(Note: This is not a medical advice. Consult your doctor if you decide to go into any diet or exercise regimen).
Fear, they say, is a powerful motivator. It creates a strong urge to move away from that state of fear, towards our “comfort zone”.
I was diagnosed with pre-diabetes (then diabetes) 8 years ago. During that time, I saw at least 3 different doctors. Among others, they advised me to go slow on carbohydrates (rice, bread, pasta, etc), exercise regularly. I was relatively younger then, and had no shortage of excuses. I was trigger happy with my cravings.
Since 2014, I’d taken metformin, the first-line medication for Type 2 diabetes. I thought I’d just coast along, expecting my condition to go away.
My parents were diabetics. The disease didn’t go away. Both died of “co-morbidities” that come with this illness (dad in 2015, and mum in 2021).
Statistically, my siblings (I have three, I’m the third child) and I face a 50% risk the genes could be passed on. Our eldest, Chris, is now taking insulin injectables to keep his high blood-sugar condition in check.
We all saw our parents go through much pain and discomfort due to diabetes complications, apart from the difficulties of old age.
Overweight: doctors’ advice ignored
The thought of going down with a similar affliction is a constant. So I religiously take (or took) my medications.
For the most part of my adult life, I’d been at least 10kg overweight. Doctors advised “lifestyle change” — i.e. weight loss, less carbs, more vegetables; less sweets, more exercise.
I dismissed all that, considered myself an exception to the rule. Now, the exceptionalism has worn off. I was starting to feel lethargic, cranky, unable to lose weight, had sugar cravings, skin breakouts, even brain fog.
My posture changed from a feeling of invincibility to that of an object of mercy in the face of impending wrath. Potentially, from the same illness that took both my parents down.
‘Diabetes corner’ in the house
As an Asian, I grew up eating anything with rice: rice with chocolates, rice with chips, rice with meat/fish, rice with coconuts. Rice with rice.
“Suman lehiya” — a local Filipino delicacy made of sticky-rice with gooey coconut milk smothered with sugar and vanilla grass (pandan) extract — is a fixture in our house (usually an extra table) on special occasions. It was my mum’s favourite dish.
In the eight years I’ve taken blood-sugar-lowering meds, I never thought much about my weight issue, or doing something radically different than what I’m used to.
I stand 168 cm — the ideal average weight is 63.5 kg. I’ve always weighed around 75kg or more. There was self-talk: “I feel OK in this weight.”
How did I decide to lose weight? The journey from a high-carb, anything-goes lifestyle to a low-carb, intermittent fasting regimen was forced upon me, sort of.
One key trigger: health insurance. My wife shopped around for medical insurance last year. Most agents rejected me right away, after I declared my “pre-existing” condition.
That episode made me feel like an outcast, unclean, a social liability. Finally, one guy offered a “global coverage” — for what I thought was a huge premium — the equivalent of $2,000 per year.
Given the rejections by insurers and the worry of falling ill, and having still-young children, I thought it’s time to face the music. Desperate times call for desperate measures.
After delivering our third child, my wife Tweet had tipped the scales at 90kg (though her ideal body weight should be 65kg or less). Since 2018, she has been prescribed four “maintenance” medications (300 tablets each) following a workup at a local hospital. Nothing seemed to work.
This led us to search for a low-carb coaching. We found Dr Josephine Chua Rojo, and Dr Lesel Ganancial, our intermittent fasting mentor. We initially tracked their live sessions on social media, then signed up for one-on-one online coaching, after paying the fees (altogether, around $100).
Part of breaking unhealthy food habits is closely monitoring our food intake and daily finger-pricks — for at least 30 days. Not easy. Eating habits is one of the hardest habits of all to break, I realised.
It unfolded like a slow-motion movie, until it became routine. They say it takes at least 21 days of daily practice for something to become a habit.
■ The rule is simple: Commit to a personal or professional goal for 21 straight days.
■ After three weeks, the pursuit of that goal should have become a habit.
Understanding is key. Advocates of this lifestyle push for a “holistic approach”, focussing on physical, mental health and wellness. Some low-carb sessions soaked us up in cell biology and biochemistry, touching on the basics of hormonal functions, metabolism, enzymes, toxicity, glyconeogenesis and glycogenolysis.
These terms were once totally alien to me. Further readings led me to Science Direct, which published a 2018 study suggesting that even the so-called “digestible carbs” are more toxic than lipids (fats).
■ Carbohydrates range from digestible polysaccharides to refined sugars that collectively lead to noxious effects on human health, a phenomenon known as ‘’carbotoxicity”.
■ This condition tells your cells to save the extra glucose as fat. Overtime, this can be unhealthy, especially you’re already tipping the scales at more than the ideal weight, which then leads to diabetes and other related health issues.
What’s behind someone’s food cravings? I had found that an imbalance of hormones, such as leptin and serotonin, could lead to such a downward craze with cravings.
Why does fasting work when combined with low-carb?
I realised fasting is easier when you’re on low-carb. They sort of support each other. Rather than a vicious cycle, it’s a virtuous one. It promotes fat-adaptation. This takes place by up-regulating fat-burning mitochondria, spurring the creation of new mitochondria, and reducing your reliance on sugar.
■ The glycogen previously stored by the liver is broken down to glucose and dispersed throughout the body.
In the low-carb community, we were introduced to the “safe”, “caution” and “danger” list of foods.
We started with a 12-hour fast daily, progressing to 14, then 16 then 18 hours, drinking only liquids (water, unsweetened tea, or sugar-free coffee) during the fasting window, and then sticking to “safe”, low-carb foods during the eating window.
Testimonies of people who have done it before us were eye openers, too.
■ One example: the conversion of lactic acid to glycogen in the liver. So glucose is so important that the body produces it, even without carbs or sweets in our diet.
What UAE doctors said
Interviews with doctors in the UAE who practice low-carb, intermittent fasting further reinforced this.
In my younger years, I was a sucker for fruit concentrates and desserts, mixing bitter chocolates with sweet ones, in a mistaken idea of reducing the bad effects of sugar.
In the UAE, where I lived 20 years, the wide availability and affordability of fruits — water melon from Iran, rock melon from Honduras, Kiwis from New Zealand and mangoes from Pakistan/India, local dates, and all sorts of food from different parts of the globe — were just too compelling.
Then I realised: There’s a reason why fasting works. For centuries and millennia, humans have survived drought and lack of food for days, if not months. Yet they have adapted their body and mind through this cycle. It’s counter-intuitive, but fasting does sharpens the mind, a physiological condition that’s key to survival (where to find the next food?) among primitive men.
There’s a downside to overabundance. The easy availability of food in general, and carbs in particular, is a modern-day phenomenon, thanks to trans-continental flights and ocean-going super tankers.
- The need for a tax in UAE: How sugar kills you
Now, some people (including colleagues at work and my grandma’s 93-year-old sister) express concern (or horror), exclaiming why I’ve lost “so much” weight.
But I never felt better: Now, I sleep better. Gone are the stomach upsets, bloating and constipation, sugar cravings, skin breakouts. Now, my blood sugar is slowly inching back to normal, without taking medications. I’m not there yet, but I feel confident I will get there in time. (Will update you here, when I do).
A low-carb, intermittent fasting lifestyle was farthest from my mind then. Desperation led me to it now. Fear, too. Perhaps, love. But despite this mix of motives, it’s a choice that makes perfect sense.
Even with the coaching and tracking, our journey has not been a perfect straight line of adherence. We allow ourselve to “fail” (with a “cheat day”), but not everyday.
And it’s never too late to pick a healthier, low-carb, intermittent fasting, purpose-driven life.
It’s a hormone produced in our pancreas, a gland located normally behind the stomach, which allows our body to use glucose (sugar) for energy. Inside the pancreas, this insulin is made in the “beta cells”.
It’s a polite phrase (biochemistry jargon) or way of saying “sugar is sweet poison”. Fruit has carbs and fructose (natural sugar), which can cause blood sugar and insulin levels to spike and muscles and joints to get inflamed.
Most dieticians suggest consumption of fruits in moderation, with a maximum serving size of 1/2 cup.
EFFECT OF SUGAR ON INSULIN PRODUCTION
When there’s a rush of sugar (from carbs/sweets/fruits), the beta cells in the pancreas (the security guards for our body) send the alarm bells off, calling up insulin.
Insulin work like dump trucks that pick up and haul all of that sugar out of the blood — and feed it to our liver, muscles, or store it as fat.
Anytime we eat these foods, our beta cells in the pancreas send the alarm bells off — to make more insulin.
So insulin is nature’s way of keeping away excess sugar from our blood, helping the body absorb glucose and keeping blood sugar levels “balanced”.
HERE’S THE DANGER:
When beta cells in the pancreas (where insulin is produced) get overused — like cars or computers — the parts eventually wear out, leading to “beta cell burnout”.
Insulin resistance (IR) refers to an impaired response of the body to insulin, resulting in elevated levels of glucose in the blood — a key component of Type 2 diabetes and metabolic syndrome.
WHY WEIGHT LOSS MATTERS
A 2013 study using a randomised controlled trial published in the journal Diabetes Care, shows increased consumption of fruits and vegetables (advocated in public-health advice), has no effect on insulin resistance in overweight individuals who are at high risk of cardiovascular disease when body weight is maintained. (Most doctors recommend that people should stick to the ideal body weight, based on BMI standards, through a combination of healthy diet or exercise).
SUGAR AND INFLAMMATION
Sugar (sugary drinks, high carbs and high-fructose fruits) is on top of the list of foods that may increase muscle and joint inflammation.
Numerous studies suggest that processed sugars release pro-inflammatory substances in the body, causing further inflammation in the joints. This effect can last for a considerable amount of time.
Consuming a 50-gram dose of fructose causes a spike in inflammatory markers like C-reactive protein (CRP) just 30 minutes later.
Sources: Diabetes Care (journal) | US National Institutes of Health | Healthline | Caryortho