Sunday, October 21, 2007

My training methodology and IF for diabetes

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Less is usually more
I've added two testimonials from people I helped get their mind right with regards to weight training; Daniel Berglind and Albert Kuller (you'll find them in the Testimonials section).

Both used an IF protocol, in combination with a low volume lifting routine, centered on compound movements like the bench press, squat, chins and deadlift, coupled with assistance movements for smaller muscle groups, and both gained a significant amount of strength while maintaining a very low bodyfat (Daniel) or losing a good amount of bodyfat (Albert). Keep in mind that these are not newbies (where one would expect strength gains, even on a diet), rather experienced trainees who spent months spinning their wheels because of an inferior training routine. They made a few common mistakes that I see people doing all the time, despite many years of weight training; training volume was excessively high, and a lot of effort was put into assistance movements for small muscle groups, while skimping on the two most important success factors in weight training: progressive overloading and sufficient rest between training sessions.

During the time I managed Daniel's training routine, he put 90 lbs on his squat 5 rep max, 75 lbs on his deadlift 5 rep max and maintained his ripped conditioning. Albert lost 18 lbs of bodyfat and added more than 10% weight to all the major movement, except his chinning strength that went up a whopping 20%.

Take away lessons:

1) progressive overload is key. You probably already know that, but how are you measuring progress? In order to do this properly, do not switch routines too often and perform movements in the same order and in a structured way.

2) has your strength stagnated and are you spinning your wheels in the gym, receiving little reward for all the effort you put in? Odds are, if your nutrition is in check, that you're probably overtraining. Cut back workout frequency to 3x/week, perform no more than 3 sets per movement and always start your workout with a compound movement.

3) Unless you have a damn good reason not to, you should be squatting (either back or front squatting), deadlifting, chinning and bench pressing regularily.


Intermittent Fasting for diabetes and blood sugar management

Tyler Kell recently sent me his story on how he used intermittent fasting to achieve an overall improvement in various health indicators, blood sugar levels and mood. His feedback is particularily important, since it shows that even people with diabetes may benefit from an IF regime.

I should note that Tyler has been experimenting on his own and is using a modified protocol that differs from the protocol I use on my (non-diabetic) clients.


Tyler writes:

I’m a type 1 diabetic and have been so for a little over four years at the time of this writing. Over this time period I have experimented with a number of diets to help manage my chronic disease. With experimentation I’ve found a low to moderate carb diet with moderate fats and a good dose of protein to be the best for controlling my diabetes. Carbs in the 50-150g range provide enough energy for training, keep me out of ketosis, and seem to be the sweet spot in general. Much less and food selections are limited and boring; much more and blood sugar becomes harder to control.

Last year I encountered some posts by Martin on the topic of intermittent fasting. The idea seemed intriguing to me because it was simple, seemed effective, relatively no hassle, and had some proposed health benefits. I wondered if I could adopt an eating pattern that was similar but modify it to better suit my needs. I knew that I would not be able to eat the standard carb intakes, but I felt as though the diet could still be useful for blood glucose control, low maintenance eating, and for health reasons. Thus, I decided to give it a try.

My method differs from most because I keep my days fairly consistent in terms of meal composition and calories although I do tend to eat a bit more on training days out of habit and to improve partitioning. This approach has been easy to utilize and has resulted in the achievement of better blood sugar control than I have ever had previously. I’ve seen information that has stated that one’s fasting blood sugar makes up the majority of their A1C value. If that is true, a strong case can be made for the use of IF in diabetics wishing to achieve near normal blood sugars.

With the titration of my long-acting basal insulin to the appropriate level, I can go without eating from 8pm until 12pm the following day without experiencing either a rise or fall in my blood sugar values so long as the last meal of the day wasn’t excessive or exercise and stress levels don’t change drastically. So, essentially, I can spend 2/3 of the day at a completely normal blood sugar without doing a thing other than taking a single long-acting insulin shot. If changes do occur, they are usually easy to treat. Hypoglycemia is rather mild because of the small amount of insulin needed in the fasting period and is easily treated with some fast acting carbohydrates. Blood sugar does not creep up during the fasting period unless the meal from the previous evening was far too excessive containing too many carbs and/or fats. Large meals like this digest slowly and release glucose into the blood stream overnight, a period of time in which I cannot test and correct higher blood sugars. This can be alleviated with an extended bolus on an insulin pump or by setting the alarm clock to wake up, test blood sugar, and administer insulin if need be. However, I find it much easier to eat most of the calories between 12pm and early evening and eating more moderately at night if possible. Keeping carbs in the low to moderate range during the eating period helps to keep blood glucose excursions to a minimum. This combined with keeping blood sugars perfectly normal during the fasting phase becomes an extremely effective method for blood sugar control.

In summary, I achieve the best blood sugars by…

1) Using an eating period from 12pm to 8pm
2) Trying not to have too large of a meal in the evening containing too many carbs and/or fats that prolong digestion and cause blood glucose to rise overnight
3) Keeping carbs at a moderate level the majority of the time (50-150g/day)
4) If I choose to eat a higher carb meal, I place it after training and increase the amount of rapid acting insulin that I use (fat intake is kept minimal)

Occasionally I do vary from the moderate level of carbs and allow myself a bit more freedom. When carb intake is increased highly, especially in a short time frame, blood glucose levels are much easier to control (as can be possible) when fat intake is limited. Otherwise, once again, the fat slows the carbs down to the point where insulin action and glucose release are mismatched either resulting in hypo or hyperglycemia. I don’t think it’s ever wise to eat extremely high amounts of carbs as it’s increasingly more difficult to match with insulin the higher you go. Digestion rate, meal composition, and insulin action all are highly variable and create a recipe for disaster if the moons aren’t aligned.

I try to save these higher carb meals for the period after training if I wish to indulge. As mentioned I keep fat low(er), protein the same, and take more fast acting insulin to cover the carbs using my personal insulin to carbohydrate ratio. Personal experimentation is always key and I suggest to start lower and work your way up. An occasional high carb day gives you a chance to take a break from more mundane eating. The high carb intake is best placed after a workout when insulin sensitivity is at its peak. This promotes better partitioning and helps the insulin to work its magic.

I think that IF is a great method of eating for the diabetic if things are kept under control. I wouldn’t suggest to eat the standard amount of carbs suggested under this protocol and expect to get away with it without some major blood glucose swings. Current research shows that it’s the glucose variability (how much your blood sugar swings up and down) that matters more than your A1C value (more or less an average of blood sugars). Knowing this and applying the knowledge toward optimum blood sugar control it would be my suggestion to eat foods that cause minimal and slow increases in blood sugar over longer periods of time, therefore limiting rises and falls and keeping blood glucose more or less constant. Low to moderate carbs, moderate fat, and ample protein achieves this nicely. Give yourself a treat once and a while and have a higher carb day. It’s a nice psychological break and when planned around a training session it can have a physiological purpose as well.

Better blood sugar control definitely improves my mood so I can say that the effect of IF on my mood has been indirect and positive.

So far using IF I’ve experienced better blood sugar control and my all-time lowest A1C value. HDL, LDL, triglycerides, and other blood work are all in the extremely healthy range. Since starting this way of eating I’ve lost about 20 lbs., maintained or gained strength in all of my lifts, and have done so with relatively little effort put into what I am eating other than making the correct choices in the correct time period.

IF certainly isn’t the only way to eat and certainly isn’t for everybody. With that said, using the proper modifications based on individual experimentation it can be an amazing dietary strategy used to achieve excellent blood sugar control.

- Tyler

9 comments:

Anonymous said...

It came as a surprice to me to see the headline of this article as I entered the page. I am a type 1 diabetic myself and about a week ago I came across IF. Since then I've been spending some time thinking if this could have a positive effect on my blood sugar. I've had diabetes for 13 years now and as long as I can remember I've always been told "You have to eat every third our to avoid that your bloodsugar drops too low". And so I've done, most of the time :) A great article, and I'm certainly going to experiment with this, and hopefully see an improvement on my blood sugar as well.

Anonymous said...

can't we just call this protocol "skipping breakfast"?

Anonymous said...

i wonder what the hemoglobin A1C was for this client..also a type one for 14 years and am experimenting with this plan.

Anonymous said...

Have you ever used IF with someone who has Type II diabetes? Or has anyone with Type II diabetes ever used it and shared their experiences with you?

Andre Chimene said...

As an insulin dependent diabetic too. I am curious to know your BS numbers and the units of insulin that you use. This tells all. Thank you

IGALC said...

hi all,
i'm dibetic myself (type 1)
for over 5 years now , today i'm traing in the gym for over 1.5 years
my weight is approx 150lbs
/68 kg , my fat is most Concentrated in the Stomach and Calves
i'm wish to lose it , but it's very hard i must say.
i'm usally training 4 days a week , in this training method , i run approx 5km,
and make the Assignments weights for the Hand muscles / back etc.. , i'm trying to lose weight any suggestions (my fat nurtion comes to 30/35g per day.
please help
regards,igal

Widgetey said...

I was diagnosed with type 2diabetes 3 months ago. I eat IF normally, I have all my life. But I had to lose 30 lbs because of junk food snacking. I cut junk food out and went totally IF. In 3 months I lost 32 lbs (180 - 148) A1c from 6.8 to 5.7, mean bgl from 136 to 105, Cholesterol from 230 to 141, triglycerides from over 500 to 70. Except for days i work out, i keep carbs to less than 125. They keep telling me to spread my carbs out across each meal but I have a hard time doing that because for over 60 years i have rarely eaten breakfast or lunch, its just not my habit. I really try though, just not succesfully. :). So most of my carbs get taken in for supper and later. The biggest change in my life has been starting a weight program. I have had no glucose level problems since i started. Weight lifting and regular walking ( 320 minutes per week) have brought my diabetes under complete control, no meds. As far as I can tell, IF is fine for type 2's. BTW, the only lifting i do is: Squats, bench, deadlift, OH press, and BB rows.

Anonymous said...

hey, great read I am T1 diabetic myself and looking to implement a similar eating protocol, Do you have tylers email adress? Or would be able to email me it? Thanks

Giovanni Van Daele said...

I'm a diabetic type one since 1992 (when I was 2) and I've done some digging about the claim regarding glucose variability.

I came across quite different research conclusions, read for yourself here:

1. http://www.ncbi.nlm.nih.gov/pubmed/19549736
2. http://care.diabetesjournals.org/content/29/7/1707.full

If you could show me where you read otherwise I'd be glad to read it, otherwise an awesome article, I'll try IF for myself.




My name is Martin Berkhan and I work as a nutritional consultant, magazine writer and personal trainer.

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