Kara's Keto Plates

Fatty Food Blogging

Category: Progress

Woo boy, I have been putting off making progress reports. Mostly because I have no progress to report. I’m losing no weight, haven’t lost since February despite counting calories and carbs, hitting my macros and upping my physical activity (significantly). I’m waiting out allergy season, on the off-chance ongoing histamine reactions cause me to carry additional water weight (apparently the nasal steroid I take could up my blood sugar, although I have a hard time believing that would have a significant effect) .  It seems kind of dumb, but I’m hoping once the tree pollen settles in the next couple weeks, I’ll magically experience a huge woosh of weight loss. In the meantime, weight loss is a bust. I’m trying to re-arrange my focus: if weight loss isn’t happening, what should my focus be? Is low-carb a healthy long-term strategy? I believe it may be, but the episode with scurvy has been frightening to me. Are there nutrients I’m just not getting? I’m taking a multi-vitamin now, but a by-it’s-nature deficient diet doesn’t sit well with me. If I’m not losing weight eating 30 g net carb a day, is it healthier for me to go back to losing no weight on my vegan + fish diet where I ate 100 g net carb a day (almost entirely from beans/lentils and fresh fruit)? Do I feel any better on that diet? These are questions with no easy answers for me, and it’s been disheartening to completely stall out on weight loss despite all my best efforts. But then, I’ve been spending time reading up about nutrition and health and specious claims about the damage obesity actually does and I’m starting to wonder whether I’ve spent my entire life hating myself for being fat and thinking my death was imminent when I should have been focusing on how to eat smart and how to keep my body moving in fun ways. I start to feel like this blog is just kind of worthless: I don’t have any advice and I have had limited success on this diet, hell, on every diet that didn’t amount to starving myself on 800 – 1000 calories a day. My original goal was to prove keto could be healthy and full of variety and vegetables but then I got scurvy.

When I was a strict vegan, I remember a furor in the community because people would quit eating entirely vegan for their health and then pretend they were still eating vegan. One blogger talked about it and  it pissed everyone off. But I get it, I mean, I get the pressure to eat and present yourself eating in this idealized, perfect way: in real life and on the internet. I haven’t found the one true path for weight loss or perfect health or perfect ethics. I am starting to doubt I personally ever will. So, how do you choose a path? How do you determine and prioritize your values, your health, your ethics? Which aspects of your health matter most: is weight loss more important than anything else? I’m torn because I watch people succeed and of course I want to succeed, I want to be thin. But at this point, I have worked for 5 years to find a way to be thin and I’m coming up empty.  I weigh what I’ve weighed for most of my adult life, what I weighed in high school. I have never,  ever in my life been thin. At this point, I have undone all the weight I put on for the two years when I was depressed and bingeing. I’m eating as reasonably and exercising as often as I ever have in my life. When I’m not hating my body for holding on to all this weight so well, I actually feel good. I’m stronger, I have big, bulky muscles, I find myself just doing these physical things without even thinking that would have been so impossible for me in the past. I should be proud of the changes I’ve made and all I feel is torn that I can’t be happy because I’m not losing weight. And this blog starts to feel like an albatross around my neck.

Scurvy Scallywag

I have, in general, thought of myself as creating a pretty well balanced diet. When I decided to go keto, I tried to resist the egg/bacon/cheese/ranch overdrive and made sure to include loads of dark leafy greens and bell peppers and berries and fatty fish and all those super-foods that I honestly kind of adore. And yet, a couple weeks ago, I woke up to bleeding gums. My initial thought was some sort of dental trauma overnight that would heal. And then two days later, again, bleeding gums.

Bleeding gums are pretty much a never occurrence for me. So I figured I probably had some horrible vitamin deficiency. Michael came home and examined my gums and mouth and confirmed I had scurvy. We went to the store to pick up super dose vitamin C for me to take daily while we waited for the uber-fancy multi-vitamins he ordered to arrive. He ground up Vitamin C pills, mixed them with natural calm and boiling water and I drank a glass every day. Within a couple days, my gums weren’t swollen and bleeding anymore. And I’m now taking a multi-vitamin, which I most likely should have been taking from the beginning (in addition to my fish oil pills and vitamin D). In order to get the Vitamin C I need in a day, I’d have to eat a whole red bell pepper; the juice from 3 limes or a cup of strawberries. That just isn’t going to happen, for a variety of reasons (carb counts; food costs and availability; etc).  I’d say that I regularly (a couple times a week) consume all of those foods in some quantity, but it just wasn’t enough. Just a word of caution.

Since starting keto, I’ve also found that I get dry scaly skin spots. This isn’t the keto acne a lot of people get, instead it looks like little psoriasis spots: I get them intermittently on my shoulders, my lower back, my sides, my calves. They tend to go away on their own after a few days (and went away entirely when I was not eating keto on vacation), but it has raised some concerns for me about possible inflammation. Michael made the point that whatever processes keto is resetting in my body could result in inflammation, anyway, but I’ve decided to cut dairy out and see if that helps with my skin.

Why dairy? Because it is the single biggest dietary change I’ve made from vegan to keto. Truthfully, I eat probably 2-3 servings of dairy a day now and I never ate that much (certainly not when I was vegan, but also not when I was just eating what I like to eat). Dairy (especially cheese) has become my easy go-to snack whenever I’m hungry. As a result, cutting dairy will likely be really freaking difficult at this point, but I’m pretty prepared.

I’ve found that I can do a very satisfactory bulletproof coffee using coconut oil and unsweetened almond milk in lieu of cream. I’ve also rediscovered my vegan protein shakes: Sunwarrior Classic,  Amazing Grass Green Superfood, Unsweetened Almond Milk (1 cup) and Cinnamon. It’s a bit chunky and mildly unpleasant but it’s also filling, dairy and soy-free, 5 grams net carbohydrate and about 20 grams protein in a serving. This shake was a fixture in my work lunch for months (accompanied by a serving of fresh fruit and half a bell pepper with hummus). We’ll see how the dairy cut goes, if it does clear up my skin, keto will get a lot more difficult in the long term.

Moving Again

I figured that I owed an update after my stall entry last week — I’ve started losing again. I’ve now hit the lowest weight I ever hit on Medi-Fast (which, coincidentally, was pretty much my weight upon exiting high school), so it’ll be a long slog (about 20 pounds or so) until I hit my next new low: the lowest weight I have known in my adult life. And after that, I have no idea. My ideal weight is about 60 pounds below that, my personal goal weight is somewhere in the middle but I have no idea what my life will look like or feel like at that point. It’s more than a little terrifying, to be blunt.

I moved off the stall by upping my calories to a 25% caloric deficit, as discussed in the previous progress entry. The good news is that since I have a lot more energy again, I’ve been cleaning and yoga-ing with new fervor. Michael and I also walked a couple miles outdoors last weekend, taking advantage of the unusually nice weather. The additional good news with the energy resurgence is once again having exercise as a tool to deal with the days I feel low, emotionally. Nothing works for malaise/depression/etc like a nice sweat.

So what have I been eating this week? The usual. Leftover egg casserole (which was amazing, froze very well and which I intend to make again and again). Creamed spinach. Baked salmon. Canned tuna. Caesar salad. Atkins shakes. Roast turkey. Steamed broccoli. Lots and lots of roast seaweed, still. My goal for the next week or so? Up the fatty fish to a couple more servings a week (likely by eating canned kippers) and to try to start incorporating tofu or TVP or tempeh in our lives, at least one meal a week. Tempeh is interesting because it’s higher protein than tofu, but I’ve only cooked with it once, to mixed success. And for some reason, it’s really difficult to find tempeh recipes which are also low carb. I’ll have to brainstorm.

I’m also in the midst of planning my gardening for this year. I have a pretty big raised bed and I’m looking at planting eggplant, zucchini, peppers (probably a few types) and plum tomatoes. I’m considering planting cool Fall produce: as well (ie: kale, broccoli) but I’ve never grown those things before. The herbs I’ll likely do in smaller containers: a couple types of basil, oregano and thyme at least. Maybe chives, cilantro, mint.  I haven’t gardened in years (since the first year Michael and I were married) and pretty much the only thing we grew successfully that year were cayenne peppers and basil (and a few Brandywine tomatoes).  But if it all works out, we’ll have plenty of tasty vegetables this Summer, hopefully limiting our grocery store needs.

Stall

I’ve been stalled out for about a month, now. No weight loss, no weight gain. Just sort of sitting at about 230 pounds. It’s a cruddy feeling, and you start picking everything apart. Should I cut calories? Should I work out more? Should I try intermittent fasting or a fat fast?

Truthfully, I believe I started my stall in December, when I said to myself that I wanted to meet a dumb goal by the end of the year. I wanted to weigh less than my lowest weight on Medi-Fast, my lowest weight since college. Essentially, I wanted to lose about three pounds in 10 days. So I cut my calories pretty significantly. And instead of losing weight, I just lost energy. It’s kind of a rookie mistake and I don’t think of myself as a rookie.

I’ve made a lot of changes over the month: I paid a lot more attention to my macros and brought my protein back up to where it should be (I was regularly getting 10-15 g less protein than I need to maintain my current lean mass). I upped my sodium intake since my blood pressure got too damn low (84/52) and I was experiencing pretty severe orthostatic-hypotension (almost passed out one afternoon upon getting up and going to the fridge for a pickle since I felt “low”). I hadn’t been eating as much fatty fish as when I started and got concerned that I might be deficient in iodine so I’ve added seaweed as a daily snack (and it has led to me feeling much more energetic). But none of those worked any magic on the scale.

So, I went over my food logs this weekend, thinking I was missing something huge. The only thing that had changed was that I had cut my calorie intake significantly (500-800 calories below an already generous 25% deficit). In December, when I cut the Atkins junk out, I never really replaced those calories with anything.

I’ve decided to stick to my 25% deficit (which means a generous 1600 calories daily) and hit the protein macro consistently and see what happens over the next month. My blood pressure is back to normal (100/70), my energy is coming back (likely a combination of the increased calories and the iodine) and my hope is that I will see some loss again, hopefully on par with how I was losing before.

That being said, I think it’s pretty normal to stall out every once in a while. I know the set-point theory is pretty much baseless, but I’ve been stuck at this weight before and then basically lost 15 pounds, all of a sudden, in one month. Having sorted out the blood pressure and energy issues, there’s absolutely nothing about this diet that feels unhealthy and it’s easy enough to maintain that even without seeing consistent loss, it doesn’t bother me to stick to it. But maybe that’s my perspective, too. I have absolutely seen this as a lifestyle change, not a quick-fix weight loss solution. And so, a stall is an engineering challenge, but not an invitation to quit and eat a dozen doughnuts.

Progress – Six Weeks In

Today begins my seventh week on a keto diet. I was feeling discouraged last week: gained water weight (as usual) due to my period and then due to muscle recovery since I spent a couple hours Thursday in the yard, raking leaves. I’ve tracked my weight enough to expect a sudden gain of 3-4 pounds with the onset of my period and then a gradual reduction, which usually takes me below my previous minimum. But it can still feel discouraging – I think this is why many people choose not to weigh consistently. It’s hard to ignore the day-to-day data in favor of the bigger picture.

This morning I hit my lowest weight yet, bringing the total loss for six weeks to 10.5 pounds – which equates to a loss rate of 1.75 pounds a week. That’s a better rate than I’ve had on pretty much any diet before – my rate on Medi-Fast, for example, was about 1.25 pounds a week.

I also took my measurements last Friday and then again today to confirm accuracy (side note: don’t take your measurements when you’re bloated and retaining water). I’ve lost an additional inch from my upper arms, waist, hips and thighs over the last four weeks.

In the end, I have no reason to feel discouraged – the loss has been consistent and the diet is easy to stick to.

Initial Labwork

In an entry on blog.4d2.org, I wrote a bit about the labwork that I have done yearly and additional labwork which was requested by my physician, which I did not have the results for yet.

Every year, I have blood drawn to check the following things:

– Lipid Panel / Cholesterol
– Fasting Blood Glucose
– TSH (thyroid stimulating hormone levels)

The cholesterol and blood sugar tests are the basic tests my primary care physicians have always run on me, I guess as a check to make sure my obesity hasn’t led to any invisible secondary health problems. The thyroid hormone is checked yearly as a result of hypothyroidism, which I was diagnosed with in 2010. My dosage of synthroid (thyroid hormone) was increased once in 2011 but not since then and my yearly TSH tests actually show a decreasing level from year to year since then (this is a good thing – less TSH indicates my thyroid is functioning normally). My fasting blood sugar has always been in the normal range. My cholesterol tends to be in the normal/good range except that my triglycerides go up when I am losing weight (which is to be expected).

My physician, in light of her belief that I am insulin resistant and may have PCOS (Polycystic Ovarian Syndrome), ordered a round of additional labwork last month.

– Testosterone
– Insulin
– C Reactive Protein (a measure of inflammation in the body)

I spoke with my doctor’s nurse on the phone today (and have a follow-up appointment for tomorrow), but the results of this additional labwork have been returned. I don’t have the figures, but I was told that my testosterone levels are normal; my insulin levels are slightly elevated and C Reactive Protein is elevated.

So what does any of this mean? In effect, it means very little. My insulin levels are not so high that the doctor would choose to treat me with Metformin or similar drugs. The C Reactive Protein indicates that there is inflammation in my body – but that is often linked with obesity and the doctor believes that as I lose weight, the inflammation will resolve. The normal testosterone level doesn’t necessarily mean that I don’t have PCOS since there are a range of symptoms associated with PCOS. Essentially the most reasonable medical intervention I can make right now is exactly what I’m doing: a low carbohydrate diet in an effort to both lose weight and lower my insulin levels. The diet alone should bring my insulin to a normal level and that should (hopefully) lead to weight loss. As I lose weight, the inflammation should resolve.

Progress Check Numero Uno:

I’ve been following this diet since September 29, so it’s been three solid weeks. Over that period of time, I’ve lost 5.5 pounds. That’s not an insignificant amount and the loss has been pretty consistent but it’s also not as precipitous a loss as many people experience on keto diets.

I also take my measurements every four weeks and was due to update them last Friday, October 17. Since September 19, I’ve lost 2.5 inches from my waist (4.5 inches total from August 22) and an additional inch from my hips (2 inches total from August 22). The interesting thing this time around has been how differently I’ve been losing weight. I’ve gained and maintained significant muscles in August and September as a result of daily yoga and so clothes I have that normally wouldn’t fit for another ten or fifteen pound loss can actually fit now (!). The make-up of my  body is changing, even as the weight may change less significantly. This feels pretty awesome, and taking the measurements helps support the overall sensation I have that my lifestyle is moving in the right direction, even if the scale isn’t always.

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