Runs in terror from Nancy LC!



By whole grains I mean whole rolled or steel cut oats (or a multigrain blend that was available at a local health food store then), I used a tablespoon of real maple syrup on my hot cereal instead of sugar, homemade multigrain bread (I was an avid bread baker before the kids came along...low fat, of course ) and by vegetables I meant green beans, carrots, peas (not often; don't care for them much), winter squash, mixed vegetable blend, broccoli, tomatoes and the occasional potato (small red potato size). Fresh, when available, otherwise from frozen. V8 juice (the very small can) was a staple in my lunch box along with grapes, carrots and apples or a small cup of sugar-free applesauce. I don't care for bananas...it's a mouth texture thing.



I admit I ate too much "quick and easy" food in college (not all junk, but quick and easy), but I attribute the weight gain not to just that, but to not playing sports a couple of hours a day any more as well. A full course load plus working a part time job didn't leave me much time for sports and my grades were more important to me at that point.




http://womenshealth.about.com/gi/dy...uchicago.edu%2F

There's still a lot of disagreement as to which comes first, the Insulin resistance or the PCOS. Given that not all women with insulin resistance develop PCOS, my position is that it's likely that PCOS develops first but the jury's still out. As for my getting pregnant, it was after several years of fertility treatments (that didn't produce a pregnancy) and the fertility specialist that treated me still doesn't understand how I was able to get pregnant (he used the word "miracle" once or twice ) since he had pretty much written my case off as hopeless and advised us to consider adoption 2 years before I became pregnant for the first time at the age of 32. No baby after 10 years of unprotected intercourse and 3 years of fertility drugs seems a pretty severe case to me. My tests were classic for PCOS; enlarged cystic ovaries, abnormal hormone levels, nearly absent menses, etc..




Dina, you know as well as I do that A1C can be influenced by a host of factors including stress level, activity level, any periods of sickness (I'd just gotten over a bad case of asthmatic bronchitis when the last test was done and had been on a steroid inhaler for 2 weeks) and variations in lab testing. I expect the next test to be between 4.7 and 5 again.



Perimenopause is known to contribute to weight gain in most women. But...I'm not gaining. As for not losing, my primary goal in beginning low carb was to get my blood sugar and blood pressure under control without the aid of medications. That goal has been met and the 80 some pound weight loss has been a great side-benefit. I'd like to lose the other 40, but I'm not in a huge hurry. I know from past experience that weight loss during the winter months is nearly impossible for me, so I'm happy with maintaining until spring. If it takes me another 4 years to reach goal...no big deal.




I did quit once for 4 months...lost 10 pounds during that time. Go figure. And yes, it's known that nicotene artificially increases metabolism which is part of the reason for the weight gain when it is withdrawn and dietary habits are not changed (or excercise increased). As for the obese smokers, perhaps they would be even heavier if they didn't smoke?



Congratulations on your very active lifestyle. It's no secret that if you want to consume more carbs, you have to move your body more but I hope you'd at least agree that your level of activity is neither typical nor practical for most people today. I also hope that you realize that if for some reason your activity level decreases (injury, job change, etc...) that the carb level would also need to decrease in proportion or you will likely see those good A1c numbers start climbing. Between working a full-time office job and raising a family, my 30 minute walk is the best formal exercise I can work in at the present.
I'd also like to point out that it's something of a fallacy that you must consume higher amounts of carbs to perform physically demanding tasks. There are people here that run marathons on carb intakes lower than what I've seen you report (around 125 grams a day wasn't it?) and some of the very popular body building routines carb up one day a week (high carb, low fat) and then work out very strenuously on very low carbs the rest of the week. Yes, you might be able to get away with a higher carb intake if you are very active, but only for as long as you remain very active.

Sorry to throw this into conversation since it's kind of off topic but...
I keep carbs pretty low (I estimate less than 100 daily, not sure exactly as I don't count) and my A1C was 5.4... and I'm not diabetic.
I don't know what my actual level of insulin resistance is or anything (it's probably much better than before when I was 280 lbs, seeing as then I had many classic signs/symptoms I don't any longer). Is a 5.4 A1C considered bad or something? You guys are diabetic and your A1c's are not only better than mine, but you seem to think they need improvement :/.

Again sorry to hijack the thread, but that diabetics would have a better A1c than I - even though I do restrict carbs - and think there's room for improvement kind of shocked me.

Hi Woo:
You've asked me that the same question that all Endos and in GP I've been to complaining about my Hb1C and my diabetes (which is my FBG). Most of the labs consider Hb1C <6% a non-diabetic range, generally speaking 5.5% is consider cut off point to avoid micro and macro complication of this diabolic desease. But not many diabetics are dx with Hb1c <6, or in my case 5.7. I've also checked my blood tests for the past 8 years, and the last from 1997, I had Hb1C of 5.2%. For me if I can keep my Hb1C <5,5%, is perfect, those following Dr.Bernstein plan strive for 4% club. Dr.B's is absolutely positive that all non-diabetics have it no more than 4.4%, and his is 4.5 or so. With all my respect, I doubt it. I asked many non-diabetics with normal FBG and they too have Hb1C > 5%. For me having Hb1C very low means being hypoglycemic most of the time. Hypoglycemia is simply an ugly cousine of hyperglycemia, if not even uglier. No, 5.4% is consider perfectly normal for most MDs except Dr.Bernstein. But this is total different story. I'm sure Lisa will throw in few quotes, she know Dr.B's book by heart and I'm too lazy to check mine (I wasn't impressed with it anyway). You can also read abstracts at his website http://www.diabetes-normalsugars.com/. I'm sure you will find many interesting ideas and will feel like you your fate is to have multiple health problems in future if your Hb1C is not in 4% club.
Just one more thing, again, from my own experience. Today I had the most unpleasant experince undergoing upper GI endoscopy combined with a "complimentary" colonoscopy, since I'm almost 48 . I've been nagging about some digestive problems to my GP and she decided to get this checked out. So, to kill two birds with one stone or to make sure I will never open my mouth to complain again, LOL, she also decided to get my colon checked not to waste some good sedation . To make a long story short, my digestive system is absolutely fine, but I've declined offered apple juice after the procedure reminding the GI that I have diabetes. Since I had to fast with just clear liquids (in my case chicken broth and tea) for 36 hours and took the most harsh laxative ever , the GI looked at my file and asked me why I think so. I was shoked, he said that my Hb1C is as good as his (he is the same age and very slim), and his FBG is somewhere in the same range as mine. He said that true diabetic will always spike high after a meal and there is no way to keep Hb1C low without medications. Go figure...Anyway, I was so tired, hungry, spent the entire night on a toilet , and was dehydrated (try to keep any liquid down with Phospho Soda:lol, that I've decided to experiment, and while waiting for DH, drank 2 small cans of apple juice with no added sugar. My BGs before the procedure was 117 (36 hours fasting), when I return home, I've checked it again (after about 45 minutes from drinking apple juice), my BG was 87. Boy, I wanted to kick myself for avoiding drinking apple juice during my fast, could be much easier.
May be it is safer to keep Hb1C in 4% range but for me it would be on account of eating next to nothing, literally starving myself or being in livivng in deep ketosis forever. I had the best FBGs after a major dental surgery while eating very little of mostly carby food, so my guess is the amount of food matters. Of course, there is always room for improvement as you ask other folks but life is not only about obsessing about numbers, either BGs or cholesterol. I agree with you that 100g carbs is very low and no need to get much lower just to get Hb1C of 4.5%. Besides, there is no standard assay yet. My Kaser lab range is 4.8-5.8% for example. Many diabetics would kill for Hb1C of <6% as far as I know, generally <7% is consider good for diabetics and >8% - action limit. So, I wouldn't stress about yours, Woo, eat good and exercise and you will be able to avoid this dx.
Best regards,
Dina

You know, it's still hard to believe that being 170 pounds and constantly in caloric deficit you've gained 90 pounds over 10 years. let's see, you had eat at least 13 calories per pound to keep your weight stable and it is a whopping 2210 caloris, now you were at 1200-1500 calories and gained. I'm sorry, Lisa but I don't believe it. Either you underestimated your calories or you cheated with high sugary treats.
I had a 2 yo son by the time I've graduated (we used to get married very early in former SU, LOL), so I had to study full time, run a household and raise a baby. I had good grades and at that point of my life I did not exercise at all, remeber I started to exercise here, it'is more american, women in Europe don't exercise they simply eat less . I did not smoke either.
Thank you, Lisa, I do know that BG can raise during any illness but before you dismissed my point that stress can be the causes of diabetes. You are an intellegent person but when it comes to discussion, you always find justification that suites you while finding your opponent argument anectodal.
I'm sorry that you have astma and can't believe you continue to smoke, it's a very subjective view on your own health, obsessing about BGs and neglecting your other condition.
I understand you simply trying to achieve this number at any cost, smoking itself is a greatest risk for heart desease alone, even MI, I hope you are aware of it.

You live in ketosis, Lisa, it's hard to gain. other women don't. But wait another 6 years, when you get a bit closer, then we'll talk.
Lisa, I wasn't smoking until in my youth, then I've had a 4 years brake after my youger daughter was born, and I was slimmer after I had the baby than even before, when I've smoked. Apparently, this time it was a combination of menopause, life style changes and simply eating too much of everything, I admit. It's also known that constant stress pushes cortisol and adrenalin, and even I didn't eat sweets, I ate much more than I used to, especially more protein and fat. So, hence the weight gain.
Actually, it's the other way around, I used exercise not to keep my BGs low and burn carbs, actually without exercise BGs are better, as you know exercise spike BGs. In addition, exercise are appetite promoting, ketosis supresses it. So, it's easy to eat less than you don't workout , trust me. I do it just for my overall health: cardio benefits, stronger bones, great mood, good skin and muscle tone, feeling and looking younger. Exercise makes everyday tasks a piece of cake (no pun intended), and gives me wonderfull feeling of wellbeing, while ketosis made my life living hell, no kidding.
As you know menopause also sets us for osteoporosis and I don't take calcium supplements, just don't take any except for herbs for pancrease support. So, by pumping iron and also make sure that my bones won't be brittle . Why do you think it's not typical and not practical to exercise an hour a day, becuase you don't do it? Many women get up at 4-5 am to be able to fit exercise in their routine, my co-workers who work full time and have little ones, all it takes is self-discipline. For many exercise is a lifestyle. All you need is a pair of dumbells and exercisee tape if you are a beginer. An hour a day is not too much and it's not my fault that my work requires lots of physical activities too, however, I do too have days in front of PC crunching data and writing reports , but I love being active.
Again, exercise is not a tool for me to manage my BGs. Exercise for diabetics is a life saver, providing tremendous benefits alone. Actually Dr.B is a big proponent of streneous exercise, if you remember. I workout because I just happen to like it and my carb level has nothing to do with it, I won't change my eating habits even with less demanding job but I never stop working out. IMO, ketosis is only acceptable if one is bed ridden. Why do you think that in order to contol BG one must be in ketosis, I browse other diabetic sites, and many ppl perfectly control this desease by just lower carb, and doing very well. May be my pancrease is not exhausted since I didn't have sweet tooth, and never binged on sugary treats. Yes, I ate 2-3 pieces fruit a day, but mostly low GI, didn't even liked grapes much before, and we had the best grapes in the world. I don't follow ADA diet either, once Ive learne about dx, I started reading as much as I could. I never been to diabetic class, simply because I don't eat starches and bread, don't drink fruit juice either. I didn't follow exchange plan, I have my own. I simply eat less overall by controlling my portions and avoid high GI food. 100g carbs a day or less, 125 is total carbs with fiber, is not a high carb diet. I keep my BG stable, don't spike after a meal (my 2 hh is almost the same as pre-meal or 10 points higher). So, why I have to torture my body and live in ketosis, I just don't understand, becuase you think it's the way to go. Again, I was self-diagnosted with hb1C =5.7, it's still non-diabetic range. As for FBG, it's another story, DP also happens in non-diabetics and my BGs drop to a normal level as soon as I eat.
Lisa, I'm sure you are very good in web browsing and so am I, both our "medical degrees" came as a result of it BUT the diffrence between us that you know everything in ...theory, quoting other ppl experience, while I always justify only with my own . I'm not advocating eating more carbs for the exercise sake, I do try to stay at 100 or lower for the most days, but I also can't carb up (if you truly know what it means, up to 700 g carbs in 36 hours, won't suit me as a diabetic). Carb up also requires large amount of glucose in form of simple sugars, I won't do it mostly because I consider processed sugar poison. You need to educate yourslef a bit on CKD, it's done actually to ptomote muscle grow at the same time losing fat. I'm not a bodybuilder, juts try to stay in shape, that is it.
You can also read ketogenic Diet and Body Opus, you will see how easy and "pleasurable" exercise could be in ketosis. I could provide a link to some abstracts but it's really not necessary, you can google it yourself. So, just to summarize, one can achieve good BGs and overall health even without being in ketosis and avoiding something as benign as fruit. If you avoid all refined and sugary food, you will be fine too. May be you should give it a try?
Living in ketosis, smoking and not working out at the same time trying to achieve optimal health, for me it's an oxymoron. So, until you start practicing what you are preaching (how about to run a marathon on 30g carbs) sorry but I don't find your ideas creditable.
Best wishes,
Dina

I didn't say I had asthma, I said I had a bout with Asthmatic bronchitis; bronchitis (a bacterial or viral illness) with asthma-like bronchospasms that my DH was kind enough to share with me. The two are quite different and I quit during that episode. I take it that you believe that one cannot have a valid point about what defines healthy unless you have 100% healthy habits yourself?



You can call me a liar if you wish, Dina (it's not like my doctor wasn't doing the same), but I do know what I was eating and in what amounts and the effects it had on my body. Ever hear of the exchange system? To tell you the truth, I actually did pretty well with my blood sugars during that time with an intake around 125 grams of carb per day (including fiber). But after 9 or 10 years of that my blood sugars literally went nuts over the period of a few months and completely went out of control. Perhaps I am unique in that respect but after reading so many stories of diabetics following the same program progressing to oral medications and then to insulin while their doctors write it off to "the natural progression of the disease", I don't think I am. I decided to get off that train before it went any further.



I agree that stress can influence the blood sugar levels of a diabetic, given that we don't have normal regulatory mechanisms, but not that it can cause diabetes in a non-diabetic.



Actually, mine came as a result of nursing school.



I already get up at 5 AM to go to work. Sorry, Dina...30 minutes at lunch is the best I can muster between work, kids, housework, shopping, meal preparation and other commitments I have currently.



Been there, done that, didn't work out that way for me long-term. Sorry, Dina. Hope it works out better for you.

Wow 4.5% sounds really low. I would think it would be impossible to keep average sugar that low without eating almost all fat, and very low calories (in other words, by forcing your body to use very little energy in the form of glucose).

My FBG is good, it was 69. But my hb1c is pretty high at 5.4.
I know stress causes blood sugar problems and insulin resistance; do you think the stress of losing so much weight quicklky might have temporarily messed up my sugar? I know 5.4 is still "normal", but lets face it it's not on the better side of normal, right? You were dx at 5.7 which is only a wee bit higher than mine.

It just seems odd that I be so young and eat so much better than the average person my age, very low carb, etc and still have an h1bc that is arguably kind of crappy.



I want to thank you for raising a very important point - sugar is created from all energy, so limiting carbs isn't the only nor always best way to keep your metabolic functioning high. I often hear people say "calories don't count on low carb because fat can only be created from insulin". True, but one is overlooking the painful fact that calories - energy - is the catalyst which raises insulin. The body runs on glucose, and glucose is created from consumed energy (or if in a fast, from the body's own tissues). Carbs just do it more effectively and quickly which is why they tend to cause problems for people with bad metabolisms.
Be sure of this; if you eat a huge whopper of a steak, your sugar is going to increase from that steak due to protein (and to a lesser degree the fat) being converted into sugar. The glycemic load of a huge 8 oz cooked steak is going to be greater than that of, say, a very small apple.

Counting carbs can help you avoid big spikes and can keep sugar even, but there's this myth around the low carb circles that only carbs turn to sugar in the body, and sugar is poison, therefore it stands to reason that carbs are poison... but protein and fat are "safe". It's better to eat unlimited meat than it is to taint your body with a carrot. It's just no where near that simple. Metabolically speaking, smaller amounts of fruit and root veggies is usually better for you, than the unlimited steak some people think will bring them slimness and eternal youth.

Of course if we are talking equal energy portions, than 100 calories from fruit is going to be harder on the body than 100 calories from meat. Unit of energy per unit of energy, carbohydrate is a simple fuel and raises energy levels quickly and causes metabolic upset more readily than protein and fat.
Still, even this (counting calories) doesn't give the whole picture. A serving of fruit usually has very few calories whereas meat has quite a lot, balancing things out a little (an average serving of strawberries with it's scant calories doesn't have a metabolic load considerably greater than an average serving of high protein food). Furthermore, the fruit comes with potent phytochemicals designed to mitigate the problems from the sugar (fiber, antioxidants, etc). On the other hand, meat has the hormones and pesticides and chemicals trapped in the fat cells of the animal (or in the case of processed isolated proteins from dairy and beans... it has other problems I"m sure, too).

Thanks Dina.
To be honest I'm worried not because I want perfect health, but because I want validation that the way I have chosen to eat is healthy for me.
I really wish I had a full lab workup done before I did this diet so I had some standard to compare it to. Right now I'm just pawing around blindly. For all I know, 5.4 is a significant improvement from where I was before.

Just an FYI re quantities of food and blood sugar levels. Dr. Bernstein makes it clear that meat should be limited to about 4 oz. (or is it 6 oz.?....I need to double-check but I've loaned out my book) per meal. Then 6 carbs at breakfast, and 12 at lunch and dinner. That is hardly a high calorie meal. In fact, he recites a story in his book about a woman who wondered why her BG levels went up after eating a whole head of lettuce. Calories per meal do count. Bernstein suggests the above-amounts but also advocates only eating until satisfied, not until full.

I do much better on about 5 small meals daily, each around 250-300 calories. If I make low-carb choices and eat like that, my BG levels stay much lower.

Even a relatively healthy person who eats way too much at a meal, particularly if the meal contains lots of carbs, can have a blood sugar spike. The major difference is that a non-diabetic will recover from the spike much more quickly. However, the fact that a non-diabetic will still have high-blood sugars after eating a big meal with lots of carbs is evidence that supports the theories of Atkins, Schwarzbein, et.al., IMHO. Because these BG spikes require their bodies to pump out lots of insulin to bring those BGs back in line quickly. And that is how the vicious cycle of weight-gain can start. Sure, it doesn't happen with everyone. Some people have metabolisms and/or lifestyles that help prevent the weight from packing on. But I think the obesity epidemic shows that those lucky ones are becoming the minority.

Woo, an A1c of 5.4 is not high by any standards. It translates out to an average blood sugar of about 115 according to this chart: http://www.geocities.com/diabetesch...sugarchart.html Keep in mind that this is an average of both fasting and non-fasting states. 69 for a fasting is almost a little on the low side; I know I'd be feeling a little hypo in that range. An A1c of 4.5 translates out to an average blood sugar of around 83 and my lowest a1c since they started testing it (4.7) translates out to an average blood sugar of 90. For some people to attain that, unless they have fairly tight control (meaning neither swinging high or low), it would mean spending some time in hypo range.
Dr. Bernstein relates anecdotally in his book that he has a practice of challenging meeter reps who come into his office to a little game of "guess the blood sugar reading" and the majority of them show a reading (non-fasting) in the range of 83-85 which, I believe, is how he comes to the conclusion that this is a normal average.

Thank you for the clarification.

Yes I think I have a tendency toward hypoglycemia, even now, but I've not been dx as such. I did feel very weak and lightheaded at the time. However this reading is quite an improvement from where I was when I was ketogenic atkinsing for a few months (and still quite ill from my previous poor diet). FBS then was only 60. No wonder I was tired and weak all the time.

I don't understand all this about blood sugar/diabetes very well, I appreciate you taking the time to share your knowledge.

ummm... that aritcle wasnt totaly corredct actually if your on a low fat diet to long it can ruin your immune system. I dont know what their talking about. Look at ms.atkins she has done the diet for a ver long time no problems so far. She looks great for her age and i assume she has no other problems. I think if you fell great with no chest pains dont worry about it. You can alwyas get an aretry scan it only takes about and hour of your day.

As posted by Woo:
"I want to thank you for raising a very important point - sugar is created from all energy, so limiting carbs isn't the only nor always best way to keep your metabolic functioning high. I often hear people say "calories don't count on low carb because fat can only be created from insulin". True, but one is overlooking the painful fact that calories - energy - is the catalyst which raises insulin. The body runs on glucose, and glucose is created from consumed energy (or if in a fast, from the body's own tissues). Carbs just do it more effectively and quickly which is why they tend to cause problems for people with bad metabolisms.
Be sure of this; if you eat a huge whopper of a steak, your sugar is going to increase from that steak due to protein (and to a lesser degree the fat) being converted into sugar. The glycemic load of a huge 8 oz cooked steak is going to be greater than that of, say, a very small apple.

Counting carbs can help you avoid big spikes and can keep sugar even, but there's this myth around the low carb circles that only carbs turn to sugar in the body, and sugar is poison, therefore it stands to reason that carbs are poison... but protein and fat are "safe". It's better to eat unlimited meat than it is to taint your body with a carrot. It's just no where near that simple. Metabolically speaking, smaller amounts of fruit and root veggies is usually better for you, than the unlimited steak some people think will bring them slimness and eternal youth."
This is all very interesting, but it is only your opinion which seems to be based on what you want to be true. To repeat the media based myth of low carb as stuffing yourself with steak is at best intellectually dishonest. To state that fat is turned into sugar without discussing how fat is broken down by the mitochondria and used for fuel is again misleading at best. Eat all the carbs you want in what ever form you want, but to take the position that you know better that the various authorities on the subject, especially since you don't back any of these statements up, is ridiculous. Nyah Levi

Funkycampe, IIRC, Dr. Bernstein doesn't put a limit on how much protein can be consumed at a meal (within reason) and instead "negotiates" with his patients on how much they estimate it would take for them to be satisfied with their meals. I believe he states that an "average" amount would be in the range of 4-6 ounces which is a decent sized portion when you think about it. What he does stress, however, is to keep the amounts you eat at each meal consistent once the target blood sugar ranges are achieved because changes in amounts produce changes in blood sugar readings. He refers to this as "The law of small numbers" meaning small changes result in small mistakes, while large changes result in large mistakes.
Dr. Bernstein also discusses cutting protein amounts when weight loss is desired (not fats or carbs) by first cutting back the amount you eat at one meal by 1/3 (from 6 oz to 4 oz, for example) and then doing it at a second meal if weight loss doesn't occur with the first adjustment.

This does make a certain amount of sense. If you were having large swings in blood sugar prior to low carbing (both high and low) and then through low carbing took your blood sugars lower than what your body is accustomed to (even normal ranges can feel hypo to someone whose body has been used to much higher levels..trust me, I've been there) already tending towards hypoglycemia, it could produce the symptoms to which you refer. Hypoglycemia is also a result of increased insulin production (and the precurser to insulin resistance and diabetes). I was hypoglycemic in college before I became diabetic later. In retrospect, you might have felt better easing into low carb more gradually than jumping in with both feet so your body (and your blood sugars) had a chance to adapt more gently.
Some people don't seem to handle such an extreme change well and do better gradually decreasing their carb intakes to the point that weight loss occurs. That doesn't mean, however, that the low carb intake, per se, was the cause, but the extreme change because the majority of those folks also find that by gradually reducing the carb level, the body does much better at the lower intakes than if they had gone from very high to very low suddenly.

I agree with you, I believe it's neither practical nor necessary to keep your Hb1C below 5%. All ppl diabetics and not have some degreee of hemoglobin glycosilation. Usually it's <6%. But when your BGs spike high and most important, stay at elevated for a prolonged period of time, this is what contributed to a higher Hb1C. Also, keep in mind that there are deviations between labs and glycosilation rate varies from one person to another. Some diabetics, especially those on OHA and/or insulin usually try to avoid hypoglycemia and settle for higher Hb1C. Since, HbaC doesn't account for hypo episodes, there is a good chance to run low blood sugar if your get very little energy from external source of glucose and only relay on gluconeogenesis.

Your FBG is good but I'd feel better with FBG around 80. There are two posibilities: 1) your insulin level is still a bit high
2) you eat too little carbs or too little in general
You've stressed yout body tremendously having lost 160 pounds in a relatively short period of time. But even your HbaC is not high at all, the only way to tell what is your Bgs are, is to monitore it for a few weeks. You can buy a cheap BG meter and a vial of strips and check your BG 2 h after a meal. I'd do this just out of curiosity. Poking yourself is not too much fun, but it's not bad at all, trust me.
No, it's not, Woo. Beleive me many young ppl have Hb1C in this range even eating helathy and not being diabetic.
Woo, I'm very delighted that you understand what I was trying to proove all along, LOL. We all have our genetic predispositions, some ethnic groups are born with genetic IR due to many factors. Some speculate that having certain blood type like O in my case, which is the most ancient type, gives you hunter/gatherer metabolism and excess carbs will make you overwieght and IR. But overeating highly processed carbs on a regular basis WITHOUT SPENDING THIS ENERGY during some physical activity, will make even a "healthy" person (if such a thing exists nowdays at all) overweight. Having sad that, I do not believe that carbs are evil and out diet should be comprised from protein/fat only. Fat can't be laid in the absence of insulin, type 1 diabetics are all very skiny and have troubles gaining weight. But it's not healthy either to get your insulin very low to promote weight (not fat) loss. We need insulin for many functions, it's a chef hormone in human's body, so if we consume too little ebergy from glucose (either protein or carbs), and have very low insulin, we'd raise glycagon, which works in conjunction with insulin and will break down your body tissues to make up for low glucose intake wither form carbs or protein. So, glycagon domination will results in muslce loss, if your protein is low anyway, sort of vicious cycle. So, it's not that simple. Carbs are burn easily (fast diegstion) while protein/fat takes much longer to digest, simply as this. But if protein and carbs are limited, then we do we have to eat: fat mostly. Some ppl just eat butter sticks, other heavy cream and pork rinds. I personally can't eat lots of saturated fat because it stalles my digestion, giving me heartburns and other unpleasant side effects. So, one needs to eat enough carbs to inhibit or decrease gluconeogenesis and not to spike high after a meal. For diabetics it means "eating up to your meter", this is the best advise I've ever heard. This means eating more low GI carbs and adequate protein. If you stay away from man made carbs (processed), you won't be able to eat high amont of low density carbs anyway. Simple as it is, it takes some chewing to get a huge salad with nuts and seeds, one medium apple will fill your stomach too, especially if eaten with a small portion of cheese or a handfull of nuts. Longer chewed food garantee early satiety, so it's comes down to high fiber. I also noticed that even sweet potatoe, butternut squash and even small amount of red potatoe, doesn't affect my BG more than a large portion of protein, especially red meat.

I doubt that large portions of cooked animal proten will give anyone a youthfull apperance, LOL. Eating protein mostly will make you slim simply because lots of protein will make you shed water fast. But it won't give you a youthfull appearnce, LOL. Not only fruits and vegetable contain great deal of vitamins and antioxidants (fruits for this matter are better deal) but eating too much protein will make your body too acidic, which can only accelerate aging process, so do the processed sugars. In addition, fruits contain high amount of water (apples are only 13% carbs by weight). I'm talking about apples becuase they also suppress appetite, contain maulic acid and high level of pectin too. Maulic acid is know to be an aid in fat breakdown, and pectin will kepp you full longer. Generally speaking folks who stick to diet high in vegetables and fruits always look and feel younger. I attribute my youthfull look and good skin to mostly eating fruits and veggies and not too much animal protein anyway. Look at asians, they have best looking skin and youthfull appearance, and they eat very little meat.
I think that animal protein is meant to be eaten row, the cooking process especially on a high heat, altered the amino acids and these altered protein is rather harmfull for human body. The best bets are raw unpasturized dairy (cheese included), raw fish like sushimi, raw eggs, and raw nuts and seeds. We should try to eat more alkalizing food and less acidic for a good health. And again, calory is a calory, and a huge salad with low GI vegetables, seeds and nuts followed by a low GI fruit, has much less calories than a huge steak. You know, Woo, I wouldn't obsess about Hb1C, ultimately, it varies from one test to another, and there is no point to think that you have health issues because of Hb1C. As for your current diet is healthy or not, the ultimate answer is only how it makes you feel overall. Bottom line is If your diet makes you feel crappy, than it's not right for you.
Best wishes,
Dina

What do you actually mean by low fat diet ruining immune system? I sure hope that you are not implying that eating high sugar diet is the same as eating low fat diet, which can be quite healthy if you eat lean protein, low GI vegetables and fruits, and adequate amount of essintial fat. I guess that your previous weight did not come as a result of eating low fat either. As for immune system, AFAIK, the only thing that actually damage it is processed carbs and sugars, espcially in liquid form.
We don't know where Mrs.Atkins great looks come from, it could be from sources others than the diet itself , neither we can absolutely possitive that she was in fact on a low carb diet. Don't assume anything based on one's look, it could be very deceiving. Joan Rivers looks not so bad too, LOL.
Well, it surely is great that you have no chest pain now, however, itcould be related to some digestive problems rather than a carido event. I'm not sure what health plan you belong to, but I doubt any health insurance will do angiogram and artherial scan unless other test like ECG, blood work, stress test confirm existing and progressive CAD.