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Pros and Cons of Going Gluten-Free. (and a brief lament about the smooshed banana)

It’s been about seven weeks on this “no way, gluten!” lifestyle, and I’m starting to find my footing.  But there are still many pros and cons to balance, so I’m listing them here.  That way, I can look back at this post in a few months and be all, “Pfffft.  Whiner.  You’re in the zone now.”

Here we go – PROS and CONS of Going Gluten-Free in ALL CAPS at times because that’s the only way my brain can operate this morning.

CON:  It’s a pain in the ass, doing this.  Reading food labels for carbohydrate content and grams of sugar in pursuit of better blood sugar control is second nature to me by this point.  After 28 years with type 1 diabetes, I’m comfortable with the carbs.  But trolling labels for that bright, shiny GF logo, or reading through each ingredient to ensure that I’m not inadvertently eating gluten is a new adventure, and one that I find very intrusive.

PRO:  As a result, weight management has been easier lately.  Which I guess is a plus but at the same time, I’m hungry, so I can’t call this a total pro.

CON:  I’m hungry.  (See above.)  All the time.  Mostly because I’m unsure of what to eat, and that insecurity leads me to eat the same things all the time.  Staples like hard boiled eggs, grilled chicken, spinach salad, yogurt, almonds, and every fruit I can get my paws on dominate my days.  Menu items like gluten-free pizza, butternut squash (done with GF ingredients), and chicken soup are being explored, but my natural inclination to be a lazy chef makes this sort of exploration tougher.

PRO:  Eating the same things all the time makes me very familiar with how they map out, blood sugar wise.  So I’m best able to pre-bolus with precision and my post-prandials aren’t gross.  This is boring as eff, but effective for diabetes management.

CON:  Low blood sugars have been really weird lately, especially the ones that follow a visit to the gym.  Before going gluten-free, I’d eat froast or some other glutened up snack to keep my blood sugar steady through cardio (yes, there are other options, but I can’t pretend to have chomped on kale during a run – that would be a big, fat lie and kale hates lies).  Now, I’m erring on the side of fruit and sometimes those sugars get in and out of my system too quickly to hold me for an entire workout.  I’m still figuring out what foods work best to deal with during- and post-exercise hypoglycemia.

PRO:  Glucolift Wildberry tabs are gluten-free.

CON:  Traveling is weird now, too, keeping gluten off my plate.  Airports are not designed for people with dietary needs or preferences, especially little airports like the one I frequent here in Providence.  Finding foods that are gluten-free while on the road is tough, with little exception.  Once I land somewhere, I’m fine, but while in transit, I keep my bag stashed with snacks.

PRO:  I’m learning a lot about what foods travel well.  These gf bars are among my favorites to toss in a backpack, and while they are not as healthy as something fresh, they can stand up to traveling with me and they are more filling than the Southwest pretzels that I can’t eat.

CON:  Bananas do not keep well in backpacks.  They turn brown quickly and often end up smeared on … oh, let’s say the lid of a laptop.

PRO:  I wash my backpack more often than I ever have before, and now it permanently smells like dryer sheets.  Which is a nice contrast to my computer, which smells permanently like bananas now.

CON:  I hate being “that girl.”  The one who asks waitstaff if certain menu options can be made without gluten.  The one who reads labels before taking a bite of anything.  The one who might be mistakenly marked as someone following a “trend diet” instead of someone who is unhappily-but-smartly following through on feedback from her body.  As good as I feel off gluten, I wish I could still eat the stuff and not make waves.

PRO:  I’m learning not to care about feeling slightly embarrassed because DUDE I feel so much better.

“You’re more … you.  The change between then and now is significant,” Chris said the other day.

He’s right.  My mood/disposition/health/everything since kicking gluten out of my diet has been ten steps in the best direction.  All of the non-celiac gluten sensitivity symptoms are gone.  The “head fog” where I would forget what I was doing or what I was about to say has receded.  The numbness and tingling in my hands and wrists is gone.  The ache in my hip joints after running is gone.  I don’t want to spend the afternoon taking a nap on the couch.  My energy is back.  My face is less puffy.  I can chase Birdy without feeling like my feet are in lead boots.  It took months to tune in to how poorly I felt, but now that I’m feeling better, the change is undeniable.

As much as I miss being more carefree about food, a gluten-free diet is the best fit for me.  And after almost three decades of type 1 diabetes, what’s one more food constraint?  So long as coffee and wine remain in the mix, I’m good.

Opening a Can of Gluten-Free Pumpkin Whoop Ass.

I’m five-ish weeks into a gluten-free life, and the waah waaaaaah is starting to wear off.  (I can’t pretend to be above the waaah.  Diabetes is such a food-anchored disease, and an additional restriction acts as an extra fun vacuum, sucking the fun out of meals even more.)  But I’m rounding a corner with this new (and admittedly self-imposed, but with good reason) restriction, and it’s time to start branching out.

My mother-in-law is an excellent cook and she gifted America’s Test Kitchen:  How Can It Be Gluten-Free cookbook to Chris and I after learning about our gluten-free leanings.  For a few weeks, I avoided opening it because I was feeling crummy about the transition, but this morning Birdy and I decided to tackle the gluten-free pumpkin bread.

I don’t know what copyright infringements exist when it comes to recipes, so I’m opting to not post the recipe here (I’m scared of the Test Kitchen people), but I will confirm that the bread, although a little bit of a pain in the butt to prepare, was delicious.  IS delicious, because it’s still sitting out on the kitchen counter cooling and the whole house smells terrific.

The bread recipe only called for 1/2 a cup of pumpkin, so we had the majority of a can of pumpkin left over, all nice-smelling and tempting us to make something else.

“COOKIES!!!” yelled Birdy, which is her answer to just about everything.  (A close second to “Why?”)

“Okay, let’s hunt down some cookies that have pumpkin in them,” I replied.

“Why?”

“Because … you just said cookies?”

“Oh yeah.  I forgot.”

Moving on.

We found a gluten-free pumpkin sandwich cookie via Google with these puffy, awesome pumpkin cookies and a cream cheese filling, so have at it we did.  Navigating the gluten-free curve has been interesting, though, because I am learning how many random things have gluten in them.  Like vanilla.  The vanilla in our cupboard is imitation (don’t hate) and according to Chef Google probably contains gluten (and also anal secretions from beavers WTF), so we used the makeshift substitution at the bottom of the recipe of 1/2 teaspoon ground cinnamon plus 1/4 teaspoon ground ginger, 1/4 teaspoon ground nutmeg and 1/8 teaspoon ground cloves.

The end result, though visually clumsy, was also delicious.

It’s easier for me to avoid desserts most of the time because eating less junk makes the most sense for me, diabetes-wise.  But for those moments when I’d like to enjoy something sweet, I’m glad there are options that won’t wreck havoc on my body.  Gluten-free doesn’t have to be gross, and I’m slowly learning that fact.

Guest Post: Diabetes and Our Relationship with Food.

Georgie is a twenty two year old university student and future French teacher living in Melbourne, Australia. She’s had type 1 diabetes since 2010 and has become very talented at hiding her pump in various dance costumes.  She hates her pancreas but loves the DOC, and is in the very slow process of creating an organisation Down Under to help those with type 1 diabetes and eating disorders. 

I feel lucky that I’ve had the opportunity to spend time with Georgie (she is my favorite holiday card buddy), and today I’m very lucky to have Georgie guest posting about disordered eating, diabetes, and the way we view food.

*   *   *

Sometimes I read things while procrastinating on the Internet that strike a chord with me. Usually they are quotes that revolve around cats and wine, but occasionally there is one gem that sticks with me. I read a quote recently while scrolling through Tumblr that read:

“We are prescribing for fat people what we diagnose as disordered eating in thin people.” – Deb Burgard, keynote at the 2011 NAAFA conference.

At first this quote didn’t surprise me – it seemed quite obvious really, I muttered a ‘duh’ and kept scrolling until I hit the funny cat pictures instead. It wasn’t until I was sitting down to my dinner that night, slowly adding up my carbs, and berating myself about my 16.8 (288 mg/dL) that I realised that there was a reason for that. I was identifying with that quote so strongly not because I am morbidly obese and have had doctors make me count my calories, but because I have type 1 diabetes and “disordered eating” is basically my normal.  We are asked to weigh our food, count our food, know everything there is to know about our food, and yet somehow keep a healthy attitude towards what we put in our mouth every day. Some people manage this – but I know a lot of us don’t!

People with type 1 diabetes are set up for a weird relationship with food, no one seems to mind, and it’s driving me crazy.

“You have to see what’s on your plate as numbers!”

“Don’t eat that, that’s bad!”

“What do you mean, you’re not weighing your food?”

We are doubly lucky though – not only do we have healthcare professionals telling us what to eat, we also have the Food Police!

We all know the Food Police. They can be sneaky – they come disguised as your work colleague, your neighbour, or your aunt at a family dinner. They usually come armed with “lots of knowledge” about diabetes, because their third cousin’s grandma had diabetes, and she “DIED because she ate too much cake!!!” It hides under the guise of concern, but mostly it’s a nosy way to exert control over you while claiming that it’s for your own good. At one point I had a member of the Food Police say, “What if I hadn’t been there to tell stop you eating that? Haha!” Oh, I don’t know, I would have eaten this muffin anyway, but without the omnipresent feeling of shame?

The only other group of people that I know whose food choices seem to be up for public comment are obese people – which is why I think the quote above stuck in my head. We are both told to live a life that revolves around counting our food, and people in our life feel the right to comment on whatever is on our plate. Is it any wonder that some of us start to see food as the enemy? The most ridiculous thing about this is that we CAN eat what we want – we are just like anyone else, except our pancreas comes in syringe/pump form. Would you ever look at the food on a twelve year old’s plate and say “There’s way too many carbs on that plate – remember, you’re trying to lose weight”? No? Then why do you feel obliged to say it to a child who happens to have type 1 diabetes?

Food shouldn’t just be a number; food is there to be enjoyed! I look at a piece of bread and I see “15 grams,” but I should also see “I am full of delicious grains to get you through the afternoon” and “Damn, I taste delicious with some avocado.”

Food is not inherently bad or good. Did your donut creep up on you during the night and rip out your pump site while letting out an evil cackle? The only labels food should have is a Post-It saying, “Eat me, I’m delicious.”

Food is food – what you eat does not define your worth as a person, and leading on from that, what you eat, how much you weigh, and what your hba1c is does not define how “good” of a diabetic you are. We HAVE to stop looking at our A1Cs, our weight, our food choices, and our insulin dosage as something that we can measure and evaluate ourselves against.

How is that healthy? Disordered eating doesn’t necessarily mean an eating disorder, it means eating in a way that could or does harm you physically or psychologically,  and I’m pretty damn sure that some of the practices that healthcare professionals are advocating do not create healthy and balanced attitudes towards food.

When I was volunteering on a kids’ diabetes camp last year, a twelve year old girl was sitting next to me at supper and wouldn’t eat her cookie.

“Why honey? The dieticians told you the carbs, right?”

“Yeah … but Mum won’t let me eat stuff like this at home, she says it’s bad.”

“Food isn’t bad or good, food keeps us going and it’s delicious – don’t you like it?”

“Yeah I do, but … Mum would be so angry – is there an apple or something instead? I can’t eat bad foods.”

My heart nearly broke – this girl, already under pressure from society to look a certain way, can’t bring herself to eat a cookie because her Mum, and no doubt her healthcare team, has told her that foods are ‘bad’ and ‘good.’

I appreciate that it’s a very fine line for carers and healthcare professionals, between keeping their patient healthy and not causing them to hate everything they put in their mouth – but food is not the enemy.  Food is not something we should judge ourselves by – we have to stand up for ourselves. Don’t let the fact that we’re acutely aware of what we’re putting in our mouths affect our enjoyment and love of food.

Food is not the enemy, our pancreases are!

*   *   *

Not Guten for My Gut.

Skipping gluten was once classified as a preference, but the last few weeks have shown me – beyond a shadow of a doubt – that gluten is not “guten” for my gut.  It feels good, figuring out what was causing so much chaos, and I feel more human, and much healthier.

So all that “oooh, so healthy!!” stuff aside, going gluten-free while traveling is a pain in the ass.

Choosing gluten-free options isn’t unfamiliar territory for me, as we did skipped gluten entirely for Birdy for the first 15 months of her life.  I’m accustomed to carefully reading food labels while shopping, and I’m no stranger to reshaping recipes to fit nutritional needs.  But on the road, it’s hard to tell what foods contain what.

Last week, my family and I were in Vienna, Austria and it was my first experience with “needing” to be gluten-free and being away from home at the same time.  At home, I can read labels.  In Vienna, I couldn’t even read the menu unless it had English subtitles.  The language barrier, plus the dessert constants, made this trip a challenge.

“Let’s stop at that cafe and get strudel!”

“How about some chocolate cake?”

“The schnitzel looks delicious!!”

Everything in Vienna looked delicious, and covered in a layer of gluten.

Being gluten-free is a double-edged sword, but one “for good,” as my daughter would say, because rethinking carb consumption is (sigh) good for my blood sugars.  Avoiding the cream-filled desserts and opting for coffee instead gave me some really steady post-prandial blood sugars.  Not piling on the carbs made for awesome Dexcom graphs, but it was frustrating to have yet another food rule in place.

“I’m pissed off because it’s not a matter of choice.  I like choosing healthier foods, but I really don’t like being forced to because of all this gluten crap,” I said to Chris over yet another boiled-chicken-over-greens lunch.

“I know,” he said, diving compassionately headfirst into a plate of schnitzel.

And sometimes things just got all screwy.  Like on the plane ride home to Boston, where I avoided the roll of bread and opted for the chicken-and-rice meal choice, only to find out from the flight attendant that the sauce on the chicken contained flour (the presence of which was confirmed by my belly about 45 minutes later).  Or when I ate a bag of plane pretzels, forgetting that I needed to care about gluten.  My brain isn’t rewired yet and I need to constantly remind myself (see also:  grabbing a bite of Birdy’s breakfast cereal, only to remember that it contains gluten, and then spitting it into the garbage).

Because it’s not all in my head.  Removing the fog and bloating from my body’s repertoire is such a relief, and I have no desire to go back to the way I’ve been feeling over the last year.  The few times I made the mistake of eating something with gluten in it, I regretted it.  The return of bloating, headaches, abdominal discomfort, and exhaustion were a reminder that my body does not respond well to gluten.  Even if the tests for celiac and gluten sensitivity came back negative, there are clear and present markers that I feel better going gluten-free.

This is an adjustment, but in time, I’ll have a plan.  I’ll have this figured out.  My health is worth the investment.  Besides, Riesling is gluten-free, so I’ll be just fine.

Belly Ache.

My celiac tests came back negative.  So did my IgA or IgG AGAs (these could be exactly the same as a celiac test but I do not know all the lingo and thus, I remain clueless).  The basic gist is that my body seems to have no trouble at all with gluten.

Except that it totally does.

I don’t know exactly when it started, but I’d say about eight months ago.  That’s when the first nondescript symptoms came into play.  My weight went up a little bit, despite the same amount of exercise and generally eating the same mostly-healthy foods.  My stomach wasn’t upset so much as a little uneasy, and my abdomen felt slightly tender after some meals … and other times without any known catalyst at all.

But I’m not good at keeping track of when things “start to change.”  The only way I knew that my weight was changing was because my clothes fit a little bit differently.  My blood sugars were fine, and my overall health seemed fine.  The decline into “not so fine” wasn’t fast, but really slow and subtle until all of a sudden, I was like, “WAIT.  Just a frigging second.  Why do I feel sick all the time?”

In the last three months, I’ve been acutely aware of not feeling well, and the list of noticeable symptoms grew week by week.  I was exhausted – falling asleep on the couch and having trouble maintaining my normal vampire hours.  I was moody and grouchy, especially later in the day.  (And I’ll just offer this up because I know you’re thinking it:  I’m not pregnant.)  My hands, on some mornings, were tingly and pins-and-needlesish.  And my stomach was angry, but in a really passive-aggressive way.  I had sharp pains in my stomach, but not all the time.  I had wicked bloating, but not intensely all the time.  I just had a permanent belly ache, and it was becoming the norm.

And I was permanently belly aching about it.  The only thing that alleviated symptoms was to cut out gluten, but I didn’t do it consistently enough or in a dedicated enough fashion to really assess if going gluten-free helped.  (Sadly lazy, but true.)  On the whole, our family is about 80% gluten-free, but apparently the 20% was enough to leave a trail of blargh.

Thankfully, my endocrinologist is thorough, so when I saw her a few weeks ago, she ran all the appropriate tests to rule out different this’s and that’s and to help establish certain baselines and other fancy doctor/patient discussion things.  My thyroid function is fine.  My A1C is fine.  My blood pressure is fine.   Nothing came back flagged as an issue.  (Except the whole diabetes thing.)  Which made me feel weird, because the absence of a concrete YES YOU HAVE A GLUTEN SENSITIVITY made me feel a little powerless, like I was just grasping at straws.

In efforts to take some definitive steps towards actually doing something, I talked with Sara(aah) about this issue, and she and I compared symptoms until I felt confident that, even if the tests didn’t flag an issue, there still could be some kind of correlation.  Whether gluten is the root cause or just a trigger, its absence makes me feel much better.  I can’t dispute that fast-becoming-a-fact.

So for the last week, I’ve been running my own gluten-free tests.  And fortunately for my body, it seems to help.  (Unfortunately for my preferences, though, because I love Italian bread and all that jazz.)  It’s been almost a full week now without a whisper of a symptom.  It’s been months since I’ve gone more than a few hours without a sore belly, so this is a step in the right direction.

My plan is to continue to go with my gut and do what makes my body feel better.  If I go against the grain, I’ll feel better.  It’s a diet omnivorous about sticking to, but I know it’s best in the long run. 

… more gluten-free puns once I cook them up.  For now, you’ll have to wheat.

 

Free Foods!

…  “You can have pickles?  Or gelatin?  Or cucumber slices!”

My mom tried to make these options sound appealing and delicious, but when I was a kid and my blood sugar was super high, pickles weren’t what I craved.  My body wanted to chug water and cheeseburgers simultaneously in efforts to cleanse the ketones and sate the high hunger.

“Can I have something else?”

“Not right now.  Those are the free foods you can have, until your blood sugar comes down.” she’d reply.

The phrase ‘free foods’ was a real one, twenty years ago in our household.”

more about free foods at Animas.

Pre-Bolusing for Snacks.

“Do you pre-bolus for your meals?”

“I do.”  (I was happy to answer this question because I actually do pre-bolus.  Pre-bolusing is my A1C’s saving grace.)

“Okay, that’s great.”  She made a few notes in my chart.  “How about for snacks?  Do you pre-bolus for those?”

“I … um, nope.  I am horrible at pre-bolusing for snacks.”

Unfortunately, hat is completely and utterly true.

Meals are easier to pre-bolus for because there’s time involved in making them.  If I know I’m cooking chicken and green beans for dinner, I have 25 – 30 minutes to let that bolus sink in before the meal is even ready.  Going out to eat at restaurants is easy, too, because I usually have an idea of what I’d like to eat, so I’ll bolus for the meal once we are seated at the table.  (Pre-bolusing backfires at times, too, but as long as I’m not in the middle of the woods, I’ll take the risk.)  A meal feels like an event, and therefore easier to accommodate.

Snacks feel like an accident.  An unplanned moment.  I don’t take an apple out of the basket and bite into it in a premeditated fashion, but more like a fluid movement without any thought involved.  (A run-by fruiting by any other name …)  It’s not until I’m done with a snack – apple, yogurt, nuts, protein bar … cupcake? – that I realize I haven’t taken any insulin to cover the carbs.  My post-snackial blood sugars aren’t grateful for the misstep.

This would not be a big deal if I wasn’t such a grazer, but when 50% of my caloric intake throughout the day is on a whim, pre-bolusing for snacks matters.  My A1C is currently in my range (under 7%) but I know if I can remember even half the time to pre-bolus for snacks, I bet my standard deviation will tighten up and blah blah blah other numbers as well.

Little, conscious changes will hopefully become habit.

 

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