Thursday, 30 November, 2023

This Week — Consistent physical activity and other healthy habits are important, even (especially?) when we don't feel like it.

Linda Eskin — Personal Trainer, Behavior Change Coach, Martial Artist, and Author at GoYouFitness.com

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Greetings, Reader!

I hope you had a good Thanksgiving, if you celebrate it, and if not, I hope you had a fantastic (long, I hope) weekend. One of the things my family celebrated this past weekend was my dad's 89th birthday. He recently survived an aggressive cancer during the pandemic, thanks to immunotherapy, and is doing very well. Definitely worth celebrating!

This newsletter is a biggie. I hope you'll read the whole thing.

I've been having all sorts of fitness (and health) adventures. Not all fun ones, but things are working out well, and I've been learning a lot. That experience got me thinking about the urgency and importance of getting after fitness and consistent physical activity right now, not waiting for some mythical starting point, like start of the year.

After a smack upside the head regarding my health I've made some significant changes. They're working.

Read on to learn what I did wrong, and how I'm correcting it.

Being sick can lead to poor health.

You read that right. Stick with me here — it's been an adventure, for sure. I've discovered some important things that I want you to know, so you can learn from my experience (and mistakes).

From the end of August through the middle of October I was out of commission, sick with two colds in a row. Seven weeks. Strangely, during the first two weeks, a "mild" cold, the joints in the tops of my feet really hurt, too, like they were almost broken. And I didn't feel good: achy, sneezing, sniffling, fever, coughing, fatigued. Bleh. During part of that time Michael had Covid, too. So I couldn't go to the dojo, and sure didn't feel like getting out for a hike or working out at home. I also wasn't sleeping well, often 3-4 hours a night.

Not only did I feel like crap when I was overtly sick, even after I "recovered" I still felt awful. No energy, much-worse-than-usual edema, very bad neuropathic pain (interfering with sleep and exercise), system-wide inflammation, ... Just plain wiped out.

So off to my Nurse Practitioner to get checked out. We each had a few theories: low thyroid levels, gout, autoimmune problem, congestive heart failure, ... It was a mystery. So, off the lab the visit the local vampire.

(Spoiler - it wasn't any of those things, thank goodness!)

I've been learning a few things:

Guess what suddenly reducing your normal activity level can do? It increases your blood sugar (glucose) level. Plus, there's less muscle activity to promote circulation, especially in your legs, so your feet and legs swell and hurt.

Guess what happens if you get less than 6-7 hours of sleep a night? It messes up your insulin sensitivity, so your muscles and other tissues don't effectively take up the glucose circulating in your blood, increasing your blood glucose. [Please also see my book recommendation, below, for Matthew Walker's "Why We Sleep."]

Guess what happens when you're not doing much, and not eating right, so you don't feel like drinking water? You get dehydrated, and that raises your blood glucose.

Guess what stress does, when you're worried about Covid, off your daily routine, working like mad, and dealing with a dozen little problems? It causes insulin resistance, so there's more glucose circulating in your blood.

Guess what happens when you eat convenient high-carbohydrate ("high-carb"), high-sodium comfort foods like pasta, pizza, tamales, cereal, toast, crackers, chips, ...? It increases your blood glucose - and causes water retention and edema.

These things all add up.

Guess what happens when you haven't been active, are stressed out about feeling like crap, didn't get much sleep recently, and don't have time to make lunch, so you eat fig newtons (all carbs) in the car on the way to your appointment and lab work? You guessed it! Your blood glucose test comes back a little high. 144. Prediabetic. Just barely, but still...

Don't just stand there, do something!

I hate the term "prediabetes." It implies a foretold timeline of inevitable progression, which isn't the case. All those things I mentioned above contributed to my high blood glucose (BG) reading that day. If you catch it early and get after it, changing those things, and doing a few other things right, will lower it again.

"Prediabetes" is like saying a low oil level is "pre-engine-seizing-up." You don't just stand around whining "Oh well, I guess my car is going to be ruined soon," you check it often, and add oil whenever it's needed!

So I got right to work.

First, I need to know what's actually happening. What is my fasting glucose level? How high and low does it go? What foods drive it up? What activities bring it down? One random lab test on a bad day every few years isn't sufficient. Can you imagine going to the doctor to take your temperature or blood pressure, and then using that one result as the measure of your health? So the next morning I got a glucose meter and test strips and started monitoring my blood sugar.

I changed a bunch of things.

I would not recommend that most people change a lot of things at once, because that can be overwhelming and discouraging. It's a recipe for quitting. You're better off making one change, then another, succeeding at each one and building on that foundation. But I've done all these things before, and know how. I had let them slide, but none of these are new to me, so I just "got back on the wagon," as they say.

Here's what I've been doing:

• Cut carbs drastically. Carbs are what raise your blood sugar (mostly). Also, eating too many carbs causes water retention and edema. I'm aiming for no more than 20% of my calories from carbs, with 40% from protein, and 40% from fats. This is a fairly low-carb diet, with moderate fat.
• Cut sodium intake drastically. Too much sodium can cause edema. Most of the sodium we get is from prepared foods (not so much from the salt shaker). Pizza, I'm looking at you!
• Drink more water. Being dehydrated reduces your insulin sensitivity, increasing your blood sugar, it also increases blood pressure, contributes to muscle cramps, and (for me) makes my chronic vertigo worse.
• Consume more fiber. High-fiber foods improve gut health and strengthen our immune system. Fiber also reduces spikes in blood sugar and helps us eat more appropriate amounts of food.
• Get more sleep. I'm aiming for no less than 7 hours a night. Ideally 8 or more. [Again, please see my book recommendation, below.]
• Move more. Funny how when we're more active we feel like being more active. I know that. Duh! But it's hard to remember when you feel icky from being sick and out of commission. Physical activity also helps lower blood glucose and reduces edema.
• Wear compression socks and leggings consistently. I've done that here and there, when things are bad, but now I'm getting up, showering, and putting those on first thing in the morning. Man, do they help! Here are the ones I like: compression socks, compression leggings.

Seeing and feeling results already!

I've been doing these things for only 14 days so far. Here's what's happened:

• My blood glucose has consistently been well within "healthy" ranges, both for fasting and after meals. This is with a goal of no more than 30 grams of carbs
• The one exception to the above was an informal experiment I did during the first week. I ate only a banana and two fig newtons for breakfast, along with my usual coffee with milk, for a total of 78 grams of carbs. That shot my BG up, well into an unhealthy "prediabetic" level of 151 mg/dL at one hour after eating. (BG should be below 140 mg/dL.) Clearly, eating carbs is a problem for me, at least for now.
• Within two or three days the swelling started to go down in my feet and legs. I am much more comfortable, and the difference in my feet and ankles is clearly visible.
• Within two or three days the pain in the tops of my feet entirely went away. (I felt like it was coming from my joints, but my nurse practitioner thought was actually due to the swelling putting pressure on the joints. She was probably right, thank goodness.)
• The neuropathic pain is much reduced. I have experienced this for many years, to varying degrees, but it was sharply worse in the recent few months, since first getting sick in August. It's still there, but not keeping me awake or constantly annoyed.
• I've lost eight pounds. A common thing to hear at the beginning of any fat loss attempt is "Nice, but you know that's mostly water weight." Well yeah! Hello...? That was the biggest and most immediate problem: water retention. It's no wonder my body hurts less! Losing eight pounds of water is huge. Cutting carbs and sodium, wearing compression leggings and socks, and moving frequently throughout the day did that.
• I have a lot more energy and enthusiasm. I didn't even realize how blah I'd been feeling. I thought I was "still getting over that cold," but I now think it was more than just that. I'm back to dancing at my desk, singing at random times, jogging down the hall... I've been walking more, feel stronger, had tons more endurance in Aikido classes. It's a huge shift.

Lesson learned:

Health and fitness tend to spiral - both downward, and upward.

It's so easy to spiral downward.

When we get sick and feel awful and discouraged. It's very hard to summon the determination to even go for a walk, never mind doing anything more active. It's easy to curl up with a plate of nachos or steaming bowl of pasta, feeling sorry for ourselves. We stay up late distracting ourselves from our misery with fun videos on our phones.

This poor nutrition, poor sleep, and lack of physical activity all make us feel worse. They also damage our immune system so it takes longer to get well. We have less energy, and everything hurts. We get less sleep, and get more stressed out, further worsening our situation. Obviously, more carbs and videos are the answer, right?

The worse everything gets, the worse everything gets.

An upward spiral can begin with small actions.

On the other hand, if we can drag ourselves out of our stupor, even a little, we can start to make healthier food choices, drink a bit more water, work up the determination to move here and there, and find the wherewithal to put the phone down and go to sleep. With these little steps we start to feel a little better. We start to get a little stronger - physically and emotionally.

Making these better self-care choices gets easier as we notice the difference it makes. Our positive actions fuel more positive actions.

The better everything gets, the better everything gets.

What to do?

It's easy to realize this (once again...) after things are beginning to go well — when we're already back into an upward spiral. And it is sometimes appropriate to rest when we're sick. But if we can catch ourselves sliding into unhealthy habits sooner, and start back upward as soon as we are able, we'll be so much more successful in our pursuit of fitness.

A strategy and plan would be helpful. I'm thinking that rereading this, myself, might give me the wake-up call and morale boost I need, so I can remember my experience. In fact, most of my un-fitness spirals start with colds or respiratory infections. I think I'll leave a note in the medicine cabinet, right in front of the cough syrup, for future-me to find when I most need to be reminded.

How do you avoid or break out of downward spirals? If you have any tips you'd like to share, let me know, and I'll include them in a future newsletter or post!

Please be sure to read my book recommendation, below. It's highly relevant to what we've just been talking about.

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Highly-Recommended Reading

Why We Sleep: Unlocking the Power of Sleep and Dreams

By Matthew Walker, Professor of Neuroscience and Psychology at UC Berkeley

​Buy the paperback on Amazon | Buy the audiobook on Audible​

Reminder: These are not affiliate links. I make nothing if you buy the book.

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This book has a been a real eye opener, although I'm sure the author would be happier if we'd close our eyes and go to sleep.

Rather than talk about my impressions of the book, here's a brief excerpt from the opening chapter. The formatting is mine, as are any errors in punctuation (I transcribed this from the audiobook):

"Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer. Insufficient sleep is a key lifestyle factor determining whether or not you will develop Alzheimer's Disease. Inadequate sleep, even moderate reductions for just one week, disrupts blood sugar levels so profoundly that you would be classified as prediabetic. Short sleeping increases the likelihood of your coronary arteries becoming blocked and brittle, setting you on a path toward cardiovascular disease, stroke, and congestive heart failure. ... sleep disruption further contributes to all major psychiatric conditions, including depression, anxiety, and suicidality.

Perhaps you have also noticed a desire to eat more when you are tired. ... Too little sleep swells concentrations of a hormone that makes you feel hungry, while suppressing a companion hormone that otherwise signals food satisfaction. Despite being full, you still want to eat more. It's a proven recipe for weight gain in children and adults alike. Worse, should you attempt to diet, but don't get enough sleep while doing so, it is futile, since most of the weight you lose will come from lean body mass [muscle and other important tissues], not fat."

It goes on and on, and the news doesn't get any better. Dr. Walker goes into great detail, citing studies and specifics about each point.

Here's why it's important to read Why We Sleep:

I was just seen for what could have been heart failure 😨, but turned out to be "prediabetes" (which only means that my blood sugar was elevated, not that I have any specific condition). Poor or insufficient sleep could outright cause either of those, plus other problems. 😴 In the weeks before my appointment I'd frequently been sleeping as little at three to five hours a night - far too little.

The medical professional I saw mentioned absolutely nothing about sleep. 😠 She didn't ask how I'd been sleeping. She didn't suggest that I get more sleep. She didn't educate me on the link between lack of sleep and elevated blood glucose levels. Not a peep about any of it.

Does she even know this? 🤷‍♀️ Instead, the entirety of the advice or information I received was "Recommend low carb diet and exercise." Given only that one-line instruction I could have easily continued with insufficient sleep, engaged in less-effective exercise at less-useful times, driving my BG up and losing muscle mass, further increasing my chances of progressing on to diabetes.

(She also didn't mention monitoring my blood glucose, building muscle mass 💪, walking or exercising soon after higher-carb meals, reducing stress 🧘‍♀️, staying well-hydrated, or any of the other things that would be effective in better moderating BG levels or increasing insulin sensitivity.)

I am betting that your healthcare team is similarly ignorant or unhelpful. The way our system works (or doesn't) in the U.S. doesn't give providers the time or funding to provide adequate information. We need to educate ourselves. Equipping yourself with important information like this could help you achieve much better health and fitness outcomes.

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The Book Report

Still reworking the structure of the book. I think I'll have a rough outline ready for your review and feedback by next week soon!

Table of Contents The Table of Contents is "in the shop" this week. The freshly-reorganized outline for the book and site will be available soon. Table of Contents

Release Notes With each significant site update I post a list of changes. Check out new posts and articles, plus website updates and new feature announcements. Release Notes

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If You're Having a Hard Time...

People often engage with fitness during major life transitions: a bad health scare, divorce or death, getting clean and sober, an empty nest, job loss, a move to a new community. We start out full of determination. But even when it's exciting, change isn't easy.

If you are having a hard time you might want to know about the crisis resource links on the website. You can find them under Fitness Resources.

Please take care of yourself, and get help if you need it. 💛

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Copyright © 2023, Linda Eskin — Go You Fitness