The Scores on the Doors

In my first post here I wrote that I was conducting an eight-week experiment on myself, going from a low-carb to a very low carb diet to see what the impacts were on the creep to my weight and my blood pressure. In my journal, I noted my aims as:

·         Improve blood pressure

·         Get my weight into an average range with 84.5kg as the lowest boundary

·         Get into 28” waist trousers.

Well, 2 out of 3 ain’t bad. The results were

·         Average blood pressure (mean and median) dropped from 130/86 to 128/77

·         5-day mean and median weight this morning was 84kg (lowest boundary 83.2)

·         No 28” trousers yet, although this may have something to do with variable sizing between manufacturers.

I also completed 5k and a 6k runs in the past four days. More on that later.

This whole thing is bedevilled by correlation and causality issues, but by any standards this was a successful experiment. The challenge now, of course, is to maintain the benefits. However, for all this was only eight weeks and the benefits are self-reported, there were one or two things I noticed along the way that made me think.

I stuck to the very low-carb diet quite closely for most of the period. Sometimes I was in mild ketosis (according to the usual pee sticks) and sometimes I wasn’t. There were noticeable, if temporary, effects when I came off the wagon – for example when entertaining visitors and friends – even if I was generally careful with what I ate. The biggest single impact was alcohol, but not on weight or blood pressure. I didn’t drink a great deal, but on the occasion I did – a street party for the coronation (remember that?) – I worked through a bottle of red over seven hours or so. My resting heart rate doubled and stayed high for at least two days.

Although the key driver of the change was diet, the impact of exercise was to reinforce and lock in the benefits. The two main exercises I did were swimming and jogging, as well as walking.

I was struck by the variability of blood pressure readings. As I mentioned in my previous post, although the figures fell quickly (within two weeks) and the benefits were consistent, there were some days when my BP was elevated and stayed that way with no obvious cause or correlation. That’s why I tracked averages. Also, my resting heart rate is in the range 45-52bpm after the consistent aerobic exercise. My impression is that the home blood pressure monitor really does not like it when the resting heart rate is in the 40s and goes off searching for a reading, over-inflating the cuff and distorting the readings.

Still on the subject of blood pressure, my preferred future is one with reduced BP medication. There are underlying drivers of my BP to do with aldosterone, but the average readings clearly responded to a low-carb diet. I suspect that systems thinking is the way to consider this - inter-relationships within the metabolic system rather than any single causative factor, but I’m no expert. My current view is that the experiment did not indicate a reduction in medication is on the cards but does show that diet+exercise+current medication means my BP is much better controlled (relative to my age).

More generally, I did not stick as rigidly to the diet as some would suggest I ought, but I was pretty close. I think the notionally perfect is the enemy of the good enough. Looking back a year, I reduced my HbA1c to sub-diabetic levels within 4 months of the diagnosis. Elements of the diet I adopted then were not as optimal as they might have been, but it still worked. For me at least, heroic self-sacrifice was not needed, just stubborn determination to follow a course of action and to enjoy it as I did it.

And that’s the lesson for people in the situation I was in when I had my diagnosis in late 2021 – don’t sweat being perfect as defined by internet and social media gurus, just aim for doing what is good enough for you in your circumstances to get results; like me, you can refine it as you go.

What now?

Now that my self-imposed eight week period is done, I don’t intend to relax things too much. For family reasons, I expect the next couple of weeks to be tricky from a diet management point of view, but I intend to stick with the programme to the extent that I can. At the very least, I’ve successfully avoided potatoes, pasta, rice and bread for eight weeks and plan to keep doing exactly that, with the possible exception of making home-made bread from time to time.

The bigger picture is that I’m focusing now on exercise planning to complement the diet. Two sessions a week in the local swimming pool have made a major impact on my general fitness, including cardio fitness, and they will remain in my schedule. More than that, and despite what I’ve written here previously, now that my jogging has reached 5k fitness again, I aim to be at 10k fitness by autumn. I could probably get there quicker but I’m wary of ever-doing it and risking injury given that I’m in my sixties; again, the heroic perfect is the enemy of the good enough.

And I’m thinking of a half marathon in 2024. I last ran one in 2009, so time to give it another shot, assuming that aging knees can cope. If anyone reads this who has experience of low-carb running in their sixties, both in terms of training and nutrition, I’d very much welcome contact as I sort out my plans. One of the things about all this, as others have mentioned, is that a lot of us are figuring it all out for ourselves and part of the point of this substack (and others, such as Tom Watson’s) is to share experience and end the isolation.