Few of us count the calories, carbohydrates, fat, and protein that we eat. It is just too complicated and time consuming. And when we eat out, we can’t know for sure just how much anything weighs.
But unless we go to the trouble of counting what we consume we can’t do a good job of controlling our blood glucose levels and lose weight while at the same time making sure that we get enough - but not too much - of the macronutrients. Some of the other strategies to lose weight or maintain the weight we already lost – like weighing ourselves every day, exercising a lot, not eating after dinner, eating breakfast every day, and some of the other tips I’ve shared here – are important.
All of us who have diabetes absolutely have to control our blood glucose levels. If we don’t we run a serious risk of ending up with one or more of the complications. Not everyone who has diabetes has to lose weight or maintain the low weight level that we have already achieved. But practically everyone who has type 2 diabetes and even many who have type 2 have to constantly fight the battle of the bulge. Fully 85 percent of all American adults with diabetes are overweight, the Centers for Disease Control and Prevention says.
But counting is key. I know because I’ve diligently followed those strategies for years. But it was only when I carefully counted what a consumed that I finally reached my body mass index, or BMI, goal.
My first goal was a BMI just below 25 - barely normal, but still a long way from where I started. Then I read that the Harvard’s Nurses’ Health Study showed us that a BMI of 23 or below is even healthier. That became my second goal.
Eventually I read a study demonstrating that the healthiest weight was "towards the lower end of the normal BMI range." Since the normal BMI range starts at 18.5, I determined to set my final goal at a BMI of 19.0. I reached that goal today by counting all of the calories, carbs, fat, and protein that I consume.
What’s the point of counting anything unless we we are trying to reach a goal? In another context that’s why I have been so determined to find out what a normal A1C level is. We need to set goals for the total amount of calories that we eat as well as the macronutrients, carbohydrates, fat, and protein.
Several times in the past I’ve gone to the trouble of making these food counts. But then I didn’t have a good idea of the goals I was trying to reach.
Now, I know a little better. But it turns out that I was not only eating too much but also setting some of my goals too low. In other words, I didn’t know what I was doing. But in just one week of counting, this time I learned a lot.
For example, I figured that I was eating about 1200 calories per day. That figure was way off. I set my calorie goal at less than 1500 in order to lose a pound a week. But in fact I averaged 1733 calories each day and lost 4.8 pounds, according to the digital scale in my bathroom. While I was happy to finally reach my weight goal, that is way too fast.
How many calories that three tandoori chicken legs have also surprised me. The one meal I ate out this week was at the nearby Nepalese restaurant where I figured the tandoori chicken was the best bet for being both low in calories and in carbs. But the three chicken legs had 900 calories and 18 grams of carbs - and that wasn’t all that I ate at that meal.
I also figured that I was getting 40 to 50 grams of net carbs (starches + sugars - fiber) per day and set my goal at 50. Turns out that I averaged 63. That’s above the very low-carb level that I know I need to stay at to keep my blood glucose in control and to avoid being hungry.
For fat consumption I was on target. I set my goal at more than 100 grams per day and in fact averaged 110. We need around that level of fats for energy when we follow a very low-carb diet.
For protein consumption I may have set my sights too low. I know that I need at least 56 grams of protein per day, because that’s what the Institute of Medicine says that adult men need at least this amount, and I picked this level as my goal. Most adult women need 46 grams, while pregnant women and nursing mothers need 71 grams. I averaged 130 grams. That’s a lot higher than my goal, but the most recent blood test my primary care physician ordered from the local lab reported that my protein level was too low.
We need three different tools when we count what we consume.
First, we need to weigh what we eat. While even a postal scale will do, the latest nutrition scales have huge food databases built in that make the process a lot easier. A couple of years ago I reviewed the two best nutrition scales.
Second, we need to use a Website that easily shows us the counts for the foods we eat. While the U.S. government’s "National Nutrient Database" is the gold standard, it is tedious to use. Fortunately, the government doesn’t claim any copyright, allowing many other Websites to build on it. The most complete and easiest to use in my experience is the free CalorieKing tool.
Finally, we need a place to record and total our numbers. In the old days (a year or two ago) I kept this food diary with paper and pen. While a food diary calls out for the use of a spreadsheet and I have Microsoft Excel on my computers, I never really learned to use it easily. Now, however, Google has introduced a suite of "cloud computing" programs including a spreadsheet that anyone with a computer can use at no cost and easily master. The Google spreadsheet is a part of Google Docs (http://docs.google.com/).
Remember the Heisenberg uncertainty principle in physics? There it’s a problem because you can’t measure something without changing it. But in counting what we eat, our act of measuring works for us.
"It’s annoying and it’s tedious" to count calories and keep a diary recording what you eat, a dieter told Gina Kolata, the author of Rethinking Thin. But that’s precisely the point. It is a disincentive to eat when you have to look up everything, find out how many calories and grams of carbohydrate, fat, and protein that it has, weigh it, and write it down. "Sometimes I’d just as soon not eat," this dieter said.
That’s been my experience too. Because I track what I eat, I eat out less often. I have fewer snacks. I avail myself of fewer freebies at the supermarket. The result has been much better control of my blood glucose level and weight. Counting what we eat is worth the time and effort for all of us who have diabetes.
David Mendosa is a journalist who learned in 1994 that he has type 2 diabetes, which he now writes about exclusively. He has written thousands of diabetes articles, two books about it, created one of the first diabetes websites, and publishes the monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, current A1C level of 5.3, and BMI of 19.8 keep his diabetes in remission without any drugs. He can be found on Twitter @davidmendosa and on Facebook at David Mendosa.