To: Lane3 who wrote (31338 ) 3/16/2016 5:33:46 AM From: Lane3 1 RecommendationRecommended By pheilman_
Read Replies (2) | Respond to of 39304 Update 6: What I eat (the only update you care about…) In 2015 I did a 6 month experiment of exactly one meal per day (23 hours of fasting, then ~1 hour of eating at dinner). Very interesting. I’m sure I discuss it in at least one of the podcasts, below. These days I’m eating about as freely as I have in 7 years. I’m still carb-restricted by the standards of most Americans, but nowhere near the ketogenic lines of 2011, 2012, and 2013. I almost always skip breakfast, and lunch is usually a salad (“in a bowl larger than my head,” if possible). Dinner is usually a serving of meat with more salad and veggies. I’m more liberal on fruit and even occasionally rice or potatoes. Also, in moments of weakness I sometimes lean into my kid’s crappy food. The biggest “news” on my eating front is that I now wear a 24-hour continuous glucose monitor (CGM) 24/7. This was the result of one of the most fortuitous flights of my life. In the fall of 2015 I was flying to NYC and half way through the flight, needing a short break from work, I went to one of my favorite watch sites . The fellow next to me made a comment—clearly he was part of the cognoscenti—and we got ultra-deep into watch idiotness. After a while I asked him what he did only to find out he was the CEO of Dexcom , the company that makes the best CGM device on the market. Fast forward a week and Kevin has introduced me to his amazing team (Christy Pospisil is awesome!) and I’m hooked. CGM is a game-changer and it does warrant more discussion than I can provide now. The insights have been staggering. I’m pretty obsessed with it (shocker, yes) and I aim to keep my 14-day running glucose around 90 mg/dL with spot-check standard deviation less than 10 mg/dL. By keeping average glucose low and glucose variability low, I can reasonably assume my insulin AUC (area under curve) is low. Below is a printout of my last 14 days. As you can see my measured average glucose was 92 mg/dL, which imputes an A1C of 4.8%. At some point I may write about the dozen insights gleaned from CGM (and I think I mention a few in the podcasts), but here’s one: measured A1C is probably directionally valuable (you know, the difference between, say, 5% and 9%), but that’s about it. If your RBC (red blood cells) live longer than 90 days—mine live much longer since I have beta thal trait—your A1C will artificially reflect a higher average glucose. Conversely, if your RBC are large, the opposite occurs. (For those wondering, MCV, which is part of a standard CBC, shows you RBC size). My A1C in standard blood tests routinely measures 5.5% to 6.0% (courtesy of my tiny RBCs), which poses a problem when applying for life insurance (prediabetic is defined as 5.7% to 6.4%). But with CGM, which is calibrated 2-3 times daily, my imputed A1C, which is much more reliable, varies from 4.6 to 4.9%. Big difference, huh? As an aside, I can’t talk about my beta-thal without hearing my med school roommate, Matt McCormack referring to them as “shite for blood” in the best Scottish accent ever. As if it’s not bad enough having an artificially high A1C… you gotta have shite for blood. And that’s the least amazing part of CGM. I’m not sure I’m at liberty to discuss the next generation of CGM. Admittedly, not too many people want to wear the device I wear, but in two years, well, that’s when it will get amazing. And that’s just the tip of the iceberg when it comes to why this device is adding insights and actionable data at a geometric rate. In two years this device will evolve into something everyone can wear. eatingacademy.com