For the month of January, I gave up eating all grains, dairy, artificial sweeteners, natural sweeteners (except fruit), and legumes. Did I discover that I have some kind of crazy gluten/lactose/stevia intolerance? Nope.
I went Paleo.
Many in the Diabetes Community have been talking about the Paleo diet lately, and it seems the trend is growing among those fellow PWDs interested in investigating new ways of eating. You know, it's what is dubbed the "Caveman Diet" since it involves eating what the "original" humans ate back in the cave-person days. So, I decided to try it out myself and see what all the hype was about.
Short for paleolithic, eating Paleo is what some folks have called a fad diet, but the premise is rooted in the supposed historical diet of humans. Established by health scholar Loren Cordrain, the Paleo diet consists of lean meats, vegetables, fruits, and nuts. See anything missing? They toss out all processed foods, grains, dairy, and legumes, along with simple sugars and artificial sweeteners.
Proponents believe that humans were genetically and evolutionarily designed to eat foods that were available during the Paleolithic era, versus the agriculturally-based diet that was only developed in the last 10,000 years -- and even more so the processed and chemically-based diet of the last hundred years. Followers believe that eliminating certain foods in their diet will reduce inflammation in the body, and folks will enjoy health benefits like weight loss, reduced bloating, clearer skin, and more energy.
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Now, I've only been experimenting with the Paleo diet for a couple of months, so I'm hardly an expert. A lot of the Paleo diet can be hard to swallow (pun very much intended), and as with anything health-related, your miles may vary. This is simply my experience and what I've learned.
With so many food groups cut out, it's easy to see how the Paleo diet might be considered a fad, unsustainable and even unhealthy. In fact, that's exactly what U.S. News & World Report thinks, which is why they named the Paleo diet the worst diet (#28 out of 28). Of course, if you look at their reasoning for the diss, it's mostly because the Paleo diet hasn't been studied scientifically in people, so the pros and cons are somewhat vague to researchers.
At least, as of now. So all we have are the anecdotal accounts of those of us who've embraced Paleo to some extent.
Why Go Paleo?
It was evident to me that PWDs who eat fewer carbohydrates seem to manage their diabetes better than those who eat a higher carbohydrate diet. Last year, I briefly researched the Paleo diet, and discovered a few "paleobetics" who seemed to be doing fabulously on the diet. I also found dozens of testimonials from people who had nothing but good things to say. Even still, I remained skeptical but I realized that I couldn't form a real opinion until I tried it myself.
I came across a 30-day experimental challenge called the Whole30, which many health bloggers have participated in. The Whole30 website then led me to the New York Times best-selling book, It Starts With Food, written by Whole30 creators, Dallas and Melissa Hartwig.
I downloaded their book on my Kindle and devoured it in four days. The book laid out the whys and hows for the Paleo diet and the logistics of completing the Whole30 program.
My first words to my husband after finishing it: "You have to read this." (Which he did, because he loves me.)
Many Paleo bloggers and their readers will readily admit that eating like a caveman is more of a general principal, because there was no single caveman diet. It's kind of like telling someone today to eat like a human. The caveman diet likely ranged from primarily meats to primarily plants, depending on where the cave-folks lived. Plus, many Paleo followers now insert various ingredients to "paleo-ify" certain foods, such as kale chips, spaghetti bolognese made with spaghetti squash, and banana bread made with almond flour. Certainly not something a caveman would have dined on!
Grains, Dairy and Legumes, Oh My!
But dissecting the diet, it's important to look at why grains, dairy and legumes so bad for us... after all, I'd been under the impression they were healthy. What about all those vitamins, minerals and good whole grains?!
Some folks attribute the rise in heart disease, cancer, type 2 diabetes and other diseases to our 10,000-year-old "diet of agriculture." For most Americans, we consume far more carbohydrates than we would need on a daily basis, and our waistlines prove it. Many health experts now believe that carbohydrates, especially processed foods but even grains, stimulate the appetite because the brain doesn't respond to the nutrients the same way it does to meats and vegetables. Think about it: how many of you can eat Oreo after Oreo without stopping? How many of you can say the same thing about a rib-eye steak?
"Legumes and whole grains contain some of the highest concentrations of anti-nutrients in any foods," Cordrain writes. "These compounds frequently increase intestinal permeability and cause a condition known as "leaky gut," a necessary first step in almost all autoimmune diseases. Further, a leaky gut likely underlies chronic, low-grade inflammation, which underlies not only autoimmune diseases, but also heart disease and cancer."
However, there is also plenty of research showing that whole grains and legumes are good for you, but that simply overdoing it on the anti-nutrients will cause problems for your gut. So perhaps it's not so much a matter of cutting these items out completely as it is consuming them in moderation — even the supposedly healthy stuff.
For the Hartwig authors who penned It Starts With Food, it comes down to believing that grains have fewer benefits compared to fruit and veggies. Because of the potentially unsavory consequences, they think we should stick to a non-grain diet. In addition, many people also report seeing health improvements when going gluten-free.
Dairy is probably the most hotly debated area of the Paleo movement. The reason: dairy can actually be really good for you. It can also be bad for you. Dairy that comes from hormone and antibiotic-infused cows living in incredibly close quarters should probably be avoided. High-fat, and even raw (if you can find it), dairy is recommended because it has a good mixture of protein, fat, and carbohydrates. On the Whole30 plan, they cut dairy out completely because it could have negative consequences to the gut. Plus, it just seems unnatural to them that we humans are the only mammals that consume the "baby food" of another species.
In addition, the dangers of saturated fat and cholesterol, which originally scared many people away from the Atkins diet, may have been overstated. New research has come out that dietary saturated fat and cholesterol does not raise the body's cholesterol. The foods that replaced them, like margarine, may have actually caused more disease than the foods the health authorities originally blamed. So enjoy those eggs!
Adventures on the Whole30 Challenge
The Whole30 Challenge itself is like Paleo bootcamp. It is the Hartwigs' attempt at rebooting your system, helping you identify foods that aren't doing your body any favors. Does dairy make you break out? Do you get indigestion from gluten? Does sugar give you a headache? For 30 days, they ask you to go on a strict Paleo diet, but they also ask you to avoid "paleo-ifying" any junk food or treats, and you aren't supposed to count any calories or weigh yourself at all. This is not a diet, they say, this is about our relationship with food.
One of the biggest take-aways of the Whole30 is that food is a choice, but many of us find ourselves in habitual cycles of poor choices. Starbucks in the morning, candy for a snack, fast food for dinner. Sometimes we anticipate the food before we're anywhere near eating it, or we think we need it because it's ingrained in our routine, like dessert even if we aren't hungry.
It's easy to look at the program and think, Wow! I could never do this. That is hard. That is crazy. I thought like that at first, too, but then the Hartwig's reminded me that this is not the Whole365. The reason to do this is simply to reboot your system, and then after 30 days, you're allowed to transition back to eating normally, if you want to. Others stick to a mainly Paleo diet moving forward, with allowances for special occasions.
Here's what the Hartwig's have to say about the challenge of the Whole30:
It is not hard. Don't you dare tell us this is hard. Quitting heroin is hard. Beating cancer is hard. Drinking your coffee black. Is. Not. Hard. You won't get any coddling, and you won't get any sympathy for your "struggles". YOU HAVE NO EXCUSE not to complete the program as written. It's only thirty days, and it's for the most important health cause on earth — the only physical body you will ever have in this lifetime.
Really, how can you argue with that?
My husband and I dove in headfirst and dumped a bunch of our non-Paleo foods. We purchased a Paleo cookbook to aid us in what we could and couldn't eat. We also referred to message boards like PaleoHacks, and blogs by Paleo experts like Mark Sisson, Robb Wolf, and Chris Kresser.
And yes, we did start and finish the 30-day challenge!
This Whole30 definitely had an influence on my diabetes and it was for the better. Here are 5 things I discovered during my 5 weeks on the Whole30.
1. My blood sugars started dropping right away. It only took a couple of days before I saw that my blood sugars were lower and steadier throughout the day. After a few more days, I started having a fair share of low blood sugars!
2. My basal insulin is impacted by my diet more than my bolus ratios. When I first started dropping frequently — a 3-4 low blood sugars a day — I thought I need to cut everything. Turns out, I did need to drop my Lantus by 10%, but I didn't need to do anything to my bolus ratios. (Yet.)
3. I have the best control in recent memory, but it's not perfect. Like anything that involves tweaking and adjustments, the Paleo diet is hardly a cure. Now that I'm taking less insulin, there are fewer chances for me to go low, and more chances for me to go high. You can never expect anything -- not a diet, not a medication, not an insulin pump -- to run the show for you.
4. If you eat low-carb, you have to bolus for protein. This was the biggest shock for me. After querying my friends, I discovered that bolusing for approximately half the protein is what I need to do to prevent a post-meal spike. Gary Scheiner, author and CDE at Integrated Diabetes Services, explained, "Since your Central Nervous System needs glucose to function, if your diet is lacking in carbs, the liver will convert some dietary protein into glucose. So it is usually necessary to bolus for some of your protein whenever you have a meal that is very low in carbs." For me, a low-carb meal is anything under 30 grams of carbs.
5. My skin and energy levels improved. Not really diabetes-related, but certainly benefits!
My body didn't respond to the Paleo diet with significant weight loss, but I did lose 4 lbs and my husband dropped a whopping 13 lbs!
A lot of people have asked me about the cost of eating Paleo. While it did cost us more at the check-out counter, we also didn't eat out at all during January. The more meals you cook at home, the more money you'll spend at the grocery store. But we found that meals with more protein kept us full longer, so we didn't need to spend much money on snacks.
Life as a Paleo-betic
It didn't take long before my husband and I were committed to keeping up our Paleo diet long-term, although we have eased up. We don't want to miss out on life moments, but we also don't want poor food choices to ruin our health either. Based on recommendations by the Hartwigs, we are eating raw and saving our non-Paleo foods for special occasions. Actual special occasions, like birthdays — not a random Tuesday afternoon when we're bored!
My next A1C is scheduled for April 1st. My first A1C since going on MDIs was nothing to write home about, but I'm curious about this next one. Many people say that diabetes is easier to manage on insulin pumps, but there wasn't any difference between my insulin pump A1Cs and my first MDI A1C. I wonder if the secret to better control will be in my food choices, rather than in my technology.
One thing that I kept thinking about during my month-long Paleo experiment was how much of diabetes really is an experiment anyway. Think about how often we have to try out different things to see what works: Changing up bolus ratios and basal rates. Fiddling with different temp basals or snack choices before working out. Alternating what we eat for breakfast. While the Paleo diet may not be for everyone, I wholeheartedly believe that if what you're doing currently isn't giving you the results you want, maybe you should consider starting another experiment!