Sunday, November 2, 2008

Joslin Diabetes Center dietary guidelines for Type 2 who are obese

I'm thinking about going back to Green Mountain in December, nearly a year since I went the first time. I want to show off my progress, and to have the opportunity to spend a week focused on exercise. I want work closely with one of their fitness experts, someone who will be straight with me about what I'm doing, how I'm doing it, etc. I'm getting to the point now that its taking more to get my heart rate up (which is great!), but I'm still too heavy to get really going. My knees are still holding me back. And I think I'm still holding me back as well...not pushing myself in the right ways.

So while I was on the Green Mountain website, I saw a reference to their connection with the Joslin Center for Diabetes in Boston, MA. Out of curiosity, I went to their website and did some poking around. And while there, I came across their dietary guidelines for those who are Type 2 and overweight or obese.

Basically, I've been very nearly doing what they say to do.
  • Protein should take up 20% - 30% of daily calories, which is higher than was recommended in the past. I've been eating about 30% because I'm quite tall and need it to help manage hunger. I choose leaner proteins, like fish and poultry, but I do eat a little lean beef and lamb once a week, and I have eggs for breakfast every morning. My cholesterol is exceptional, so I'm not so worried about high cholesterol. I also include a lot of legumes as a source of protein, because they also provide carbohydrates and fiber...more about that in a bit.
  • Keep carbohydrates at 40% of caloric intake per day, but they say to make the bottom limit at around 130 gms. of carbs per day. This is a new low for diabetes guidelines. Out of personal experience, if I go above 150 gms. or carbs per day, I stop losing and start gaining weight, and my blood sugar starts to go up. But they also want us to take in a minimum of 25 - 30 gms. of fiber a day, with 50 gms. per day being closer to what we should shoot for. This means that if I'm restricting my carbohydrates, that I need to add high fiber choices from other food groups, such as legumes, fruits and vegetables. Also, eating that much fiber in a day mean a whistle-clean colon, but it takes time to work up to the 50 gms. per day.
  • 30 - 35% of calories should come from fat, with less that 300 mg/day of saturated fats. This is slightly higher than my daily goal of fat intake, but probably closer to what I'm achieving. I found some really good extra virgin Greek olive oil recently and have been anointing everything with it!

They are recommending a modest rate of weight loss, one pound every week or two. And their exercise recommendation is 2.5 to 3 hours a week at a moderate intensity, using a mix of cardio, stretching and resistance.

So I guess I'm right on track. It's just a matter of not losing focus and not backsliding into old patterns. I have made major changes in how I live, and my body is slowly moving in the right direction. At this rate of weight loss, I'll achieve my goal in a little over two years. I wish I could do this faster, but I am seeing the benefit of losing at a slower rate. My skin is really not hanging off me. The fat is loosening up (some parts of me are quite squishy!), but my skin is still fairly tight, even after 40 lbs. of loss. So I've decided not to worry about my skin shrinking. I'll just stay focused to toning my muscles. By the time all the excess fat is gone, I should have some nice muscles to show off.

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