenly have this insight on feeding people whove been fasting or starving. I’ve been Googling and trying to figure out what the refeeding process is with someone who’s been undernourished and it’s not very clear to me, but it seems the medical establishment obsesses over the patient’s insulin levels getting too high too fast.

Seems to me they ought to be doing a reverse of Atkins. The patient needs a kidney function test to see how much protein they can tolerate, among other things. But the first calories they ought to get should be fat calories. You’ve got catabolism going on, which involves using fat and protein as fuel sources. Give a body enough dietary fat and it won’t need as much protein. You’d change the proportions from mostly fat to fat-and-protein, gradually increasing the protein as tolerated, and then bring in glycemic carbohydrates–again, gradually. I don’t imagine it would take much time but if you get the patient stabilized with a caloric intake that agrees with what their body is presently doing, shouldn’t that make re-introducing glucose safer?

I’m really surprised nobody seems to have thought of this yet, especially with the low-carb craze of the early aughts and all the scientific literature available demonstrating that BDK is safe. Obviously starvation is not benign ketosis but you could make that ketosis benign by the choices of what you feed the patient.

It’d be really funny if, in finding a diet that helped his cardiac patients, Dr. Atkins also found a way to help victims of starvation. He did not pioneer the earliest work on benign dietary ketosis, but he popularized it. Odd how life works out sometimes.

Carb counts and cheat foods

The weight-loss phases of Atkins are an excellent argument in favor of preparing most of one’s food at home. This is the most frugal and nutritious approach anyway if those are goals of yours; you know what’s going into your meals and you have total control. But it’s also a huge help with carb counts. Even when someone else makes my meal for me when I’m at home (my little girl’s dad sometimes cooks for us), I have to guesstimate a lot, but if I do it myself it’s no problem.

It sounds obsessive and control-freaky but one of the goals of Atkins is to know your limitations insofar as how many grams of carbohydrate you can get away with in a day and stay at your current weight or lose weight. And the reason this matters is that the primary metabolism for human beings is the glucose metabolism, and glucose calories are therefore the calories that count for most people. Fat is turned into various biochemicals and used to transport fat-soluble vitamins; protein is used to build cell structures; if you’re getting enough carbs, neither fats nor proteins are used for fuel. This is the gaping, bleeding hole in calorie theory. Calories do count, but only the ones you’re burning!

Meanwhile, I’ve been rotten this week, but only to a point. Wednesday I decided I was tired of salads and had a wrap sandwich at Subway. They don’t use the low-carb tortillas for their wraps anymore but I could have done worse; the wrap was 33g (I don’t know about the fiber content), lower than any of the breads. I checked the next day and I was still in ketosis. I’m not sure if I’d been knocked out of it at any point and then went back in; if not, my carb tolerance is higher than I thought it was! Yesterday at the state fair I ate a few French fries (as in, less than half a dozen) and bought a sugar-free “homebrewed” root beer at one of the booths; the man said he’d gotten complaints about the sugar-free version and his fix was to add less than half a cup of the sugary stuff on top to help the flavor. I agreed to it because he sweetens the diet root beer with aspartame, which I really do not like. I think I had one or two other episodes with stuff I was not supposed to eat–oh yeah. I got some sugar-free Twizzlers Thursday night. That in itself wasn’t much of a problem although it’s kind of stupid to use up your carb allowance with something that can only be described as junk food, but at the time I was missing junk, probably because I was hungry. So I ate more of those at a time than I should have. Again, it wasn’t an excessive cheat; I seem to be good at taking dabs here and bits there every now and again and then stopping. I still have some Twizzlers left, actually, I think, and it was a small package to begin with.

The cheating bugs me a little because even though I am reasonable-ish about it I don’t want to turn this into a nasty little pattern of justifying cheats to myself and then shriving myself afterwards. This may just be my conscience working in overdrive, though. I’m more worried, actually, that I’m not getting my full carb count during the day with stuff I AM supposed to eat than I am about the cheats.

I’ve upped my allowance to 35 grams a day for the next few weeks and will be doing my utmost to make sure I hit the mark more often than not. I really need to see if the weight loss continues at that level. It makes me wonder about how realistic it is to increase carb count 5g a week like the Atkins book says to do. Seems like in no time I would be up to 50g a week and wondering when the heck my weight loss stopped and having to back down again. Better to take it slowly, I would think.

Which also makes me wonder about the folks who choose to stay in Induction for months at a time. Dr. Atkins thought this would not be harmful to most people who try it, but why not simply add on about five grams a month? Then it’s lots easier to see where your carb tolerance is and you can still lose weight like whoa. And you can also still do the Pre-Maintenance phase of adding 10g at a time, at least in theory, later on.

Although I’m starting to wonder about that too. You’re supposed to do OWL until you’re within ten pounds or so of your goal weight. OK, fine. But what if your carb tolerance is low? It would be all too easy to overshoot your limit in Pre-Maintenance, I would think, especially if your ACE (Atkins Carbohydrate Equilibrium) is 40g or so.

Oh well. The beauty of this diet is that you can tailor it to some degree to meet your needs. Some people who go on Atkins never do Induction at all, but start at 100g a day or so and gradually lower the carb intake until they start losing (if they aren’t losing at 100–some people do!). Whatever works for you.

Well, here goes nothing.

I was going to take the domain mylowcarblife.wordpress.com, but much to my dismay someone had disregarded the WordPress team’s request that folks not take domain names they weren’t going to use… so the domain I wanted sits as an empty blog, completely unedited and abandoned. *weeps* I could not for the life of me think of another name that wouldn’t sound hokey or conflict with another LC blogger, so I dropped the “my” from the domain name; lo and behold, it was available.

LiveJournal is great for personal blogs, especially as their security filters are very easy to use. Unfortunately there is something of a high-school mentality among many of the users at that site, LJ is not taken terribly seriously in the rest of the blogosphere, and it can be difficult to drum up an audience if you want to do a specialty blog. I don’t need a multitude of usericons here; I’m only here to write about my experiences and share info with others. Also, my LJ audience doesn’t seem terribly interested in my weekly weight loss adventures other than the occasional “Atta girl!” when I’ve lost a few pounds. So, overall the specialty blog approach on a “real” blog site seems best. We’ll see how this goes.

I have attempted Atkins three times. The first time, in January 2004, I stayed on plan for at least four weeks. I did not have a scale at that time to measure weight changes but it seemed to me I was losing inches already. At that time I stayed pretty much in the 180-pound range at 5′6″, so I needed to lose weight but it wasn’t desperate.

The second time was two years ago when I realized my weight was ballooning. I had had my second child in November 2004 (I had quit Atkins before finding out I was pregnant–and I mean just), and while I originally got down to my prepregnancy weight with seemingly no effort whatsoever, the pounds started coming back on soon after. By the time my daughter was two months old I was just over two hundred pounds, as the scale testified at my postpartum visit. At roughly the same time it seemed like I was losing a lot of hair, which may have been hormonal changes, but my skin was also dry and scaly in weird places. I suspected thyroid issues, as did others close to me, but when I got tested I was told the results were normal. I was on Medicaid at the time and the doctor seemed dismissive, so who knows what was going on there; I know now that TSH is not the only possible indicator of thyroid problems, and that you can have a normal TSH and still be hypothyroid. I don’t have insurance at this point and I’m losing weight on Atkins now, so it’s pretty much moot until I can get coverage again or get taken seriously at a free clinic.

Anyway, so by that summer I finally got hold of a scale and was unpleasantly shocked to discover that not only was I over 200 but creeping ever closer to 250! I don’t remember now exactly what my weight was but it was a jarring discovery. Hence starting Atkins again. I was nursing my daughter and was aware that Dr. Atkins had recommended against nursing mothers attempting the diet, but I had done my homework and learned that mothers in famine conditions still produce nutritionally perfect milk, and I knew I would be eating better than a mother in famine conditions.

Unfortunately, the whole thing backfired. Induction was tremendously difficult, I was trying to take care of a young baby mostly by myself, I was stressing out over a little cat family I had taken in to keep them out of the shelters (they were tearing up everything, it seemed like), and to top it off my daughter was starting to complain when she nursed. I suspect I smelled funny to her once I achieved ketosis, and she was too young to know that it was OK, just Mommy smelling different. I couldn’t take the stress after a couple of days and gave up.

This time around my daughter is two and a half, I have better emotional and logistical support with my life in general, and I got a rude awakening when I went to a local festival and visited a diabetes advocacy organization’s booth. My first non-fasting glucose number was 54; the second was 39, which is the highest end of normal range. I’m not sure why the numbers varied so greatly within thirty seconds of one another, but even high normal is scary with my family history. Everybody female in my mother’s line plus aunts and possibly a sister or two of hers is diabetic, Mom’s father is diabetic, and my father was diagnosed with Type 2 at the end of 2005. Then came the high nonfasting number and I knew I’d better get my butt in gear or I was facing serious health problems in another three to five years. And that’s being generous.

It isn’t that I think being fat is going to cause my diabetes. This is something that I think even some medical personnel don’t quite understand: Obesity is a symptom of underlying health issues which lead to diabetes, not necessarily a cause. If being fat always caused diabetes then there shouldn’t be any skinny people out there with hyperinsulinemia, which is a symptom of insulin resistance and a precursor to type 2 diabetes–but there are. So while I don’t like being this overweight and wouldn’t mind looking better (to me, anyway), the truth is that the changes I need to make to stave off diabetes are going to be the same changes I’d need to lose the extra weight, just as your runny nose goes away when your body kills off a cold.

So, this time around I began at the beginning of July. My starting weight was 237.5. Yesterday I weighed in at 224.5, a loss of thirteen pounds. That’s a loss of 2.6 pounds per week. I lost more in Induction phase and I had a week or two where I appeared to stall, but 2.6 a week is nothing to sneeze at. If I kept up at that pace I would lose all the weight I needed to lose in just under a year, or by eleven months from now. I will probably not continue losing at that pace, because sooner or later in the Ongoing Weight Loss phase you slow down significantly from your original loss pace, but that’s all right. I feel better already and can do things like change the bedsheets without winding myself, and that’s just with a thirteen-pound loss so I certainly can’t complain!

“Before” photos, beginning measurements, and a summary of how I’ve done so far are forthcoming. I hope you will follow along with me on my journey and that we both learn something positive from it.