One of the things I did when putting my diabetes into remission - perhaps the most important in some respects - was to set myself a range of targets and keep a journal of my progress and otherwise. The targets were a set of proxy indicators surrounding some very specific measures to do with HbA1c and, later, ratios (Total cholesterol/HDL, Triglycerides/HDL, LDL/HDL and HDL/LDL).
One of my targets was the waist size of my trousers, allowing for differences between manufacturers. Starting from a 38” waist I targeted 28” as an ideal endpoint. I didn’t make 28” but have been stable at 30” since October 2022. I still have my belt buckled at the same notch.
What has been variable is my weight. At present I’m 5kg heavier than I was this time last year, although I have been in the same broad range for most of the last 4 months. This is despite all my efforts to repeat my earlier processes and knock a couple of kilos off my average weight. My diet is broadly the same as it has been for the past two years. The only real change is that I have been unable to run because of a knee injury, though I have been going to the gym and substituting the rowing machine as my cardio exercise.
This has got me thinking about the relationship between weight, food and exercise. I eat well and sensibly and I exercise more than many and I keep my eye on what I eat. I can see little causal relationship between what I eat and fluctuations in weight for the most part - the one that does impact is anything meat-heavy, I think because of the time it takes to digest. Hydration has an impact as well.
I haven’t reached any firm conclusions, but do have some provisional thoughts. The first is that, all things being equal, there is no obvious causal relationship between calories in and calories out, or at least to any noticeable extent. I rarely overeat, but over the course of the average week, things tend to even out anyway.
In a similar vein, 3 visits to the gym per week with a focus on free weights and resistance with some cardio in the mix doesn’t make a lot of obvious difference even where my Garmin watch suggests a higher than usual calorie burn. The main difference in exercise has been the switch away from running to weights and resistance.
The place I’m coming to is that we are not dealing with linear causation but a non-linear relationship: that the causality is multi-factorial and depends on a number of factors within the metabolic system of the individual. I’m approaching metaphor here (I’m thinking of something like the classic Lorenz Attractor as an illustration), and won’t be able to test this until I can run again, but I hypothesise that I’m currently in one equilibrium state and will switch to another if and when I can run again, because there is something about that particular exercise that impacts my body in a particular way. Swimming might trigger it too.
If that’s true, and I have a lot of journal entries tracking this, then a headline indicator like marginal weight variation, is not something to worry about if all the other indicators, whether ratios or proxies such as waist bands, are fine. (Which also says a lot about the context in which we should interpret derivative measures like BMI.) I also note that my weight varies over any two-week period and that it is the median rather than absolute number that is the one to keep an eye on. I don’t think this is a rationalisation.
I’ll let you know when I test the hypothesis (though I have a family wedding to deal with first.)
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When I first received my t2d diagnosis, rather than prescribe any medication, my doctor suggested I read one of Michael Mosely’s books. It is no exaggeration to say that it changed my life. I was sorry to read of his death two weeks ago. RIP