Last week I posted about the weight and health check station at the pharmacy, and how, after the initial weight loss when I stopped taking steroids, it's going to start being work to get my weight under control.
I did another check in today, and it was one of those good news/bad news stories. The good news is I lost about 5kg last week. The bad news is my overall health score dropped from 3.6 to 2.5.
That happened because my blood pressure and pulse rate had gone up. I can explain that. Last week I was using my scooter at the shopping centre. This week, I tried walking. That's what increased my blood pressure and pulse rate: exercise. With the pain and exhaustion that followed from being on my feet for about two hours doing the weekly shopping and odd jobs, I think next week I'll go back to the scooter. So next week my blood pressure and heart rate will be my resting rate again.
I will keep my exercise to the Lupus Exercise workout a couple of times a week, and a bit of pottering in my garden.
Really, the balancing act between doing enough to care for my health, and over-doing things and making myself sick, is a challenge I struggle with every day. I know other lupies struggle with this too. It's a tightrope we all have to walk, and the consequences of doing too much or too little can be greater for us than they are for healthy people.
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For the last few months, I've had a problem with my bathroom scale. I will gain and lose more than six or seven kilograms per day. Clearly my scale was faulty.
Rather than go to the expense of buying another one, I thought I'd check in at the free health check station at my local pharmacy.
It checks weight, BMI, body fat percentage, blood pressure, pulse, all kinds of things, and emails the results.
My results were very sad. My weight came up worse than the scale at home said at any time. My overall health score was 3.6 out of ten or bottom six per cent of the population.
Now, don't get me wrong, I wasn't under any delusion I was healthy, but I hoped that despite lupus, I wasn't that bad.
I guess I have a lot of work ahead of me.
Key to that will be slowly building up to daily exercise, and using my Calorie King app to get back in control of my eating.
When my steroids were reduced, I dropped a dress size, without trying, which was great. It's becoming clear, however, that to get any further will take some actual work.
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give $1 a month to support this blog?You can become a patron for as little as $1 a month (up to any amount
you choose.)As a thank-you gift, I'll
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How did this amazing thing happen, when I've been unsuccessfully battling weight for years?
A while ago, I talked my rheumatologist into letting me try a lower dose of prednisone.
He told me that the 5mg dose I was on shouldn't be enough to make me gain weight. However, he was finally persuaded to let me gradually reduce to 3mg per day.
It doesn't seem like a lot, does it?
I knew it would mean extra pain, and I was prepared for that. I find I'm using more meloxicam (anti-inflammatory tablets) and anti-inflammatory gels and rubs. With that help, I'm managing the pain.
But I stuck to Calorie King, which regular readers know I've been doing for years, and slowly, something is starting to change.
My weight still fluctuates wildly from day to day because of my problem with retaining fluid, so I really can't reliably tell how much I've lost, but my jeans had been getting looser and looser.
About a week ago, I found I could pull them on without undoing them.
Today, I found an older, smaller pair. They're loose.
In my ongoing struggle to lose weight while taking prednisone, I found myself reading "Fat is a Feminist Issue" by Suzie Orbach. (The Kindle version I bought has both the first and second books.)
Orbach is a psychotherapist, and her books look into the psycho-social development of women and our relationships with our bodies, and how this leads us to the constant dieting/bingeing cycle that so many women (and increasingly men as well) are so incredibly familiar with.
The book reminded me very much of Dr Dorrie McCubbrey's "How Much Does Your Soul Weigh?" that I read a number of years ago.
Both authors say the solution to the problem isn't yet another diet. It's about understanding our relationship with food, with our bodies, with how we see ourselves.
For those of us who have repeatedly gained and lost weight, the cycle can seem like it has no end. Each time, it gets harder to keep control, to stay disciplined enough.
Both Orbach and McCubbrey say stop being so disciplined. Stop fighting for control. Stop seeing food as the enemy. Start understanding why you eat the way you do.
Years ago, when I first read McCubbrey's book, I did a lot of work on my emotional relationships with food, the memories food brought up, the fear of scarcity, of not having enough or not having my share.
Revisiting this again, I think there is now just one main reason I do still binge.
On what I call a "normal" day, I will eat far less food than Calorie King would allow me. That's not because I'm super-good or super-self-controlled. It's because I've eaten enough and I'm not hungry any more.
But once or twice a week, I will break out and have a binge. I will eat until I feel sick an keep eating. I won't care what I'm eating. Reading Orbach's book has helped me pull myself up mid-binge and work out just what was going on.
Are you ready for this?
It was fatigue.
I was so exhausted I was trying to give myself an energy boost by eating.
Do you know what? It doesn't actually work.
Sometimes I can overcome fatigue for a short while by drinking lots of coffee, but most of the time, really all I can do is sleep.
Instead of kidding myself I'm fine and can just keep going and going, I actually need to stop when I'm tired and have the rest my lupie body is demanding.
Bingeing won't fix it.
From now on, when I'm tempted to binge, I'll go and lie down first if the option is at all available.
Will that make me lose weight? I don't really know. I'm taking prednisone, after all. I don't know how it works, but I do know that prednisone has done all kinds of weird things to my body - such as make me retain stupid amounts of fluid and give me a problem with high blood pressure (when my blood pressure was always just a tad lower than it should have been before.)
I do know I feel much better when I'm not shovelling in food I don't want in an attempt to achieve the impossible.
Those of us taking steriods often struggle to lose weight (or even to stop gaining weight), let's revisit the basics of weight control with an expert in the field of food. The following post, by Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle has been republished from The Conversation. See the original version here: https://theconversation.com/health-check-six-tips-for-losing-weight-without-fad-diets-52496
Health Check: six tips for losing weight without fad diets
Clare Collins, University of Newcastle
Monday - start diet. Tuesday - break diet! Wednesday - plan to start again next Monday.
If this is you, it’s probably time to get off the diet roller coaster and make some bigger changes to the way you eat, drink and think about food.
Here are six tips to help you get started.
1. Improve your diet quality score
When trying to lose weight, it might be tempting to quit carbs, dairy or another food group altogether.
But to stay healthy, you need to meet your requirements for important nutrients like iron, zinc, calcium, vitamins B and C, folate and fibre. These nutrients are essential for metabolism, growth, repair and fighting disease.
Our review of diet quality indexes used to rate the healthiness of eating habits found that eating nutritious foods was associated with lower weight gain over time.
Improving your diet quality means eating more fruit and vegetables, lean meats, poultry, fish, eggs, tofu, nuts and seeds, legumes, dried beans, wholegrains and dairy (mostly reduced fat).
Rate your diet quality and get brief feedback using our online Healthy Eating Quiz www.healthyeatingquiz.com.au.
2. Mum was right - eat your veggies
Fruit and veg are high in fibre, vitamins and phytonutrients, but low in total kilojoules. So eating more can help you manage your weight.
A study of more than 130,000 adults found that those who increased their intake of fruit and vegetables over four years lost weight. For each extra daily serve of vegetables, there was a weight loss of 110 grams over the four years. It was 240 grams for fruit. Small, but it all adds up.
Not all vegetables are equal.Michigan Municipal League/Flickr, CC BY-NC-ND
Drilling down to specific fruit and veg gets interesting. Increasing cauliflower intake was associated with a four-year weight reduction of about 620 grams, with smaller reductions for capsicum (350g), green leafy vegetables (230g) and carrots (180g). The reduction was 620g for blueberries and 500g for apple or pears.
It was not good news all round, though. Corn was associated with a weight gain of 920g, peas 510g and mashed, baked or boiled potatoes 330g.
3. Limit your portion size
If you are served larger portions of food and drinks, you eat more and consume more kilojoules. That sounds obvious, yet everybody gets caught out when offered big portions - even when you’re determined to stop when you’re full.
Research shows offering larger portions leads adults and children to consume an extra 600 to 950 kilojoules (150-230 calories). This is enough to account for a weight gain of more than seven kilograms a year, if the kilojoules aren’t compensated for by doing more exercise or eating less later.
4. Watch what you drink
A can of softdrink contains about 600 kilojoules (150 calories). It takes 30-45 minutes to walk those kilojoules off, depending on your size and speed.
Children and adolescents who usually drink a lot sugary drinks are 55% more likely to be overweight.
Switch to lower sugar versions, water or diet drinks. A meta-analysis of intervention studies (ranging from ten weeks to eight months) found that adults who switched had a weight reduction of about 800 grams.
5. Cue food
Our world constantly cues us to eat and drink. Think food ads, vending machines and chocolate bars when trying to pay for petrol or groceries. Food cues trigger cravings, prompt eating, predict weight gain and are hard to resist. They can make you feel hungry even if you are not.
Ditch the oily popcorn and take your own snacks.rpb1001/Flickr, CC BY-NC
Try to minimise the time you spend in highly cued food environments. Avoid food courts, take a list when you go to the supermarket and take your own snacks to places where highly palatable food is advertised, like the movies.
This will reduce autopilot eating, which sabotages your willpower.
6. Resist temptation
A treatment for food cue reactivity is called exposure therapy. With the help of a psychologist or health professional, you expose yourself to the sight and smell of favourite foods in locations that commonly trigger overeating, like eating chocolate when watching TV. But, rather than eat the chocolate, you only have a taste without eating it.
Over time, and with persistence, cravings for chocolate reduce, even when cues such as TV ads or people eating chocolate in front of you are present.
You can also draw on your brain’s own self-management skills to resist temptation, but it takes conscious practice. Try this food cue acronym, RROAR (remind, resist, organised alternative, remember and/or reward), to train your brain to resist temptation on autopilot.
When you feel yourself pulled by cues to eat or drink:
Remind yourself that you are the boss of you, not a food cue.
Resist the tempting food or drink initially by turning your back on the cue. (This gives you time to think about next steps.)
Have a pre-Organised Alternative behaviour to use against food cues. Grab a drink of water, walk around the block, check your phone messages, read, take a walk in the opposite direction. Diversion works.
Remember what your big-picture goal is. Do you want to eat better to help you feel better, reduce medications, lower blood pressure, improve diabetes control or manage your weight?
You can add another R for Reward. Financial incentives help change behaviour. Each time you complete your organised alternative behaviour put $1 in a jar. When it builds up, spend it on something you really want.
Swap to small plates to reduce your portion sizes.Robert S. Donovan/Flickr, CC BY-NC
You need a plan
The journey off the diet roller coaster needs a cunning plan. Here’s how you can put it all together.
Start by assessing your diet quality using the Healthy Eating Quiz.
Next, plan weekly meals, drinks and snacks. Write a grocery list and buy extra fruit and vegetables.
Swap to small plates, cups and serving utensils. You’ll serve and eat less without thinking.
Aim for half your plate covered with vegetables and salad, one-quarter lean protein (trimmed meat, chicken, fish, legumes) and one-quarter grains or starchy vegetables (potato, peas, corn).
Change your food environment to avoid constant prompts to eat.
Minimise the places you allow yourself to eat and drink to reduce food cue exposure (not in front of TV or computer, at a desk, or in the car).
Keep food out of sight (unless it is fruit and vegetables). Store in opaque containers.
Remove workplace food displays, such as food fundraisers.
Plan driving and walking routes that do not take you past fast-food outlets or vending machines.
Prerecord TV shows and fast-forward food ads.
Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle
This article was originally published on The Conversation. Read the original article.
It's a while since I've shared my struggle with my weight.
As many lupies know, losing weight while taking steroids is a major challenge, and the older I get the harder it seems to be.
I may have always had a bit of a weight issue, but many years ago, I got control of it. In my early 20s I was a Weight Watchers success story. I got to my goal weight and stayed there. I gained during two pregnancies, and then got back to my goal weight in reasonable time. (Actually, in the first pregnancy, I was so sick that I lost an extra 5kg before I started gaining, so I was below my healthy weight for a while.)
Not only was I a success at my own weight loss, I was a Weight Watchers leader for a while, and helped other people reach their healthy weight goals as well.
Major life events have got me off track at times, but for at least a decade I was always able to bring my weight back under control with a bit of effort.
Fast forward to lupus and prednisone.
More recently, I've been up to twice my healthy weight. (I was attempting to make an L-sign for lupus awareness.)
Since starting on prednisone, my weight has been out of control.
I've tried again and again to get it under control, and again and again, it's got away from me.
At my worst I've been up to 115kg. (My healthy weight is in the range of about 52-60kg).
My rheumatologist keeps telling me to lose weight - but with prednisone, it's hard.
Prednisone makes me hungry almost all the time, but apart from that, it just seems to make weight stay on and stay on, even when I do everything right.
It causes lovely things like the "buffalo hump" that makes me look a bit like Quasimodo. So the weight isn't just staying, it's staying in weird places.
So what's happened to make me determined to try again?
On Christmas Day I ate too much. Not only that, but most of the food available where I celebrated Christmas was full of gluten, and I decided to just eat and deal with the consequences.
The consequences were that I was so sick that I couldn't face food.
Do you know what happens after a couple of days of eating hardly anything? Well, for me, it means not really wanting to eat a lot. It's the perfect time to start to get control of my eating, to go back to the habits that got me to a healthy weight and helped me stay there for years.
So, when I was ready to start eating again, I installed the Calorie King app on my phone, I filled the fridge with fresh healthy non-processed and minimally-processed foods, and I began recording everything I eat.
I know how to do this. I've done it before. I just have to stick to it, and sweat out the times prednisone tells me to eat and eat and eat, and not get discouraged when prednisone and lupus make me retain so much fluid that it seems I'm packing on weight.
I'll keep you informed how I go. If you're a long-term reader, you know I've tried this before.
What makes now different? I turn 50 in May. (Actually this blog turns 5 at the same time. For those readers who've been with me from the beginning, can you actually believe it's been this long? I'm having trouble getting my head around it.)
I'm getting older. I'm sick. I don't need to be fat as well. So prednisone or no prednisone, I'm determined to overcome this time.
And it would be good to force my rheumatologist to have to come up with a new lecture. "I prefer my patients to have an hourglass figure," is starting to get old.
I'll try hard to take care of my diet, and to do a little bit of exercise. If I fail, I won't beat myself up over it, and will just try again the next day. I'm going to do what's good for me, without worrying about the number on the scale (because prednisolone and any number of other things affect that number any way.)
I'll try to keep on top of my work around the house and garden, so I don't have lots to catch up. But, if I don't get to keep up with everything, I'm OK with that.
I'm not going to stress about what I don't get done. If you visit me and the dishes aren't done, don't be surprised. (The carpet will be vacuumed - my son does the heavy jobs.)
I will rest if, and when, I need to, and I won't feel guilty about it.
I will try to build some relationships with other lupies locally. (I've already arranged a get-together for the Lupus Association Queensland, at the end of February, so lupies who live in this area can meet up.)
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Most of my life, I have been mostly interested in caring for other people. This year, I'm aiming to learn to care properly for me. (That doesn't mean I will forget everyone else.)
Overnight, my ankles swelled so much that the elastic supports that I use to help ease the pain, were slicing into me.
About a month ago Dr K, my rheumatologist, asked me to stop taking sulfasalazine for a month to see if it was still working.
Well, I definitely found out.
I've found myself in a flare.
To start with my usual aches and pains became more pronounced than usual.
My ankles have been hurting so much that the only way I could keep the pain under control enough to sleep was to put elastic joint supports on them.... but then my feet and ankles have swelled so much that in one night supports that were comfortable (and comforting) at bedtime, were cutting in to me the next morning. Actually, truth be told, by morning my ankle didn't look much like an ankle at all - there was no shaping at all, my leg just seemed to end in a foot with nothing in between.
The pains grew worse, and more diverse until the point when even the small joints in my fingers and toes were hurting.
My fatigue reached a point where I was sleeping all day. I was also nauseous, and had a couple of nights of alternating between sweats and chills. I was guzzling coffee and binge eating to try to get the energy to stay awake for a couple of hours each day.
So, over all, I guessed that, yes, the sulfasalazine had been doing something after all.
I've started taking it again.
After a few days back on it, I'm a little less tired, and a little less sore, but I've got some way to go to get back to where I was before stopping the drug.
My drug cocktail is based on trial and error. Some of those trials are pretty awful, and the errors I'd rather avoid. But this is life with lupus.
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I had my regular visit to the rheumatologist this week.
Dr K works in the city, which means driving to the station, a train to the city, and a 20 minute walk from the station to Dr K's surgery. (OK, it's probably a five minute walk for most people, but this is me.)
So he immediately noticed that I looked unwell.... I explained I always look unwell after a 20 minute walk, but I persist in believing that little bits of exercise must be good for me, even if I can't go to a gym for a full work-out any more. For once he didn't bother to give me the "with lupus, if you use it you'll lose it" speech.
Instead he gave me the "you need to lose weight" speech. He added a horrible warning this time - my arthritis in my ankles may be from lupus, but unless I lose weight, I'll also have osteo arthritis, which isn't ever going to go into remission.
Now, I'm fully aware that I'm well and truly over my healthy weight. I know it's completely necessary to lose the excess.
I also know that Dr K has me taking prednisone which puts on weight just by existing, but which also gives me an uncontrollable appetite. Every time I try to diet, I can stick to a program for a couple of days but by the end of the week, the ravenous prednisone appetite gets to the point that there's no way I can possibly suppress it. Add to that, that Dr K stopped me going to the gym, and absolutely insisted he would not give me enough pain relief to be able to do any strenuous exercise (the "use it and you'll lose it" speech), I'm well and truly sunk.
So here I am stuck, with willpower that's just not strong enough to beat prednisone and a body that can't and won't exercise more than a very slow walk, or a hydrotherapy workout.
The next day, I told my problems to my GP (for those of you overseas, a GP is a General Practitioner, a family doctor). I asked if there are any weight loss pills that actually work. Her answer was simple - no there aren't.
I wanted to know, what else I could do (apart from developing a weight loss tablet that doesn't work, advertising it as a miracle drug, and getting rich).
Her answer was to try a different kind of weight loss program. She recommended the book The Fast Diet by Michael Mosely. Dr Mosely looked at scientific evidence for fasting on alternate days providing lots of health benefits - not just weight loss, but reduced inflammation, better blood pressure and cholesterol, and number of other benefits. He then developed the idea of a fast on two non-consecutive days a week, on the basis that it is easier than alternate days, and people would be more likely to stick to it.
By self-testing, he found he lost weight by sticking to a fast on two non-consecutive days a week, and found that his health improved as well.
On a fast day, women eat no more than 500 calories (if you're like me and grew up with kilojoules, that's 2100kj), men eat no more than 600 calories (2520kj).
Do I really believe that a fast on two days a week will do everything for me that the alternate day fasting, which scientists actually researched, would do? I'm skeptical. But on the other hand, if on the non-fasting days, I don't eat more than usual to compensate, then in any given week, I have surely eaten at least 5000 to 6000 kj less than I'd normally have eaten. That's a whole day's food less than usual, so I should theoretically lose weight. And it means I don't have to struggle with maintaining willpower day after day - I just have a "first day of the diet" to deal with - then I go back to eating normally, and then have another "first day of the diet" to deal with. I always know that I'm only one day away from being able, without guilt, to give in to the craving for chocolate or cake.
So far, I've fasted two days. I've found it not at all difficult. In fact, I'm starting to wonder if I want to increase it to three days per week during Lent, and to explore some of the spiritual side to the tradition of fasting.
And if I do have a bout of the prednisone hungries on a fast day, all I have to do is nominate it a non-fast day after all, and have another fast day in its place.
Hopefully, this will work. It has to. My ankles are depending on it.
Reference:
Mosely, Michael. The Fast Diet: Lose Weight Stay Healthy and Live Longer with the Simple Secret of Intermittent Fasting.
As regular readers know, I struggle with my weight.
I know I'm not the only lupie with this problem. Sometimes, prednisone just makes me ravenous. I can't stop eating. That's the reason for my failed attempt to wean off it. (OK, I have discovered what a wimp I am - I just can't take the pain I suffer if I take less steroid.)
Then there's other times, such as the past few days, when I can't eat. I can't tell you why it happens. I just don't know the cause. I know that some of the books I have read have said that lupus can cause anorexia. I know that some of my medications have anorexia listed as side effects. When I'm 30kg overweight that I can't say I could be considered anorexic in any way, shape, or form.
But I have times, when the thought of food revolts me, and when I force myself to eat, my stomach objects in no uncertain terms. For half the week, I've been trying to force myself to eat. I'm almost at the stage of giving in and just buying a can of Ensure powder to sustain me until I get past this stage.
It's always passed before, either in days or a week or two at the longest.
What I'd like is a half-way point. I would love to be able to eat the way healthy people eat - to have enough, and know when to stop. That's the dream.
In my ongoing endeavour to finally lose my excess weight, and hopefully improve my health in the long-term, I'm in the process of weaning off my steroids.
Last fortnight I dropped to 4.5mg per day. And today I go down to 4mg per day.
I've already noticed an increase in pain levels. But I've also actually started to lose weight - down half a kilogram last week. Losing 30kg is going to be a long, slow, painful process. But it will mean long-term, taking the excess stress off my joints. It will also hopefully help protect my organs, which I'm sure will much prefer to not be wrapped in fat.
Lupus medication is always a difficult balancing act.
The side-effects of our drugs are horrible, and can have serious long-term implications for our health.
Lupus patients find ourselves taking drugs to mitigate the side-effects of our drugs.
Trying to keep our bodies safe from the worst of the disease activity, while also keeping us safe from the worst effects of the drugs that control the disease, is always a challenge.
One of the many issues that a lot of lupies seem to face is managing our weight.
Some of the literature about lupus warns that anorexia can a symptom of lupus. Some of the patient information sheets that come with lupus medications also warn that anorexia can be a side effect.
Talking on Facebook, there's a number of lupies who struggle with being underweight. They try, but lupus or medication just make them so sick they can't eat enough, or eat and can't keep down enough, to gain weight. They're just always unhealthily underweight. It's not anorexia in terms of the poor body image, it's just a simple practical issue of it being a major effort to try to eat enough energy for their body's requirements.
Then there's the group like me. Medication, and steroids get blamed more than most, but some others get the blame as well, make us put on weight. Prednisone (steroid) causes fluid retention and uncontrollable appetite as well as a number of other equally unpleasant effects. Some people (very heroically to my mind) have won the battle of losing weight on prednisone, but there's lots of us who have tried and tried and just haven't got anywhere.
I'm at the stage of having asked my GP to help me wean off prednisone so I can lose weight. My rheumatologist insists that I need to lose about a third of my bodyweight, and I've struggled for years but been unsuccessful while taking prednisone.
I'm sure there are a fair number of lupies who manage to stay within a healthy weight range. For others of us, both lupus and lupus drugs make it very difficult to manage something that is so basic and important to health.
At my weight loss group this week, we were talking about stress eating, and more constructive ways to deal with stress.
Of course, the best way to deal with stress, is to solve the problem that is causing stress. But that isn't always possible. Everyone in our group was able to identify sources of stress that were constant, and had no solution. As someone in the group said to me, "You can't leave your body behind."
Whether it's your own or a family member's chronic illness, or another problem that doesn't have an easy or practical solution, there's often causes of stress that can't be fixed.
It's no wonder that many people, like me, use food as a means of dealing with stress - some of us binge eat, others don't eat enough. In many ways, it's not as bad as using dangerous drugs to cope, but it's still not healthy, and it can still have fatal consequences. (Obesity-related illness is a major killer, and, let's face it, if you're reading this site you've probably got enough health problems without adding any more.)
If it's not possible to deal with the cause of stress, to fix the problem, then it seems the only way to deal with it is to deal with the results. Instead of having stress hormones giving us fight or flight messages our bodies can't do anything with, we need to encourage our bodies to produce the kinds of hormones that tell us everything's fine and we don't need to worry.
We can help ourselves to feel happier, more content (and less likely to feel on edge and to eat to calm that feeling).
For many people, exercise helps with this. That's not always an option for lupus patients. Doing what exercise we are able is good for a number of reasons, and regulating those stress hormones is only one of them. It also makes a difference to joint mobility and overall health.
Sometimes, the way to deal with the stressors that we can't change, is to take a tip from small children - to announce that we're just going to "run away". To simply take a break from the cause of the stress.
We can't take a holiday from our bodies, but we can take our minds away from our stresses for a while.
Here's some suggestions for "running away" from stress:
Read a good book. Slip into a fantasy world, and forget reality for a while. (If money for buying books is a problem, remember council libraries are free.)
Watch a movie or a play.
Try writing fiction, create your own fantasy world.
Arts and crafts can give you something to focus on, where you can have a sense of achievement, and create something worthwhile.
Pets can give you something to focus on beyond your own stressors.
Meditation and prayer give the opportunity to let go of the stress, to relax, to feel that you are not carrying a burden alone.
Put on some favourite music and dance.
Play an instrument.
Have coffee with a friend. (It's just as good having coffee at home as it is to go out to an expensive coffee shop.)
Do all of these things sound obvious? Yet, it's easy to go on and on for weeks even months without doing any of these things, or anything else that makes you happy, takes you out of yourself, or gives you some sense of happiness or achievement.
It's possible to have stress just build up and build up and build up, to get depressed, or to engage in self-destructive behaviours, like binge eating, to try to deal with how we feel. It's much better to try to release the pressure in some healthier ways.
Sometimes, the only way to achieve something is to set a definite goal - not just, I will do better at something, but that I will do something I can measure to know I've achieved it and set a time limit.
awesomeanimals.cheezburger.com
Once I moved, and realised I could at last afford my rent, and not keep getting further into debt, I looked at my finances. I have a plan now to be out of debt by the end of 2016. That's without missing out on anything I really need, and starting to save to cover anything unexpected.
To do that, I've had to sacrifice some things that I know I can live without, for example, I've dropped the hospital cover from my health insurance, and now only have extras cover. If I need hospital care, I will go to the public system. Throughout my adult life, whenever I have had enough income, I have private health insurance, otherwise I have counted on the public system. To me, it's an ethical choice, if I can afford a private hospital, I'll leave a space free in the public system for someone who really needs it, but when I can't afford the private system, I don't feel guilty about taking my place in the public system. I've been a patient in both, and have to say I've actually found the public system far superior.
I'm also saving money by simply spending more time at home, eating all my meals here, inviting friends here for coffee instead of meeting them out, and not using the car as much.
How not to lose weight - failblog.org
There's another goal I needed to set, and absolutely must achieve. With continual reminders from my doctors about my weight, and now not needing to escape my home to get out of the heat constantly, I can start to address the basics of food and exercise. It's time to set the weight goal as well. I will be a healthy weight (for me, that's the range between 52kg to 62kg) by the end of 2016. Again, that's enough time to allow for some setbacks, lupus flares, etc.
My plan is quite simple. I need to go back to calorieking.com.au and follow the program carefully. I need to make sure I know what I'm eating and how much, and that I'm doing sufficient exercise. Because the flat is cooler and more comfortable, I'm able to spend the time in the kitchen to cook healthy meals.
I've started to exercise, with a daily walk around the block with my old dog. (Calorie King also counts housework as exercise, so that also contributes.)
Three years seems like a long time, but with both of these goals, the only way to achieve them is the long, slow, way. And the time to get started is right now.
It's Thursday, which means I have weight loss group tonight.
I feel very strange this week, trying to come up with a topic on healthy eating and lifestyle, when I know that for the past week I haven't had the energy to eat food - I've been living on coffee and Ensure.
So tonight, instead of looking at what we should be eating, I thought of looking at one of the "recipes" in Dr Dorrie McCubbrey's book How Much Does Your Soul Weigh?
In her book, she suggests that the answer to weight problems isn't so much in what we eat but in what is happening in our minds and souls.
The last chapter is a series of "recipes" for the soul.
Tonight, we're going to look at Recipe #11 (Happiness): I accept myself exactly as I am.
We will list the things which we don't like about ourselves. Then look at those things from the point-of-view of a close friend (someone who knows us really well), and give ourselves the positive view of those things.
Often the messages we give ourselves about ourselves, are very negative. And often, they are not true. This exercise is about seeing ourselves as we are.
Reference:
McCubbrey, Dorrie. How Much Does Your Soul Weigh? New York: HarperCollins, 2002.
High fibre foods and mono-unsaturated fats lower LDL.
Well, it's weight loss group tonight, and we have a question that came up at last week's meeting: Does eating rolled oats actually lower your cholesterol?
The short answer is "yes".
The longer answer is as follows.
Cholesterol is a kind of fat that your body needs. It's present in all the cells of your body. It helps make hormones, and control metabolism.
But like the salt we talked about last week, we need far less than most Australians actually have. According to the Heart Foundation, 51% of us suffer from high blood cholesterol.
When we are concerned about high cholesterol, we usually concerned about high levels of LDL (Low Density Lippoprotien) which carries cholesterol to the cells and can block arteries. The other kind of cholesterol, known to be the "good" kind is HDL (High Density Lippoprotien) which takes cholesterol out of the body.
To lower LDL, we need to eat a healthy diet.
There are foods that can help lower LDL, and one of them is yes, rolled oats. It helps because it contains soluble fibre - and all foods with soluble fibre help to lower cholesterol. So that's rolled oats, barley, legumes, fresh fruit and vegetables. The fibre that helps us feel full and keeps the digestive system functioning well, also helps lower cholesterol.
Eating monounsaturated fats, such as the omega three fats in fish, olive oil and the fats in nuts and avocados also helps to lower LDL.
The "bad fats" the saturated fats in animal products will increase LDL. So another way to reduce cholesterol is to take the skin off chicken, remove the visible fat from meats, and where possible avoid the hidden fats in things like cakes, biscuits, and fried foods. And, of course, we need to opt for low fat varieties of dairy products.
Exercise also helps reduce LDL, so adding exercise into the daily routine can help.
In summary, to lower cholesterol
Eat lots of whole grains
Eat legumes/pulses
Eat fish
Eat olive oil, avocados, and other mono-unsaturated fats
Eats lots of fresh fruit
Eat lots of fresh vegetables
Take visible fat off meat
Eat skim or low-fat dairy foods
Avoid deep fried foods
Avoid cakes, pastries, etc
Avoid fatty meats
Have some exercise daily
References:
Better Health Channel: Cholesterol http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Cholesterol_explained
CSIRO: The Facts About Cholesterol Levels http://www.csiro.au/en/Outcomes/Health-and-Wellbeing/Prevention/CholesterolFacts.aspx
Harvard Health Publications: 11 Foods That Lower Cholesterol http://www.health.harvard.edu/newsletters/Harvard_Heart_Letter/2009/October/11-foods-that-lower-cholesterol
Heart Foundation: Fats and Cholesterol http://www.heartfoundation.org.au/healthy-eating/fats/Pages/cholesterol.aspx
Mayo Clinic: Cholesterol Top 5 Foods to Lower Your Numbers http://www.mayoclinic.com/health/cholesterol/CL00002
One of the questions that comes up at Thursday night weight loss group quite often is the question of how much salt we actually need, and how much is too much?
So what have I been able to find out?
Firstly, we don't need salt, as such. We need a small amount of sodium, most of which we habitually eat as salt (sodium chloride). About 90% of our sodium intake is in the form of salt, so for our purposes, watching our salt intake, is a good way to keep our sodium from getting out of hand.
The amount Australians eat, is far more than we actually need. Most of us are eating around 10 grams of salt a day.
The upper safe limit (according to the National Health and Medical Research Council - NHMRC) is 2300 milligrams (2.3 grams) of sodium per day. That equates to about 6 grams or 1 1/2 teaspoons of salt. That is the maximum amount of sodium it is safe for an adult to eat (from all sources - not just what we add when cooking or at the table). Interestingly, this is the amount used for the % of Recommended Daily Intake used on boxes of cereal and other products.
The amount the NHMRC recommends as a target amount for people to eat is, not surprisingly, a long way below that upper limit. It sets a target of 1600 milligrams (1.6 grams) per day for people who are older, overweight, have high blood pressure, or want to maintain a healthy blood pressure across the lifespan. I expect that people wanting to care for their blood pressure should include everyone. That 1.6 grams of sodium equates to 4 grams of salt (a teaspoon full).
An "adequate intake" the minimum to give us all that we need is about 460 to 920 milligrams (0.4 to 0.9 grams) of sodium. That's about 1.15 to 2.3 grams of salt. (So unless you are eating less than half a teaspoon of salt from all sources each day, you are not in danger of having too little.)
So, all up, our salt from all sources should be no more than a teaspoonful in a day, or 1600mg of sodium, and having a little less than that will not hurt us.
Given that the average Australian eats more than twice that amount, we need to look at how to reduce our sodium intake.
Here are some tips:
Cook at home, instead of going out. Take-away food has lots of salt, and you only have to watch an episode of Master Chef to see how much chefs love salt. Cook without adding salt.
Use fresh ingredients wherever possible - virtually all packaged food products have some form of salt added. Fresh fruits and vegetables do contain sodium - but nowhere near as much as you will find in packaged foods.
When you must buy packaged food, choose foods that have less than 120mg of sodium per 100g of food.
Use herbs and spices to add flavour to food, rather than fats and salts.
Remember the reason people like food that tastes of salt is just because of habit - habits can be changed.
Steam, grill, stir-fry, or microwave food. Don't boil food in water, because flavour is lost (along with some nutrition), and it is tempting to replace the lost flavour with salt.
And now, the big question: why bother? What does eating too much salt do to our bodies? Excess salt is linked to:
High blood pressure
Kidney problems/ kidney stones
Oedema (swelling, fluid retention.)
Some Cancers
Osteoporosis (sodium encourages the body to excrete calcium)
There are also dangers from too little sodium, but it is very unlikely that people in Australia are going to suffer from this, because of the way salt is introduced into almost all our foods. (It's possible to die from both too much and too little sodium.)
References:
Better Health Channel: Salt http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Salt
Food Standards Australia: How Much Salt and Sodium are We Eating - More Information http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets/howmuchsaltareweeating/howmuchsaltandsodium4551.cfm
Healthshare: How Much Sodium/Salt Should We Consume Per Day? http://www.healthshare.com.au/questions/42121-how-much-sodium-salt-should-we-consume-per-day
Mayo Clinic Nutrition and Eating: Sodium: How to Tame Your Salt Habit Now http://www.mayoclinic.com/health/sodium/NU00284
Nutrition Australia: Salt and Hypertension http://www.nutritionaustralia.org/national/frequently-asked-questions/salt-and-hypertension
I haven't posted about Weight Loss Group for a while, because we've been working our way through the National Dietary Guidelines. That's taken several weeks of just continuing on the same thing.
If you've never read it, it's a good explanation of how to have a healthy, balanced diet.
So here's two examples of breakfast cereals. (There's no point in comparing foods of different types - we're looking for different things in different types of foods.
Cereal A:
Cereal B
I'll actually take the boxes to the meeting to for people to look at tonight - but reading the information panel, is really all you need.
The ingredients are ordered from greatest to least. So 93% of this is Corn. The other 7% is a mix of sugar and salt. Glucose is a form of sugar. (Point to note, anything ingredient ending in -ose is sugar.)
So mostly this cereal is just corn, with added sugar and salt for flavour. There's no artificial additives. There's also no added vitamins or minerals, and no ingredients high in fibre.
Cereal B: Rice Flour (66%), Maize (Corn) Flour, Psyllium (6%), Sugar, Apple Juice Concentrate (4%), Salt, Rice Bran Extract, Vitamins (Niacin, Thiamine, Fiboflavin, Folate).
There's a lot more ingredients in this. It still has two kinds of sugar (fruit juices are another way to include sugar, without calling it "sugar"). It also has salt, although we'll see later that it is much less salt than the other cereal. It has psyllium and rice bran extract, which both provide natural fibre.
It doesn't have artificial colours or flavours, but it does have added B group vitamins and folate (which is important to help the body absorb iron).
The Nutrition Information Panels
It's interesting to note, that each pack has three columns on the nutrition information panel.
Cereal A: has average quantity per serving, % of daily intake per serving, and average quantity per 100g.
The first thing to do here is ignore the middle column. This is % of daily intake for someone on an 8700kj per day diet. If you check your recommended intake on Calorie King you'll find that is very much more than recommended for women, especially women trying to lose weight.
Cereal B: has average quantity per serving, average per serve with 1/2 cup skim milk (the way you actually eat it) and average per 100g.
Comparing the two: You will notice that a serve of Cereal A is 483kj and a serve of Cereal B is 796kj, which makes it appear that Cereal B has more energy than Cereal A. This is just an appearance. If you look closer, you notice that a serve of B is 50g, while a serve of A is only 30g. For a fair comparison, we need to look at the average per 100g column of both - this is the one that is the same.
Serving sizes are set by the company making and marketing the product. They can be manipulated to make the product look better (ie by having a small serving size). This is a trick you'll see on a lot of products in the supermarket. A number of packages that look like single serves will actually have two "serves" according to the nutrition information panel. Be aware of the risk that you may be tricked.
For an accurate comparison of two foods of the same type, we need to line up the information in the 100g column side by side.
Cereal A Cereal B
Energy per 100g 1610kj 1590kj
Protein per 100g 7.5g 6.7g
Fat total per 100g <1g 1.3g
Saturated fat per 100g <1g .4g
Carbohydrate total per 100g 86.0g 84.0g
Sugars 7.5g 9.3g
Dietary Fibre per 100g 1.5g 7.1g
Sodium (salt) per 100g 400mg120mg
What are we looking for when we look for healthy food?
We want the lower energy because we're trying to lose weight - Cereal B wins here, but not by a lot.
We want lower saturated fat - they're both quite low.
We want low sugar (but only because sugar is energy dense and increases the energy in food.) Cereal A wins here. Remember, the glycaemic index is far more important than whether the carbohydrate is sugar or starch, but neither of these cereals are marked with their GI.
We want high fibre. Fibre helps us feel full, and helps keep our bodies functioning effectively. Cereal B wins this by a long way.
And we want low salt, because although we all need a small amount of salt, most people eat far more than is healthy. Cereal B wins this one as well.
From comparing the two, I'd go with Cereal B for preference.
Now to serve it
We use the 100g (100ml for liquids) column of the nutrition information panel to compare products so we have a fair comparison.
When it comes to our actual serving, and recording it on Calorie King, it's time to use the actual serving size set - or to set your own serving size, but measure it, and tell Calorie King how much you've actually eaten.
You don't necessarily have to weigh and measure food every day, but doing it from time to time to ensure you still have a fairly good idea of what a serving size is, will make a huge difference to your weight loss. No matter how hard we work at checking that we are buying the very best food, if we are not actually paying attention to our portion sizes, we'll end up eating far more energy than our bodies can handle.
Note:
Our weight loss group uses calorieking.com.au which is a free site, or the Calorie King books which can be purchased fairly cheaply from most newsagents as the base for our program.
It may be the last month of winter - but in Brisbane August is known for cold winds. (They usually arrive in time for the Brisbane Exhibition - the state's biggest agricultural show - tens of thousands of people cramming into a small space sharing coughs and colds.)
The nights and mornings have been quite cold (at least cold in Queensland terms). On days I haven't had to leave home, I've stayed in pyjamas and warm dressing gown all day.
I've also found I've been having longer naps, and feeling less like doing things.
I put the question on the Sometimes, It Is Lupus Facebook Page, asking if other lupies were affected by the weather. There was an overwhelming response. It seems that lots of people, like me, are affected by the extremes, either hot or cold can make us feel sick.
We all wanted to be somewhere the temperature stayed at a moderate level throughout the year.
Extremes of temperature can make lupies more tired or more sore, or both.
Last week I posted about the weight and health check station at the pharmacy, and how, after the initial weight loss when I stopped taking steroids, it's going to start being work to get my weight under control.
