12. Update - one year on
I began taking control of my blood sugar and cholesterol levels in October 2017 and this blog recorded my progress over the following six months using a combination of dietary change and exercise. By May 2018 I had achieved a spectacular turnaround in my blood sugar and blood lipid levels so the goal then was to consolidate that progress and to improve further if possible. I must admit, having ruthlessly tracked everything I ate and drank for six months, as well as all the calories spent in gym exercise, that it was a somewhat daunting thought to abandon that proven regime and return to "normal" again. You can't spend your life counting every calorie and macronutrient and what I did to counter the threat of diabetes and raised cholesterol was really only an intervention to reset the baseline. However, from the outset, I was pretty confident the intervention would work so I had also thought very carefully about how I would maintain the changes going forward.
One of the key factors behind my decision to adopt Michael Mosley's 5:2 Fast Diet and Mediterranean Diet was that the transition to "normal" eating would not involve any change in the type of food I ate or the eating pattern, only the quantities consumed. The vast majority of weight loss diets seem to me to be doomed to failure because they rely on a restrictive regime of food types and calorie intake that are unlikely to be sustainable in the long term, so when you return to your previous "normal" eating you are likely to experience the same outcomes as before, which means that the fat will return.
So my transition to "normal" was really easy because "normal" had been redefined by the Mediterranean diet I ate for the previous six months while losing my 20kg of body fat. The only difference was that I no longer needed to lose any more fat so I gradually increased my calorie intake to the equilibrium level needed to sustain my new body fat level (approximately 2200 -2300 kcals/day excluding significant gym exercise) over a period of about four weeks. That ensured the change was gradual and I continued to monitor my weight and fat levels to ensure that all remained under control.
One of the side benefits of monitoring calories and macronutrients rigorously over the previous six months was that I became much more educated about the calorific and nutritional content of the meals I prepared. Basically my understanding of portion control had been completely reset by the exercise! In addition a major takeaway for me was that the diet had demonstrated very clearly that I was intolerant of simple carbohydrates, so there would be no return to starchy carbs or sugar. Fortunately the taste buds reset very quickly so my definition of sweet is now completely different to six months ago : milk chocolate, for example, now seems impossibly sweet and I have no desire to eat it, fortunately!
I continued with two days of fasting every week because my experience over the previous six months showed a real benefit in allowing the gut to have some down time each week. On Fast Days I eat only one meal in the evening after gym training so this means that I have 2x24 hour fast periods per week. Because I am not fasting to lose fat any more, I no longer limit my food intake to the 800kcals prescribed in the fat loss phase. I do not count any calories but I do stick to my high fat, moderate protein, and lower carb diet, one that is also quite high in home made full fat kefir and yogurt.
I also fast now on non-Fast Days. That’s because I understand much better the major role that fasting plays in correcting the imbalance in the insulin hormone that drives fat storage. On “normal days”, I aim to leave at least 16 hours from the last food on the previous day to the first food on the next day. So if all food is consumed by 9pm then I aim to not eat anything before 1pm the next day. This is the “16:8 Leangains” approach and it is very easy to incorporate into every day eating because it basically involves skipping breakfast, which I find easy anyway, and having a light snack for lunch anytime after 1pm. In practice I find that I rarely want to eat anything before 3pm on most days anyway so my “normal” days now include a fast of typically 18 hours. Occasionally, following a particularly heavy weight training session the evening before, I may feel sufficiently hungry in the morning to have some breakfast, although the need for that has become pretty infrequent as my body has adapted to the weight training. If I do have breakfast, I will ensure that I leave at least 13 hours from the previous night’s dinner as the basic principle of fasting is that the period of eating and not-eating should, as a minimum, be equal. But if you have a lot of fat to lose and are becoming insulin resistant then you should definitely aim for a period of non-eating that significantly exceeds the eating period. During my 6 month fat loss period I fasted for 2x24 hours each week, but I was also restricting calories and snacks on normal days by a small amount (typically a few hundred kcals), and that worked superbly for me.
I have found during the last nine months of maintenance mode that the substantial drop in my fat levels seems to have significantly reduced my appetite (as should be the case when the insulin imbalance has been corrected) and that a shorter eating window each day works really well for me. I’m building muscle and I’m no longer constantly hunger so the urge to snack or graze has disappeared completely. Consequently, I actually eat much less than when I was diagnosed as borderline pre-diabetic yet my energy levels have never been higher. Maintenance actually involves zero effort. I just avoid all processed carbs and processed foods in general, I eat loads more natural fats, and I eat till I’m satisfied without counting calories. Oh, and my olive oil consumption has increased substantially too!
Having achieved my target for fat lossI began to ramp up the weight training sessions to add a bit of muscle tone because I was looking decidedly scrawny at the point I transitioned to normal eating. Since May 2018 my body fat has stabilized (it has actually dropped a small amount by about 400g to around 5.2kg total, yet I have added about 6kg of lean muscle, and possibly increased some bone density. I can tell you that losing 20kg of body fat is a whole lot easier than gaining and maintaining 6 kg of muscle, which is really hard work! Currently I spend at about 7 hours each week in the gym split roughly as 5 hours of cardio to 2 hours of weights.
My Waist to Height Ratio (WHtR, about which more follows below) has remained unchanged over the past year which confirms that there has been no increase in belly fat following the return to eating. My chest, however, is 2.5" bigger as a direct result of the weights. I think I am happy with the overall increase in muscle mass so the goal now is to try and maintain at the current levels. Here is a summary of where I was in May 2018 when I reached the fat loss target and in Dec 2018 after about 7 months in maintenance mode :
