A change in Diet

12/31/2009 at 5:27 AM Leave a comment

One of the hardest things for people is changing what they have done for all of their adult life. Be it smoking, drinking, or the food they eat and love, change is hard, if barely possible. And it doesnt matter the reason for changing it. Whether it is to prevent lung cancer or foot amputation, the present every day cost is much higher than the severe long term consequence.

For most people life is hard. There are countless things to deal with and struggle with. Your comfort behaviors help you through these everyday challenges.

So when someone comes in with a new diagnosis of diabetes (or heart disease)  they will ask me how they should change their diet. They are full of motivation and are determined to do their best. But diabetes gets you by being insidious. Every single day it is there, no time off for good behaviour.

I find it much more important to have them make small sustainable changes than to aim for some ideal diet. I have seen patients after they have talked to dieticians, they see how difficult it is going to be and they give up. Whatever they change to, it has to be compatible with going out to restaurants, going to a friends house or just being busy one day and not having time to cook correctly.

I start them with very minor and easy changes where they will get the most bang for their effort. With diabetes the issue is sugar and carbs. With sugar being the bigger culprit. Most adults don’t have much trouble with sugar. It is their carbs that are difficult. So I start them with sugar removal. Candy, syrup, sugar, soda, frosting–I eliminate all of these. Fortunately there are substitutes. With medicine their sugars improve dramaticaly and they get a very positive feedback.

Later patients will ask what more they can do (or if they still need to improve their Blood Sugars more) and we talk about Carbs. Here the goal is to decrease their carbs by only 10% at a time. I have them focus on eating their carbs earlier in the day, to decrease their serving size just a tad and if they reach for seconds to think about reaching for protein rather than carbs.

I also talk to them about planning for holidays. I tell them it is unreasonable to expect them not to indulge when everyone else is. So I have them compensate by exercising more that day. They have the time to walk and it will reduce the guilt of eating. I also have them focus more on the turkey and veggies than on the potatoes.

As time goes on and they get older they usually want to do more and I encourage them to improve in tiny manageable bits. Rather than the standard method of describing the ideal diet and have them try as hard as they can before they fail.

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Entry filed under: How things work. Tags: , .

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