Half-Marathon Training – an Update

 

a picture of a blood testing machine on The Diabetes Diet
Post-run blood sugar today. Ten out of ten for me (for smugness too).

“Stone the crows, Emma! Wouldn’t have thought excessive temperatures would be the weather issue throwing a spanner in the half-marathon training, hmm?”

Good people, the woman who signed up for the Glasgow half-marathon in January uttered various predictions about running in Scotland. Most of them involved rain. As it turns out, my lightweight shower-proof coat has needed minimal use. Instead, I’m reaching for the sun cream and hugging the walls in a bid to stay in the shadows as I pound the pavements.

Smell that sizzling tarmac! Scotland has just reported its hottest June ever. Let’s give a shout-out to the poor polar bears in Aviemore.

Fortunately, I’ve discovered I can run in the heat. Again, not something I’ve had the chance to test out much over the years. When I trained for a half-marathon ten years ago, there were two hot days in May. I ran during them and hated it.

Blood sugar levels

But now? I’m okay. Running’s so bloomin’ difficult for me, the heat isn’t the thing that’s bothersome. It’s still the breathing, the adjusting of blood sugar levels to minimise low or high blood sugars and my reluctance to build up my miles

My half-marathon is three months away. I’ve yet to go farther than six miles. Most training plans are for 12 weeks, so there’s still plenty of time to add them up. I’ve found my ‘pace’, a super-slow snail-like jog. I’m hoping my general fitness will stand me in good stead, so that if the pre-race miles don’t stack up, those walking miles will cover ‘em.

I ought to join a running group too. Nothing like surrounding yourself with like-minded idiots people to spur one on. And they might know some different routes. I run the same roads all the time, favouring the reassurance of knowing at what point I draw on my reserves of energy and where I get excited because the end’s in sight.

Jessica Smith TV

Last week, when it was very hot (32 degrees), I exchanged outdoor for indoor exercise. I found an indoor jogging work-out on YouTube. “T’uh!” smug self said, “This’ll be easier than running out there in that heat.”

Not so! Ten minutes in and I decided I’d have been better off running outside in the blazing sunshine.

The heatwave here is set to continue. I’ll be training in high temperatures for a little while yet. Again, I’m hoping this magically builds up my fitness so that when I do talk myself into running more than six miles, it’ll be easy.

 

 

 

Public Health Collaboration Conference 2018: a great success for Lifestyle Medicine

I was delighted to attend and speak at the third PHC conference in London this year.  We met at the Royal College of General Practitioners in London on the sweltering weekend of the Royal Wedding. Apart from superb international speakers we were treated to low carb, high protein food, such as one would typically eat on a ketogenic diet. Instead of picking at our dinners as we often have to do with mass catering  we could eat the whole lot. Great!

Dr Peter Brukner from Australia started off the weekend with a review of what was happening in the low carb world. There are more and more reports coming out describing the advantages of ketogenic and low carb diets to different groups of people but the establishment are fighting back viciously as can be seen by the attack on Professor Tim Noakes in South Africa.  Indeed if his defence lawyers and expert witnesses had not worked for free he would be bankrupt.  This is a terrible way to wage war on doctors who are acting in the best interests of their patients.

Dr Aseem Malhotra also described bullying tactics that had been used against him when he was a junior doctor and first becoming publicly engaged in the low carb debate. I have been subjected to this as well.  Professor Iain Broom showed that the proof that low carb diets are superior to low fat diets goes back 40 years.

Dr Zoe Harcombe gave us an explanation of how the calories in- calories out idea just doesn’t add up. The well known formulas about how many calories you need to avoid to lose weight don’t work in practice because of the complex compensatory mechanisms we have to avoid death from starvation.  How you put this over to patients and give them useful strategies for weight loss and blood sugar control was explored by Dr Trudi Deakin.

Food addiction is a real issue, at least it is for the majority of the audience in attendance, who answered the sort of questions usually posed by psychiatrists when they are evaluating drug addiction.  Unlike drugs, food can’t entirely be avoided but ketogenic diets are one tool that can be used to break  unhealthy food dependence. This worked for presenter Dr Jen Unwin who at one point had a really big thing for Caramac bars.  I haven’t seen these in years but they did have a unique taste.

Dr David Unwin showed clearly that fatty liver is easily treatable with a low carb diet.

Dr Joanne McCormick describes how her fortnightly patient group meetings are making change accessible for her patients and how many GPs in the audience could broach the subject in a ten minute consultation.

The website Diabetes.co.uk will shortly be starting up a type one educational programme online that all are welcome to join. I discussed the issue of what blood sugar targets are suitable for different people and how they can achieve this with dietary and insulin adjustment.

Dr David Cavan spoke about reversing diabetes in patients in Bermuda. Although Bermuda looks idyllic the reality is that good quality food is about five times as expensive in the UK as it is all shipped in. Many inhabitants work their socks off but barely cover their costs and cheap sugared drinks and buns are their staple diet. Despite these setbacks he managed to persuade a lot of diabetic patients to ditch the carbs and this had favourable results even after the educational programme had stopped.

A cardiologist Dr Scott Murray described the effects of metabolic syndrome on the heart and really why sticking stents in diseased arteries is too little, too late. He is convinced dietary change is needed to reverse and prevent heart disease. This is the first time I have been told that certain types of heart failure and atrial fibrillation are direct effects of metabolic syndrome on the heart.

The importance of exercise for physical and mental well being was not neglected and we had Dr Zoe Williams describing the great benefits that even the minimum recommended exercise can produce.

Dr Simon Tobin and Tom Williams spoke enthusiastically about Parkrun. This is a free event that runs every Saturday morning in parks all over the world. You can choose to walk, jog or run the course.

Claire McDonnell-Liu is the mother of two children who have greatly benefited from a ketogenic diet. The conditions are urticaria and epilepsy.  Although NHS dieticians do help families with childhood epilepsy who want to use a ketogenic diet, they can’t do it unless drugs have failed, as this is NICE guidance. I wonder how many children would benefit in fit reduction without side effects of drugs if this guidance was changed?

This was a fabulous conference with a positive enthusiastic vibrancy. Thanks to Sam Feltham for organising this event especially since he has become a new dad as well.

The Public Health Collaboration are putting all the talks on You Tube.

I was interviewed about diabetes and women’s health issues for Diabetes.co.uk and Diet Doctor and these interviews and many others will be available for you all to see to improve your lives with diabetes.

 

 

 

This Week I’m…

It’s all about me, folks!

Is anyone’s week of that much interest to anyone else? Blogging demands a certain conceit – that yes, your activities and opinions are either interesting or useful to others*. I’m HUGELY entertaining, but only really to myself. Sometimes, my mum and husband laugh along too, if they are feeling kind.

Nevertheless, I experimented with this blog form elsewhere and decided to run with it on the Diabetes Diet. So, this week I’m…

Trying out new recipes. Like most folk, I’ve been stuck in the same ol’ recipe rut for a while. Prawn cocktail Monday, seabass with avocado Tuesday, sausages at some point. (Well, they are so flippin’ good.) I decided to try out lots of new recipes recently, and I’ve enjoyed the process.

Some of them worked wonderfully – steaming seabass and dressing it with ginger, soy sauce, sliced chillies and sesame oil gave me something new to do with fish. And the crust-less pizza was fun too. I tried Good Food magazine’s budget-friendly pot roast recipe, using silverside of beef, carrots, celery and stock, which would have been good if I hadn’t overcooked it.

It was as tough as old boots. My jaw still aches remembering the workout it got. Still, the gravy and the veg that came with it was MARVELLOUS!

Re-discovering running. I started running 13 years ago, did it regularly, entered a lot of 10k runs and even a half-marathon, and then lost the love. It was hard, it needed a massive amount of willpower to make myself get out there and do it, and it was dull, dull, dull. Seriously, there are good reasons why runners look so miserable. Then, four weeks ago, I decided to go for a run anyway.

Just to see if I still could.

And I could! Two days later, I thought I’d try again. I still could! And here I am, four weeks later going for a run every two days, and LOOKING FORWARD TO IT.

What’s different this time? I run so slowly, your granny could probably overtake me. If you take it super-slow, you don’t get that nasty struggling with the breathing thing. Or the lead-like calves. And I listen to a podcast while I do it. Anything comedic is a good bet, though you try listening to Radio 4’s News Quiz as they tear into our politicians and Donald Trump, and run at the same time. Laughing like a loon and heavy breathing is HARD.

Adjusting to the dark nights. For those of you outside of Scotland, by the start of November, it’s dark by 5pm (and it’s only going to get worse). You can do worthy things, such as making sure you do get some daylight at lunchtime if possible. On the other hand, it’s a great excuse to park your a**e on the sofa and binge-watch your way through Stranger Things 2.Image result for stranger things 2

 

*The stats for any blog serve as a great reality check, should you ever find yourself under the illusion that your opinions/activities ARE fascinating to anyone else…

Exercise and a Low-Carb Diet

Some people claim that as a type 1 diabetic, you can’t follow a low-carb diet and exercise. Is this the case*?

For most type 2 diabetics, the advice doesn’t apply. If you don’t take insulin or any blood-glucose level lowering medication, you’re not going to suffer from hypos, where blood sugars dip too low. A low blood sugar is usually defined as below 4mmol (or 70mg/dl in the States). There are no problems following a low-carb diet and exercising.

What happens to you as a type 1 diabetic when you exercise?

Lower AND Raise

Exercise or activity can lower your blood sugar levels. It can also raise them too, just to make life extra complicated. Many people find that intense exercise, such as high-intensity interval training, will temporarily increase blood sugar levels. But the same thing can happen with any activity that makes you huff and puff—a perceived exertion level of hard (15-17 out of 20 on the Borg Scale).

What happens to blood glucose levels also depends on how long you exercise for. Shorter periods of exercise and activity (less than 45 minutes) will not have as much effect as an activity that lasts longer than an hour. Timing is also crucial. When I want to go on a long walk (90 minutes), I usually schedule it for the morning or just after lunch. If I do this, I’m less likely to experience low blood sugars. In the morning, my body is fighting the cortisol spike that raises blood sugar levels. If I go for a walk right after lunch, I don’t take any insulin with my low-carb meal. A long walk will have the same effect as insulin. This might not work if I ate a high-carb meal.

I’m more likely to experience low blood sugars if I exercise in the early evening when my insulin sensitivity is greater anyway.

Basal Rate Reductions

If you know you are going to exercise or be more active than usual, you can lower your basal rate to compensate. With a pump, you can also put on a temporary basal rate reduction an hour or so before you start, keep that on during exercise and for an hour or so afterwards. Or you can switch to a different basal programme for the day.

You will also need to keep an eye on blood sugar levels over the next 24 hours. High-intensity interval training, for example, can lead to a temporary increase, but then a drop in blood sugar levels the next day.

One final point is adaptability. When we first try out a new exercise or activity, it often feels really hard. If you keep it up for a few weeks, what felt difficult soon becomes okay as your body become more efficient. So, a 30-minute spin class, for example, that might have given you a dramatic blood sugar level drop the first time you did it, has minimal effects five weeks later.

There are so many variables to type 1 diabetes, blanket statements such as “you can’t exercise and eat low-carb” do not apply to everyone. It’s challenging, yes, but if you know your body, you’ll know what exercise and activity you can do, when you can do it and how much to do if you want to avoid hypos. Like everything else, personal experience and logging what happens to you during exercise will help.

 

*The usual disclaimer applies. My opinions don’t constitute advice for other people. If you want to exercise and follow a low-carb diet, you will need to experiment to find out what works for you. If you go to classes or use a gym, make sure the instructors are aware that you have type 1 diabetes and always carry your testing equipment and fast-acting carbs, such as jelly babies, with you.