January 14, 2008

Diet Reflections of an Almost Old Lady

The comments posted in response to my previous post on calculating protein got me rereading Lyle MacDonald's book and rethinking the whole question of what we "know" about nutrition.

Partly this is because, after two weeks of eating a low calorie, very low carbohydrate diet containing the nutrients that all the nutritional calculators tell me should have resulted in a weight loss of 2 lbs, I haven't come close to losing 2 lbs. The same thing happened last year when I dieted for an entire month, logging and weighing anything and eating on an average of a measly 1150 calories a day--for an entire month--only to see a whopping 1 lb weight loss that vanished when I started eating more food.

The explanation of why my body pays no attention to what nutritional research says should happen is most likely my age and gender: I'm a lady in late middle age, but over the past 50 years all nutritional research involving weight and diet has been conducted exclusively in healthy young men or, in those rarer cases when the studies included females, young females.

No one has done a well-conducted study in which the nutritional needs and physiology of ladies past the age of menopause has been thoroughly investigated. When I was young, I could lose five pounds in a couple weeks just by not eating bread, potatoes, and dessert. Now I can to eat a lot less than what guys in those famous starvation experiments ate--guys who didn't weigh a whole lot more than I do--and not even lose a pound.

I know age has a lot to do with this. Cutting out estrogen packed weight on me faster than you can say, "Now I know why all middle aged ladies gain weight!"

So it's worth thinking more deeply about what the nutritional research has "proven." The protein calculator I put together was based on information taken from studies of starvation and nutrition conducted on young men which came up with the "fact" that people need 100 grams of carbohydrate to run their brains. They also came up with the idea that any diet providing under 100 grams a day of carbohydrate is ketogenic. This last bit of information is repeated everywhere that the topic of ketogenic dieting is discussed.

But in my many years of ketogenic dieting, I found that I would pack on glycogen--a sure sign I was no longer in a ketogenic state and was taking in excess dietary carbohydrate--as soon as I ate over 75 grams of carbohydrate. NOT 100. The dramatic water weight gain of 2 or 3 lbs I experienced as soon as I exceeded that carbohydrate intake level was predictable and reproducible. So it's pretty clear that for me somewhere under 75 grams is my ketogenic threshold.

If that is the case, then, what does it say about how much glucose my brain needs? Who knows? No one has studied the glucose needs of the brains of old us ladies. It is possible that as we get older, we may make adaptations very much like those of long term ketogenic dieters and be able to run our brains on less carbohydrate and more of something else even when not in a long-term ketogenic state.

Why do the physiologies of old ladies work so hard to pack on weight and manage to do it on such low caloric inputs? Beats me. My guess is that it has something to do with the fact that evolutionary pressures select for the kinds of genes that produce old ladies who can survive on lower amounts of food because their presence enhances their grandchildren's chance of surviving to reproductive age.

If granny eats too much, when times get tough she's not likely to survive--what food there is goes to the males and more aggressive young women who grab it for their kids. But if granny can pack on some fat by living on scraps in the good times, she'll survive the tough times and put her life-accumulated wisdom to the task of keeping the grandkids alive so they can reproduce those genes.

Should Old Ladies Diet?

I've already cited the NHANES data that concludes that a bit of overweight appears to enhance long-term survival and that being thin or a normal weight after a "certain age" predicts an enhanced likelihood of death. So it might make sense to just live with the weight.

I saw this among my mom's friends. The ones who watched their weight and went to the gym are long gone. My mom, whose only exercise program involved walking to the restaurant for lunch and strolling around the plus size department, out lived them all.

That suggests to me that, by denying me weight loss despite my best efforts, Nature is trying to tell me something. On the other hand, the particular weight I'm trying to dislodge packed on extremely quickly--over five founds within two months. At that rate of gaining I was not going to end up in the comfortable "overweight" range, but be heading for "obese" in another year--a status that does not correlate with health and could really mess up my blood sugar control.

So a-dieting I go.

No matter what the weight outcome of this particular diet, the good thing about doing a month or so annually of a stringent diet is that it makes me aware of the bad eating habits that have crept in over the year. I notice all those "daily" pieces of chocolate that turned into five daily pieces of chocolate, to say nothing of the once rare visits to the bakery with the great homemade soup and homebaked bread that got out of control.

A couple weeks of carefully watching everything I eat and eating just about no carbohydrates at all should put me back to where eating that one chocolate a day seems like a treat again and the soup visit happens twice a month, not two or three times a week.

I'm going to stick with this extremely low carb diet for a while longer because eating that way is the only way I can go without insulin, and the change to analog insulins--though it resulted in beautiful blood sugars--seems to be what caused the sudden and unexpected weight gain. As I said before, I can't eat 2-5-5 forever. It's far too restrictive. But I'm heading into week 3 now, and will go through it before deciding on my next step.

Eventually I have to figure out a way to add more carbs and find an insulin regimen that won't pack on the weight. Finding out that 3 oz. of white wine at night is almost as good as very low does basal insulin for controlling fasting BG is a good first step, though I don't know if it will hold up when I start eating more than 5 grams of carbs per meal again. I can do this because the kind of diabetes I have involves a failure to secrete in response to rising blood sugars, but I do still produce a small but steady amount of basal insulin--just not enough to cover any significant amount of carbs at meals any more.

But for now, my diet is doing a good job of resetting my expectations and providing my annual overhaul of my eating habits. If I could lose a couple pounds, that would be nice, too. At least I'm not going to be gaining 5 lbs this month.


Anonymous said...

I liked this article by Ron Rosedale, which noted that insulin's main role isn't to lower blood sugar (that wouldn't have been a problem for most of human history), but to store energy. Gary Taubes, as I recall, also covers this in his book.

Here's the Rosedale link:


So whether one is producing too much insulin or injecting it, it makes weight loss extraordinarily difficult.

Was wondering if you & your daughter got your results back from your testing...

Good luck!

Jenny said...


The insulin itself isn't the problem. I had been using Regular human insulin (R) for more than a year and actually lost weight for much of that time.

But switching from R to analog insulin--which is NOT the same as th insulin our bodies produce caused an immediate and serious weight problem.

The dosage I was using with the analogs was the same as what I used with R.

The last I heard from the gene researchers they were planning to make some "custom probes" which they warned me would take some time. That's all the news on that front.

Anonymous said...

I think it was Dr Malcolm Kendrick who pointed that people with Diabetes had better outcomes with a BMI slightly over 25 rather than in the "normal" range. Sorry, no link to hand at the moment


Anonymous said...

Have you ever taken a look at the Hyperlipid blog? I just found it and am fascinated. I thought of you while reading this post:


And as kathy w mentioned, Taubes has a lot to say near the end of his book about insulin, metabolically active fat cells, energy regulation, etc., which I found extrmely interesting. I am finding my energy levels increase on days when I eat a *lot* more fat, especially coconut oil, MCT (medium chain triglyceride) oil, and full fat coconut milk.

Anonymous said...

Like Anna, I was wondering about your fat intake whilst reading the post - particularly if you're focussing on calories. Coconut oil has some very interesting properties - I learn that epileptics on a ketogenic diet use MCT fats to allow them to eat more carbs and still stay heavily in ketosis. No personal experience - although I'm sufficiently intrigued to have bought a pot of the stuff :)

Jenny said...

I hadn't been logging food this time around, but yesterday I did, out of curiosity. I ate a bit more yesterday out of fears that I might be slowing my metabolism too much.

I came up with 80 grams of fat for 68% of calories. 26 grams of carb and 7 of fiber for 8% of calories and protein at 103 g for 33% of calories. Those ratios are about right. Total calories were 1276.

The carbs were almost all from vegetables, salad, half and half, and cocoa powder.

I have heard about coconut oil too, and occasionally cook with it.

Unknown said...

I have to say I am very sympathetic to your situation Jenny, as a 25 year old female, I lose weight pretty well on much more food, and I can avoid gaining weight if I keep it around 1700. This is at a weight most people consider skinny (after holiday folly of 100 carbs and darn near 2000-3000 cal many days, I'm 123 at over 5'5).

I am amenorrhetic but I suppose I have enough estrogen to avoid those metabolic complications.

I notice my mother too, 58, seems to require very little food to lose weight. I suppose it must be estrogen.

Do you think maybe some of it could be related to thyroid problems? It's very common in older women and underdiagnosed. I am actually wondering if thyroid issues are at least partially responsible for my mom's problems. She's been a lot more lethargic and takes naps during the day. I know she's up there in age but that doesn't strike me as normal for 58.

Jenny said...


I've had my thyroid checked with the sophisticated tests and it comes through resolutely normal.

I've read that metabolic rate slows 10% for each decade.

When I look at cars that are as old as I am, I realize how astonishing it is that this body still works at all. But there is rusting--oxidation, and the breaking down of various tissues and the storing of bits of crap here and there going on that result for 6 decades of organic chemical reactions.

When people get a whole lot older than I am, they seem to stop wanting to eat much too. I'm not there yet.

I am at the phase in this diet where every night without fail in my dreams I'm eating huge muffins and pecan rolls.