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Thursday, December, 03, 2009
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Walking with Poles

David Mendosa
David Mendosa
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Medical Journalist Living with Diabetes and Author of Fitness and Photography for Fun, www.mendosa.com/fitnessblog

After earning a B.A. with honors from the University of California,...

David Mendosa

Tuesday, July 14, 2009
View All of David Mendosa's Posts
  Walking is the exercise of choice for most people, especially when we would rather be outdoors than in a gym. Walking is one of the best ways to prevent heart disease, the biggest problem that those of us who have diabetes face. If all we want to do is strengthen our lower body, we need on...
  1. backpacking
    Lynn
    Wednesday, July 15, 2009 at 06:48 PM

    Off topic here, David: could you please consider writing about how to pack food for very low carb backpacking? BD (before diabetes) I used to pack Lentils and Rice, or, for variety, Rice and Lentils, with varied seasonings, or ramen, or mac & cheese. I can manage for a weekend, but for a couple weeks I am baffled. Somehow the weight of a jillion tuna pouches seems overwhelming. Any thoughts? Thank you, dear.

    Reply
    re: backpacking
    David Mendosa
    Wednesday, July 15, 2009 at 07:12 PM

    Dear Lynn,

     

    Good question! We can start with my previous articles on trail food, i.e. food for day hikes. Over the years I've come up with only two types of food: nuts, especially almonds and macadamias, and canned fish, especially sardines, mackerel, salmon, and tuna (only from vitalchoice.com).

     

    Like you, I am right now in the midst of planning a two-week expedition (not a backpacking trip this time, because the mules will carry almost all of the load on their backs). For it I have been going over my low-carb food requirements with the trip leader. My menu will be very limited!

     

    The mules will carry breakfast for me, a drink of veggies (see http://www.healthcentral.com/diabetes/c/17/67280/drink-veggies ) to which I have added a very low-carb protein powder.

     

    The nuts and canned fish will have to do for my lunch for every day of the two-week trip. For dinner I will have to compromise, probably mostly beans. When they certainly aren't low-carb, they are low glycemic.

     

    No eggs, no salad, no fresh fish, of course (unless we catch it en route). Now, please tell me what additional suggestions that you have!

     

    Best regards,

     

    David

    Reply
    re: re: backpacking
    Gretchen Becker
    Thursday, July 16, 2009 at 10:06 AM

    Mix one part wheat or rice bran with one part ground flax seed (you can add cinnamon or other flavorings if you like). Then measure out a couple of tablespoons and add hot water (I'm assuming there won't be a microwave <G>) for a filling cereal. Sweeten with a powdered sweetener, and add berries if you find them on your trip.You could also pack some dehydrated berries.

     

    Get a good book on eating from the wild and learn to identify the plants that would be available in the area you're traveling to. I eat milkweed, pigweed (chenopodium), and purslane regularly in the summer. This will add some variety.

     

    Pemmican would be relatively light for the calories provided.

     

    Get some tepary beans. They're higher in protein and lower in carbohydrate than regular beans. The Pima Indians used to use them on long trips because they're more filling than regular beans. And when you're on long hiking trips, you'll burn more carbs than usual.

     

    Dried soybeans would be another option. They do require long cooking, however, assuming you're not backpacking with a pressure cooker.

     

    Another possibility would be chana dal, a very low GI lentil-type food. In fact, because you'll be walking all day, you might even be able to tolerate regular lentils, especially the tiny varieties that have more fiber to starch.

    Reply
    re: re: re: backpacking
    David Mendosa
    Thursday, July 16, 2009 at 10:45 AM

    Dear Gretchen,

     

    Many thanks for all of your tips. I especially appreciate your suggestion for pemmican. When I go shopping later today I will look for it or other forms of jerky that Whole Foods might carry. I will also search out wild foods on the trail. Already on a couple of recent hikes I have enjoyed dandelion greens and wild raspberries. My stomach will appreciate your tips when I am hiking in the High Sierras from August 2-15.

     

    Best regards,

     

    David

    Reply
    re: re: re: re: backpacking
    Lynn
    Thursday, July 16, 2009 at 12:45 PM

    What an interesting challenge, David.

     

    Here are my parameters: in two years when my younger child reaches 12, the minimum age for a Grand Canyon raft trip, I intend to take both sons on a two-week trip. In the meantime,  I often go canoe camping or back-country camping without refrigeration, unlike standard car camping with a cooler. I find that I need a relatively high-fat diet to keep down my weight and my blood sugar and to keep from getting hungry, now that I eat almost no carb. When I exercise more than just mild walking or errand bicycling, I get ravenously hungry and cannot keep from overeating, especially carbs. I'd want to make sure I kept my dietary fat level high. Unlike you, David, I am a cook. Also unlike you, I don't know if I could choke down the green sludge you drink for breakfast. Also unlike you, I have a food dehydrator. 


    Right now, my doctor has me on a headache-elimination diet, which has removed several foods I have used as my high-fat, low-carb staples: soy, seaweed, avocado, nuts, aged cheeses, dried fish and nitrate sausages. The first four provided much of my fiber, as well as flavors: dried edamame (as a snack; these are very high fiber, and almost no net carbs), dried black soybeans to be reconstituted, soy miso, tempeh, sauce and so on. The sausages (eg pepperoni) and dried fish had been staples when I canoe camped earlier this year.  I hope that within the next two years I'll be able to identify headache triggers and bring some of these foods back.


    Meanwhile, I agree with you about nuts and canned fish. I might add pepitas (although those are seeds) and almond meal. If it's not too hot, I might make "cookies" of almond meal, pure cocoa powder, vanilla extract and melted butter or melted unsweetened chocolate. I like these even unsweetened; I can taste the natural sweetness of the almonds and cocoa. I do wonder about the back-country safety of carrying emptied fish containers around: oily fish cans or pouches can sure draw predators and varmints. Any thoughts on that?


    I had been on a Japanese food kick this year until the headache police yanked away those food sources. If not forbidden, I would take sesame seeds (first soaked in sea-salted water, drained and then oven-dried), tahini (if I could solve the empty container problem), various seaweeds that can be snacked on out of hand (nori) or reconstituted for lovely salads or for soup (hijiki, wakame), along with other dried Japanese veggies: mushrooms, lotus, daikon. Tofu is available dried; the reviews I've read about it are disparaging, so  I'd try it first. I'd wonder about taking  tofu in aseptic packaging,  it's heavy with water, and I'd need maybe a pound a day, so I don't know how practical it is. I'd also take dried shrimp, dried anchovies and bonito flakes: shavings of dried tuna that are used for soup. I have a feeling that bonito in typically eaten quantities has almost no calories and rather little nutrition, though.


    I'd dry other veggies and fruit, mainly low-sugar berries, which I use very sparingly. Trader Joe's has freeze-dried blueberries and green beans.


    Then I'd try my dehydrator at homemade jerky, since the preserved sausages aren't allowed for me. I don't know how well or how long that keeps; it might not last the whole two weeks. Almost all the commercial jerky has sugar added. I found a Native American company that makes buffalo/cranberry jerky, but it has 5 g of sugar per ounce. 


    Next, I'd explore some high-tech foods that a chef out of Chicago has been promoting. One that interests me is spray-dried cream, also called heavy cream powder. I'd experiment ahead of time with a mix of cream powder and cocoa powder for a high-fat cocoa mix. I could make yummy soup w/ the cream and various dried foods or fresh fish and foraged veggies. I came across the high cream powder when I was thinking about dried milk, but rejected it because of the high carb content. If I could find or dry drained yogurt, I'd take that.


    My main concerns for back-country travel, besides the usual ones about weight and preservation, are getting enough protein and fat to meet my caloric needs and to keep me from getting hungry so I don't lurch toward the carbs other folks are eating and enough fiber for trail regularity. I also wonder about packaging disposal and varmints getting into the smelly foods.  I like Gretchen's ideas, too. Thanks for all the notions.

     

    Reply
    re: re: re: re: re: backpacking
    David Mendosa
    Thursday, July 16, 2009 at 02:36 PM

    Dear Lynn,

     

    Great ideas! I've recently discovered that I need a higher fat diet, like you recommend. In fact, I will be writing about it soon. That will be a problem on my two-week trip, but I will probably have to revert to carbs to handle my energy needs.

     

    The "green sludge" that I love for breakfast actually tastes wonderful -- if and only if you get the right brand (http://www.healthcentral.com/diabetes/c/17/67280/drink-veggies ). I've added protein powder to it and at home use sparking mineral water from the fridge. I like it so much that it's sometimes my dinner too.

     

    I followed that headache-elimination diet for a while and really missed the avocados and nuts. That National Headache Foundation low-tyramine diet (http://www.headaches.org/pdf/Diet.pdf ) is specifically for migraine, which I sure hope that you don't have. But then my neurologist ruled on migraine (as well as the serious organic causes including a tumor and an aneurism). But I also stopped drinking any alcohol and any coffee (except decaf), and started chiropractic, massage, and acupuncture treatment and now the headaches are gone.

     

    Great suggestion for dried edamame! I love the fresh beans and just added the dry ones to my shopping list.

     

    On my two-week trip we will, of course, store the empty fish cans with the food. Whenever I go backpacking I store all food -- and anything that smells of food -- in a bag tied really high in a tree (I think that I've read that some parks now require heavy metal canisters). The only time I ever had bear trouble was on a trip in the Upper Peninsula of Michigan, where a girlfriend and I left our backpacks on the ground for an afternoon stroll along Lake Superior. When we came back a bear (I presume) had destroyed her pack and absconded with all of our food. Needless to say, we abandoned our trip at that point and learned a lesson.

     

    You are so right about commercial jerky contained sugar. The last time I checked I couldn't find a single brand that didn't. It may be a compromise that I will have to make for the backcountry.

     

    The protein powder in your breakfast drink -- if I can persuade you to try GreensFirst -- could go a long way toward providing your protein requirements on the trail. While the GreensFirst container says to refrigerate after opening, I didn't notice that once and probably lost little anyway. My current protein powder doesn't have that restriction. By the way, I am experimenting with various protein powders. Whey is the most common, but some folks say that whey may be somewhat inflammatory. I am now planning to check out egg white protein, simply because eggs are, as I remember, the most complete protein.

     

    I would love to find a good source of freeze dried foods. But NOTHING is low-carb. By far the best brand I've ever discovered in MaryJanesFarm, not only for the contents but also for the packaging, which you can burn in the campfire, and for what I know about MaryJane Butters. REI carries a near-complete line of her products. But the lowest carb dinner, Kettle Chili, has 25 grams of net carbs. Still, it tastes great and in the absence of much fat that I can carry, I chose to eat it on a lot of my trips.

     

    Reply
    pemmican
    Lynn
    Friday, July 17, 2009 at 11:09 AM

    Well, David, I think you'll be well prepared for your trip. Would you please let us know how the food works out, and impact on your blood sugar?

     

    I am also curious about how you handle the elevation in the High Sierras. I know you live in CO but don't know how high up. Last summer coming from low-level Ohio to the Tetons, at about 5 or 6K feet, I had altitude sickness, which I think is somehow related to diabetic autonomic neuropathy. The medical descriptions of mountain sickness report it starts at 7K and higher, but nobody told that to my stomach and head.

     

    Also wonder if Gretchen knows a source for pemmican. The traditional recipes call for rendered fat and dried meat, resulting in a high-fat product. Or do you make it from your sheep?

     

    Thank you both for your suggestions. I think I'll manage well, and hope you do, too, David.

     

    Also, David, I am glad you are eating higher fat -- and using your walking poles again after your fall. I wonder if you have grown too thin?

    Reply
    re: pemmican
    David Mendosa
    Friday, July 17, 2009 at 07:21 PM

    Dear Lynn,

     

    Don't you know the old saying that, "You can't be too thin or too rich?" But, yes, maybe I am too thin. Several doctors have in fact told me that.

     

    The altitude won't be a problem for me -- now. When I moved to Boulder, Colorado, at 5,400 feet, it did take me quite a while to adjust. But now I am totally used to it. This week, in fact, I make four hikes, each of which was between 10,000 and 12,000 feet, without problem.

     

    Thanks for your concern!

     

    David

    Reply
  2. Untitled Comment
    sjs
    Friday, July 17, 2009 at 07:25 PM

    REI has trekking poles on sale from time to time. I bought a set at one of those sales, but usually only use them when hiking somewhere in the mountains. I also found them useful when walking in sand at a beach. One time when visiting the Devil's Postpile area, I wished that I had them with me because I didn't fell safe walking up the steps to the top of the postpile.

     

    I had neuropathy in my feet for several years before I realized I had diabetes and it sometimes seems that this has put me off balance a bit, so poles would seem to come in handy especially I have to go down long stairs that have no handrails (e.g., in a lecture hall at a university). But I don't carry them with me there because it would probably make me look weird. I just go down the stairs slowly so as not to fall and I haven't fallen yet.

     

    A couple of years ago, after I had a foot ulcer, Kaiser sent me to get orthotic shoes which they paid the provider $400 (which seems exorbitant to me even though the fitter spent a total of about 1 hour of his time with me) for. After less than a year, the uppers came unstitched and I took the arch supports out and put them into some other shoes. I think, however, that the right arch support "wore out" or something, because my heel got very sore and skin started flaking off it. I switched to some other shoes without the arch supports and my heel has mostly healed.

     

    The Kaiser primary care doctor I used last year left Kaiser and I had to choose a new doctor because I needed to get some prescriptions refilled. The KP website said my annual diabetic foot exam was overdue so I mentioned this to him while I was there. I also told him about my experience with the orthotic shoes. He only looked (and not very thoroughly compared to what other Kaiser doctors have done in the past) at my right foot and didn't even ask me to take my left shoe and sock off. He is a pleasant fellow, but I wonder if he has had any experience with diabetics. 

     

    I was in a Costco a few weeks ago and was given a leaflet that says that Costco (maybe only at certain locations) was now selling orthotics for $90 a pair and, since I don't know if my Kaiser plan would pay for orthotics, I was thinking of going there. But, according to footankle.blogspot.com/2009/07/costco-orthotics.html , what Costco sells is a relatively a good OTC arch support that is 20 to 30% overpriced. I suspect that in my case an OTC arch support would not offer the best fit.

     

    There is a link to another page that describes how fitting for orthotics is done (footankle.com/custom-orthotic-casting.htm). The place that Kaiser sent me to used the put your foot in the foam box method to make the casting. I don't believe the guy who did the casting is a doctor.

     

    Reply
    re: Untitled Comment
    David Mendosa
    Friday, July 17, 2009 at 07:55 PM

    Thanks for sharing your experiences. Just a couple of weeks ago I got orthotics from my podiatrist. He suggested them because a callus on my left big toe was becoming painful when I hike (he also suggested massaging the callus with hand cream and his nurse made some wraps for my toe to protect it). The orthotics cost $300, but my health insurance paid all except the co-pay ($50).

     

    Years ago a chiropractor got me some OTC orthotics that didn't fit as well. Anyway, my callus is already MUCH reduced!

     

    Best regards,

     

    David

    Reply
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