Diet Drift and a Hard Reset
By: Michael Ham
Tags: Diet, Diabetes Diet, Resolutions, Diets That Work, Plant Based

Diet Drift and a Hard Reset

Withered good intentions can bloom again if you learn how to recover from failure

These crooked branches grow into an orderly top; a crooked path can still reach your goal. (photo by author)

Given that immediate and sustained success is extremely rare, we all experience multiple instances and kinds of failure. It follows that knowing how to handle failure—and, ideally, how to recover from it and set things aright — is an important skill to learn.

Some failures are easy to spot and have simple solutions — for example, a basketball player who can’t make a free throw can see the failure and remedy it through practice. Other failures are more invidious, developing gradually over time with the signs of developing failure obscured by the signal noise of daily life.

For example, anyone who seriously wants to maintain a good practice finds that discipline rot can easily set in — minor oversights that over time clump together and result eventually in major omissions, with demoralized despair a likely result. I’ll here look at an example of such a problem and describe one approach to tackling it: doing a hard reset through a back-to-basics emphasis on observing the fundamentals and in that way restore the practice.

A common example of discipline drift happens when the good practice one wants to follow is to maintain a healthy diet. We can fairly easily learn what (and how much) we should eat, but we also must learn how to maintain the practice — and that implies that we must learn how to regain our footing when we slip. That particular lesson — how to get back on track — is the focus of this story.

A good diet is important for everyone, but for those with diabetes, a good diet also is urgent. I have type 2 diabetes, and I’ve had it for 25 years. For most of that time I have controlled it fairly well with medication and some modifications to my diet. From the outset, I sharply restricted refined sugar and foods that contain it, and later, when I saw their impact on my blood glucose readings, I also avoided also bread, potatoes, and rice.

Eventually I discovered the low-carb diet. I stayed on that for five years. That diet, plus the medication I was taking (a statin, metformin, and medication for hypertension), kept my blood glucose (and blood pressure) under control. I also lost weight, except for the last twenty stubborn pounds.

About a year and a half ago, I posted on Quora an answer praising the low-carb diet. A physician commented on my answer, telling me that the reason my blood glucose was low was that I was eating so few carbs (around 30g per day of net carbs — total carbs minus dietary fiber). He warned me that a low-carb diet can result in long-term health problems.

His remark led me to do some serious reconsideration and research. I happened to read Dr. Michael Greger’s book How Not to Die, based on the result of many research studies (including many of the “gold standard” variety: randomized, double-blind, and placebo-controlled) that show clear benefits for a whole-food plant-only diet.

“Whole-food” means no refined or highly processed foods, which eliminates refined sugar (and foods that contain it), refined salt (and foods that contain it), flour (and foods made from it), and foods made from refined ingredients using industrial processes and sold packaged with a brand name (and heavy marketing) — for example, Wonder Bread, Oreos, Cheez Whiz, Diet Coke, and most “convenience” foods.

“Plant-only” means no meat, fish, dairy, or eggs, and no foods that contain those as ingredients — thus no mayonnaise, for example.

It took me a month or so to find my footing. I had to develop new routines and new pattern of food choice and preparation. A major change in one’s diet is like moving to a new city: at first it’s hard to find your way around — going anyplace requires conscious thought, careful attention, and checking a map, whereas in your former city, you could go to most places without conscious thought. But in time, the new city becomes familiar, and you once again can get around with ease, and the same is true for a new pattern of eating: at first unfamiliar and awkward, then understood and applied without much conscious effort. (I collected the lessons learned in my diet change in a lengthy post.)

And indeed this change in my diet meant a big change in what I ate. I had been eating a lot of meat, fish, eggs, and cheese, and almost no carbs. I went from eating around 30g/day of net carbs to around 145g/day—but, oddly, my blood glucose remained under good control, with no spikes. I had assumed that more carbs would mean higher blood glucose readings, but that didn’t happen. Why not?

The first reason: in addition to the increase in net carbs, my intake of dietary fiber also greatly increased. (If you avoid refined foods and instead eat whole plant foods, you get a lot of fiber.) On my new diet my intake of dietary fiber is around 60g/day. (Meat, fish, dairy, and eggs contain zero dietary fiber — and dietary fiber is essential for the health of your gut microbiome, and that is essential for your own health.)

I eat a serving of grain at every meal, but it is intact whole grain, not grain that had been cut (steel-cut oats, pot barley) or polished (white rice, pearled barley) or mashed flat (rolled oats, barley flakes) or pulverized into flour (and flour is often “refined” by removing nutrients, though sometimes a few of those nutrients are added back: “enriched” flour). I also eat a serving of beans or lentils at every meal, and those are high in dietary fiber as well as in carbs (and protein).

The second reason: by eating only (unrefined) plants I avoid saturated fat. It’s long been known that saturated fat spikes blood glucose. The only common plant food containing saturated fat is coconut, so I don’t eat it.

After being on a whole-food plant-only diet for 10 weeks, I saw my doctor. He looked at my current lab results and told me to discontinue all the medications I had been taking. He said I no longer needed them.

I did as he said, and my blood glucose, cholesterol, and blood pressure readings remained well within the normal range. (My HbA1c went to 5.2% — without any medication.)

And I did lose those last 20 stubborn pounds. Animal foods in general are calorie-dense, and plant-foods in general are not (exceptions include nuts, dried fruit, avocados, olive oil). With animal-based foods, feeling full generally means consuming many more calories than when feeling full from eating vegetables.

But then…

Fast forward a year. Because I was doing so well, I thought it would be okay to eat a piece of fish once every week or two — and I do like steelhead trout.

You can easily guess what happened. The piece of fish once every week or two became one or two pieces of fish a week, and then three or four pieces a week. I decided that an egg (or two, cooked in butter) would be okay occasionally (and then frequently —after all, I had to use the dozen before they went bad). And then I ventured to eat a steak about once a month. Moreover, it seemed appropriate to have wine with my meals and an evening cocktail.

My fasting blood-glucose readings gradually increased: they had been around 5.5 mmol/L (99 mg/dL) to 5.7 mmol/L (103 mg/dl).

I started seeing 6.0 mmol/L (108 mg/dL) fairly often, then 6.1 (110), 6.3 (114). The readings bounced around, but readings above 6.0 became more common.

My doctor had once told me that so long as the morning readings were below 7.0 (126), all was well, but I became uneasy. My blood glucose meter shows averages, and I couldn’t help but notice that the averages also were slowly increasing (naturally enough). My morning readings started to include an occasional 6.5 and then an occasional 6.8. But since the readings jumped around a lot, I naturally focused on the “good” (lower) readings. (Confirmation bias seeking to reassure myself that all was under control.) Then I noticed an average of 6.5 (117).

And one morning the reading was 7.0 (126). That worried me, and I immediately became more moderate in my food choices, and the readings improved. Problem solved!

I relaxed my vigilance and resumed the occasional (well, frequent) treat. I again reassured myself by noting how much the readings varied day to day, taking note of the good readings (and ignoring the increasing averages).

Then I hit a rocky series of readings, starting 18 November 2020: 6.5 (bad, so I was careful), 5.8 (that’s more like it) — and then 7.0, 6.7, 6.4, 6.5, 6.1, 7.0, 7.3 (!), 6.7, 6.8, 6.1, 6.5 — and I thought “Enough’s enough.” I decided I had to do hard reset.

The hard reset

I knew, of course, exactly what I needed to do, but this time I wrote it down — putting things in writing makes them more concrete and, in effect, nails them to the wall. I wrote:

No alcohol. (first day was 30 Nov 2020 and I’m continuing) Daily walk with Sunday as rest day (first day was 2 Dec 2020, 1900 steps; goal is 8000 steps/day; now averaging 6000) No food intake — not even a bite — after 5:00 (first day was 3 Dec 2020 — not eating in the evening helps with fasting blood glucose)

When I began, my 90-day average was 6.5 mmol/L (117 mg/DL), and the other averages were much the same. At the left are the averages two weeks into the hard reset.

I’m surprised at how quickly a better diet brings fasting blood glucose into line. (And recall that I am taking no medication at all.)

It’s worth noting that 5.5 mmol/L (99 mg/dL) is within the “normal” range rather than being “pre-diabetic.” True, it’s the top of the range — 5.6 mmol/L (101 mg/dL) is “pre-diabetic” — but that’s the average and I’ve had morning readings of 5.1 (92) and 5.2 (94), comfortably within the “normal” range. (“Diabetes” starts at 7.0 mmol/L (126 mg/dL).)

I had always avoided refined foods, eating only whole foods, but then I did start adding animal-based foods to my diet. “What’s the harm in just a little?” I thought — but it’s clear that eliminating those foods made a noticeable (and rapid) improvement in my fasting blood glucose levels. In the rocky patch of readings listed above, that first 7.0 reading was the day after I had a steak and the 7.0 and 7.3 pair followed a dinner of braised beef shank one night and the leftovers the next.

Certainly the daily walks also help — not only physically, but also psychologically. Getting out of my apartment and walking through the neighborhood improves mood and morale and expands one’s spirit. In fact, one of Dr. Greger’s Daily Dozen recommendations is 90 minutes of moderate activity or 40 minutes of vigorous activity.

Resist entropy

My experience follows a common pattern: I started with good resolutions, got good results, and had good persistence, which lasted for a little over a year. But then my growing confidence blossomed into overconfidence. I knew the guidelines, but I started to test the boundaries. Initially, I stepped just a little over the line, but when nothing much happened, I moved the boundaries by changing how I ate.

When negative effects started to show, I at first ignored them, then minimized them and made minor and temporary adjustments. But finally it reached a point where I could not deny that things were not going well. (Denial can work up to a point, but for most reality eventually breaks through.)

Ultimately there’s an awakening: “What am I doing?! What have I done?!”

That shock was what triggered me to do the hard reset. I thought it would be difficult, but it’s been oddly easy — because I know what to do and I had a year’s practice in doing it. “It’s like riding a bike.” Resuming my old practices was easy — comfortable, familiar, even reassuring — and with a new interest from my time away. It’s been like returning to one’s home town after a decade away: familiar and yet in a way new.

Putting my immediate goals in writing helped a lot. Doing that provided focus and underscored commitment. I was also helped by the restrictions due to the pandemic, since those have eliminated restaurant meals and socializing over food and drink.

Now I must resist drifting way again. The carrot will be to enjoy the foods that fit with the plan; the stick will be reminding myself what happened when I cast caution to the winds — or even when I merely nudged it aside a little. Pushing a pebble over the ledge can lead to a landslide.

Obvious caveat

Medical research studies generally do not base their findings on a single person (though there are rare exceptions). Studies generally use multiple subjects for a good reason: people differ, and among those differences is how their bodies react to food. (Consider, for example, a peanut-butter cookie: enjoyed by some, lethal to others. Or cilantro: loved by some, loathed by others.)

The diet I describe works extremely well for me, but would it work for you? I don’t know — and unless you try it, you probably won’t know either. (How Not to Die includes many research findings that show how (and to some degree why) this approach is healthy for most — and why the Standard American Diet is so unhealthy for all.) You might consider adopting a whole-food plant-only diet rigorously for a month in order to see what its effects will be for you.