Is butter a carb?
February 24, 2012 2:05 PM   Subscribe

I have just been diagnosed with Impaired Glucose Tolerance. I am really freaking out.

Logically I know that this is no big deal. My doctor told me that I should eat more protein and fewer carbs and I would be fine. But she only talked to me for like five minutes (I go to a clinic) and I don't feel like I really understand. Everything on the internet is contradictory. I feel like I am never going to be able to eat anything again...and I am always, always hungry, which I guess is caused by the IGT?

What are some good web resources for this condition? And others who have been diagnosed, did you find that changing your diet really did change your hunger levels? I am most afraid that I will figure out what I can eat and I will still be constantly hungry. I am mostly vegetarian, if that is relevant.
posted by chaiminda to Health & Fitness (25 answers total) 8 users marked this as a favorite
I am really never hungry, unless I've been doing dirty deeds with cake.

If you're that confused, see a nutritionist. But as an experiment and proof of concept: for a week, try to avoid eating much white food (which includes sugar in things that are not white). Use SparkPeople or FitDay or a pocket-sized nutritional reference book or whatever so you can teach yourself which foods are high-protein and which are high-carb.

I am most afraid that I will figure out what I can eat and I will still be constantly hungry.

This is so unlikely that if it is true it probably means that glucose intolerance is not your primary issue. Yes, it does take a little more effort to eat good protein as a vegetarian, especially if you don't want to soy-soak your reproductive organs, but people do it every day without any special resources or equipment.

You will be fine and you will figure this out and you will probably be stunned at how much better you feel when you get your diet under control.
posted by Lyn Never at 2:25 PM on February 24, 2012 [1 favorite]

I don't have impaired glucose tolerance, but I'm type 2 diabetic so I deal with some of the same issues. Changing my diet has definitely made a difference in my hunger levels. Basically the mechanism is that if I have a carb-heavy meal, my body overproduces insulin to process it; then when that washes through my system my blood sugar goes down really quickly, and it's the slope of the blood sugar curve that affects hunger more than the actual level.

The best suggestion I can give you is to get a blood glucose monitor and a prescription from your doctor for it so that insurance will pay for the testing strips. (The monitor should be super-cheap, it's the cost of the strips that'll kill you.) Start testing your blood glucose around meal times and get a sense of how your body responds to different foods. With a couple of weeks of trial and error, I'm willing to bet that you'll be able to find meals that will control both your blood sugar and your hunger levels.
posted by asterix at 2:25 PM on February 24, 2012 [1 favorite]

I don't have IGT, but I do have hypoglycemia and I'm supposed to be following pretty much the same diet as diabetics. Whether your glucose is too high or too low, the same foods will help keep it regulated. I know it's a lot to take in at once but you'll get it down. This link provides a lot of good information and if you want to google more, just google for diets geared towards diabetes. Being vegetarian shouldn't be an issue. I'm a vegan and I haven't had any problems. And there are still plenty of foods that you will be able to eat, so don't focus on what you can't eat.
posted by MaryDellamorte at 2:27 PM on February 24, 2012

First of all, you should try to talk to an Endocrinologist, if you can. You mentioned going to a clinic, see if there's one there that can see you, as that's the specialist most prepared to properly diagnose, treat and explain to you everything about your glucose/insulin levels.

I don't know if your title is supposed to be a joke or not so much. Generally I've found that I take my knowledge in nutrition for granted, as I just picked it along the way from school, internet, peronal research, and a few nutritiologist friends, but I've been seeing more and more people who have no idea of what they're doing when it comes to their own diet.

So, start by reading up on basic nutrition information. Carbs, protein, fats and their interaction with each other. Also about proper serving sizes (to be taken as a general guideline, not law). A quick google search brings up things like this. That will help you navigate easier when researching your condition and how to properly take care of yourself. Also, read everything with a LOT of critical thinking and don't make any mayor changes without consulting with a doctor first.
posted by CrazyLemonade at 2:29 PM on February 24, 2012 [2 favorites]

Gosh, "nutritiologist" should really say nutritionist.
posted by CrazyLemonade at 2:32 PM on February 24, 2012

In addition to the more protein/less carbs, you should also regularly exercise if you want to avoid full blown type II diabetes. It is very possible you may never develop diabetes but getting diagnosed with IGT says is your body has a harder time managing blood glucose levels than normal.

If I were you I'd follow the advice from the American Diabetes Association on how to prevent "pre diabetes" which is IGT + your fasting glucose is higher than normal but lower than diabetes.

What helps me manage my fully blown type 2 diabetes is getting exercise watching my total caloric intake and specifically reduce carbs. And by carbs I mean delicious stuff like bread, pasta, cookies, cakes. A Girl Scout cookie or two won't kill me, but a box in one setting won't be good for me.

As a former fat person that was hungry all the time, I found that being aware of what I'm eating and adjusting when I ate helped with the hunger pangs. The more protein and fat in your diet the more sated you'll feel. Since a food can be either a carb/fat/protein, you may need to learn to not obsess on your fat intake. "Low Fat" does not mean healthy. And if you have glucose intolerance it could be unhealthy because a lot of stuff that is low in fat are higher in carbs. Starting now, you should keep a log of what you're eating and look at the macro nutrient information. You may surprise yourself with the amount of carbs and overall calories you're consuming.

If you make the lifestyle change now, you can dodge the diabetes bullet. You don't have to be become an athlete or have a nutritionist cook your meals but you do have to exercise some and lay off the muffins for breakfast (or bagels) and no caloried sweeteners in your coffee. I can't help you on the vegetarian part of it, but being a carnivore really helps up your % protein and fat and most meat negligible amounts of carbs. And butter has a negligible amount of carbs.
posted by birdherder at 2:42 PM on February 24, 2012 [1 favorite]

Best answer: You can definitely do this! I've been following this type of diet for a couple of months and have never felt so full and satisfied! Some tips to help with the transition:

- veggie proteins and fats: cheese, EGGS, avocado and tofu. Remember to give yourself bigger portions so you don't miss the carbs on your plate!
- in between snacks: nuts and more nuts, seeds, celery sticks, cherry tomatoes, olives...
- start eating full fat, no 'low-fat diet' rubbish (usually full of sweeteners and of little nutritional worth anyway). I did not believe that anything could fill me up like porridge, but actually full-fat Greek yoghurt with berries and almonds keeps me totally sated til lunch. Butter is the best, and roast cauliflower is a brilliant alternative to mashed potato.
- Eating in company: try to go for Indian or Thai, places where you order the rice or bread separately. Instead of bland carby side dish you can have scrummy vegetable side dish!

If ever in doubt, ask yourself if a food has grains or sugar in it. If the answer is no, you can probably eat it (so long as you moderate your intake of root veg).

Disclaimer: not IGT, just a sugar addict surprised by how pleasant a low-carb diet can be.
posted by dumdidumdum at 3:22 PM on February 24, 2012 [9 favorites]

As an addendum: I'm not recommending you gorge unhealthily on fat, but it is important to keep yourself feeling full in order to avoid carb cravings, especially in the first few weeks.
posted by dumdidumdum at 3:27 PM on February 24, 2012

Track your food, carefully read labels, don't fall into the diet food trap (low-fat, no sugar, low-sugar, lite, etc are all usually swapping one thing for another, and any way low/no sugar foods often still have plenty of carbs).

Have you been instructed to lower your carb intake alone, or are you needing to lower cholesterol/blood pressure, too? This is often a problem diabetes patients have to tackle, but I realize your condition isn't quite the same.
posted by asciident at 3:29 PM on February 24, 2012

I've been eating low-carb for a year and change, have lost weight, pretty much never feel hungry, and feel great.

There are a zillion foods you can eat that are not bread, pasta, and potatoes. And you can still have those, just not tons all the time.

It's an adjustment, but it's really unlikely to be the hardest thing you've ever done. There are lots of online places where you can track your carb intake, and I highly recommend doing this when you first start so you can get a good idea of what you're eating. Eat whole foods.

Call your doctor back and get a referral to a dietitian (generally, in the U.S., anybody can call themselves a nutritionist; dietitians have specific schooling and licensure requirements). Don't panic. You can get a handle on this.
posted by rtha at 3:32 PM on February 24, 2012 [1 favorite]

I cut out a lot of carbs and started a real exercise program with a trainer at the end of Dec after a scare from my doctor about my blood sugar level. I had been eating way too much pasta and bread. I was really surprised to find that on a higher protein, lower carb diet with lots of fruits and veggies I am not hungry, have lost almost 20 lbs, and feel much better in every way. A lot more weight to go, but this is really working and worth it. I have also started reading labels, something I never used to do, and have learned a lot I did not know about nutrition and what is in some foods you would not expect.

Exercise helps a great deal, but diet is important as well, and if you learn the right things to eat hopefully you will not miss the carbs. When I do have some pasta now, it is Dreamfields Low Carb pasta which tastes just as good as regular, and of course no seconds like I used to take.
posted by mermayd at 4:10 PM on February 24, 2012

Response by poster: Thanks so much, folks. I'm think I'm mostly struggling with this because I've never had to think about my food all that much, being naturally skinny and drawn to healthy foods from childhood. A lot of the advice on the internet says things like "lose weight" (I couldn't lose more than ten pounds without being abnormally thin) and "don't eat junk food"--I already don't eat a lot of sweets or sodas, eat a salad about every day, etc. I find a lot of the dieting culture in the U.S. to be harmful and creepy and I hate using those kinds of sites as a resource.

If you eat this way, is there a good food blog that follows this kind of diet?

(For those of you who are confused by my post title, you should really watch Mean Girls. It is truly delicious.)
posted by chaiminda at 4:11 PM on February 24, 2012

For some real-live in-person advice, I'd recommend finding a diabetes educator in your area. Even though you don't have diabetes, you can learn to adopt some of the healthy habits and coping strategies. Depending on the clinic/educator you work with, these could be group classes where you can get to know others with your condition. I know you asked for web resources, but sometimes it takes the reinforcement and encouragement that comes from a real person showing you what a healthy plate of food and carbs looks like. And to teach you that you won't go hungry! One of the key things that diabetes educators emphasize is that you are NOT on a diet... you're modifying your eating habits to keep your blood sugars in check.
posted by watch out for turtles at 4:30 PM on February 24, 2012

dumdidumdum has great advice. I also thought that cutting out carbs would be The End Of Everything, but it's not bad at all, especially now that more and more people are doing it -- asking for a lettuce wrap instead of a sandwich doesn't get me funny looks anymore, for instance. Likewise, the hungry-all-the-time thing is probably being caused by your carb-heavy diet, so I wouldn't worry too much about that... going low-carb really balanced out my hunger.

Being "mostly vegetarian" and low-carb can be tough, but it's do-able, especially if you're open to eating eggs and/or dairy products. You might check out Low Carb Vegetarian and Stocking the Low-Carb Vegetarian Kitchen for some ideas. You might also check the paleo community for blogs -- eating paleo tends to be more of a fitness thing rather than a dieting thing, so it's a little less lose weight now now now!, though there are exceptions. Most paleo diets are pretty high-carb by my standards, but the emphasis on veggies rather than grains may give you some ideas. No Meat Athlete is a well-regarded vegetarian paleo blog.

Speaking of fitness: weight training is one of the best things you can do for yourself. Lift heavy and hunger will become your friend, not your enemy...
posted by vorfeed at 4:59 PM on February 24, 2012 [1 favorite]

I'm Type II. Lots of good advice above especially see an endocrinologist, diabetes educator and/or a nutritionist (in that order). Getting a glucose meter is good; you can usually get them for free if you buy extra testing strips (if you get a prescription to help with the costs, that's even better). Exercise is good even if just a half an hour walk per day. dumdidumdum has great advice food-wise.

Not to freak you out, but since you're thin and hungry all the time, you could very well be Type I diabetic. How old are you? Have you done a glucose tolerance test and/or the insulin tolerance test? If your doc has diagnosed you with IGT with just a simple blood test s/he really should run those tests or refer you to an endocrinologist to run the tests.

Above everything - remember "everything in moderation". If you want a hot fudge sundae, have one. You just can't make a habit of it.

Good luck!
posted by deborah at 6:24 PM on February 24, 2012

A site that has been helpful to me in my low carb journey is Low Carb Friends. It is an active board with lots of people doing various low carb diets, including vegetarians and lots of people with blood sugar issues.

Once you get over the cravings and adjust to a different food mindset, it is not a hard way to eat.
posted by monopas at 6:32 PM on February 24, 2012

Response by poster: deborah, they did a glucose tolerance test and my levels were really high after drinking the disgusting juice (apparently my fasting level was good). I do plan on going to another doctor, because I originally went to this clinic to figure out why I have had an upset stomach for the last month and they still haven't told me anything useful about that.

I am 26, I feel like that's pretty old to find out I have Type 1, but yeah, the symptoms do sound like me...
posted by chaiminda at 7:02 PM on February 24, 2012

"pretty old to find out I have type 1"

I was diagnosed with type 1 at 38. It's an autoimmune disease that you can develop at any age. It is NOT RARE to get it as an adult.
posted by kestrel251 at 9:19 PM on February 24, 2012

chaiminda, I really hear you about how hard it is to get weight-neutral or weight-increasing advice about nutrition! I find that, oddly enough, body-building forums are a good place to find people talking about different food plans in a weight-neutral or pro-weight-gain way.
posted by Sidhedevil at 9:56 PM on February 24, 2012

Like kestrel251, I was diagnosed with type 1 as an adult--26. I also thought I was too old, but it turns out there's no such thing as "too old." In fact, I think I've read that about half of all people with type 1 were diagnosed as adults.
posted by McPuppington the Third at 12:25 AM on February 25, 2012

Response by poster: I am definitely going to ask for a second opinion about that too! Thanks guys.
posted by chaiminda at 5:02 AM on February 25, 2012

I will second the Paleo Diet. I follow a low-carb paleo diet. Paleo calls for no grains as they are post Agricultural Revolution and imho moderate fruit intake. It is a higher protein intake but doesn't get to the extremes of Atkins.

A book I've found helpful is The Metabolic Typing Diet; comes with a quiz, diet tracking sheets and can eat / moderate intake lists.

Both books discuss (the first advocates, the second cites instances) a sort of diet calibration method that goes something like this...

1.) Start out with a high protein diet for about a week - pretty much Atkins.
2.) Gradually add in veg for another week
3.) At some point you will overshoot your sweet spot and start to feel groggy / depressed / anxious / hyper - however you respond to carbs
4.) Take away some veg til you regain a better feeling

And that will give you a good idea of how to balance your meals.

I have found that getting boot camp on my diet has alleviated a whole host of issues. I'm sure it will do the same for you!

ALSO... it is possible to lower insulin resistance through lifestyle changes. Gary Taubes is another writer who talks about the (failure of) the modern diet... and what to do about it. He's a low-carb advocate as well & his books have helped me understand the science behind it all & make better decisions.
posted by HolyWood at 7:15 AM on February 25, 2012 [1 favorite]

PS Here's a link w some preventative measures one can take, summed up:

Eat dark leafy greens
Add turmeric to your cooking
High intensity exercise a few times a week and lose any belly fat
Eat low-glycemic
Chromium and citrus peel supplements
Get enough sleep, lower your stress levels
posted by HolyWood at 7:38 AM on February 25, 2012 [1 favorite]

If you are just starting out with low-carb and you feel awful, read about Low-carb Flu. Not everyone gets it, but for a lot of people the change in your body chemistry from having high carbs to low carbs causes symptoms that you have to just get past.

Also, another blog that does a lot of good vegetable recipes is Kaylin's Kitchen. Her official focus is South Beach Diet, so you may have to sift through some meat recipes, but she does a LOT of vegetables and other low-carb stuff and everything I've made from there has been great.
posted by CathyG at 10:07 AM on February 25, 2012

Coconut is a fantastic food for low-carbers, doubly so if you don't eat much meat. It's full of healthy fats.
posted by Earl the Polliwog at 4:44 PM on February 25, 2012 [1 favorite]

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