I want to discuss my dietary approach openly, because it's complicated, and I'm sure other people struggle the way I do. I also want to acknowledge that I'm privileged for being able to more or less ignore rising food prices and eat what I want to or need to. This might come across here when I review or discuss foods or meals that are expensive, relative to typical grocery stores. I'm discussing how I eat - if I discuss it well, you might be able to take some inspiration, but your situation and mine may not be alike. To be clear, I have no connections to the food industry except as a customer. I don't have or accept sponsorships for anything (and in particular for food), and I don't get anything for anything I say.
That's the disclaimer for everything these days, I guess, but it's always a good idea to write it down.
With that in mind, I plan on publishing blogs here in haphazardly, as I find foods or have thoughts. But if you do have questions or feedback, please feel free to reach out on my contacts page. No guarantees but I'm generally an open book about this stuff.
Nobody's an expert on everything, and I'm not a doctor, just a patient. Some things I said may not be obviously connected to food if you're unfamiliar, or maybe you're familiar with them but not how they interact to make my relationship to food challenging. I can't cover everything in one post, but this should serve as a quick introduction.
Diabetes: Diabetics must eat a low-carb diet to control their diabetes. Not all carbs are created equal (fiber is different from starches is different from sugars, ...) in terms of how much or how fast they hit my blood sugar levels, but any caloric intake - and especially any carbs - eventually make it there. This also changes how I need to time my food intake and daily activities, because insulin and food need to be taken together, so some common advice that translates poorly here is "eat many small meals", which necessarily implies eating when I can't take insulin. Insulin also contributes to obesity, since it forces the metabolic processes of energy storage. This is nearly a one-way street, so it's easy to gain weight, and much harder to lose it compared to non-diabetic people. (I have type 2, I discuss that implicitly, I'm aware that other types of diabetes are different, but I don't know enough to discuss their implications on dietary choices.)
Gout: Gout causes extreme pain, and in repeated episodes, can also cause joint damage. I get my flares on the top of my foot rather than the classic big toe, which means it's rather debilitating when it happens. The mechanism here is that uric acid builds up in the blood, until it reaches sufficient concentration that it starts to crystallize in the joints. Usually your kidneys remove uric acid, you pee it out as urea, but if you either over-produce it or don't remove enough, gout happens. I'm on a drug that helps reduce uric acid, but I still have to be careful when eating foods high in purines -- as a rule of thumb, the more protein something has per unit weight, the more purines it has, although you can google for the details. For my purposes, the biggest issue is that this restricts and alters how I select proteins, and limits my options for substituting in proteins for fats or carbs.
Pancreatitis & Hypertrigliceridemia: My episode of pancreatitis was acute, caused by hypertrigliceridemia although at the time I was also taking Ozempic for my diabetes, which includes pancreatitis as a risk factor. I don't have this chronically, but since I've had it once, it's much more likely to reoccur. From a dietary perspective, controlling hypertrigliceridemia is the primary treatment. That means, low fats, and of those low fats, mostly healthy fats. Unilke gout, I won't likely trigger pancreatitis from one bad meal, but my overall diet needs to incorprate this.
For those keeping score, that means I have some medical condition meaning I need to keep all three of the macros low, with varying consequences. Broadly speaking, this balance is where most of my dietary challenges arise from.
Sleep Apnea: This one probably sounds less like diet than most people realize, and it's not so much a dietary issue directly as it is an ongoing background challenge. The problem is poor sleep messes with cortisol levels, and that makes it much harder to metabolize fats. Combined with the insulin I take for my diabetes, getting rid of adipose is more challenging than it otherwise would be.
Obesity: I have struggled with obesity since I was a child, with limited success even in the best of times. While there are many factors going into this - the diet I had available as a child, family history of obesity, psychological associations with food, the sleep apnea and diabetes diagnoses, and more - the bottom line is it's also a feedback cycle. Obesity itself causes all of my other medical conditions to be worsened. From a dietary perspective, reducing calories is the basic goal, although it's not quite that simple because it has to be orchestrated with my blood sugar, and the insulin makes it hard to access stored fat. But this is a backdrop for my complex relationship to food, as it is for many people.
As I mentioned at the outset, I don't have any particular schedule in mind here, but I do have a few categories of post in mind.
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