Tuesday, June 30, 2009

Maintenance is a head game

I had that as my Facebook status on Sunday. Because it's true.

As usual, I've done great on the diet portion of my journey. I actually love to diet. You get all this positive feedback and it's not that hard if you are a "systems" person like me. Most diet programs have a system and I just plug myself into it. If it's Weight Watchers, I count points. If it's Jenny Craig, I eat one from column A and one from column B and do exchanges on the non-Jenny food days.

For weight loss surgery, my program had guidelines. Granted they were more open-ended than most diet programs. But I was able to fashion them into a system and come up with some routines that worked well for me.

Then came maintenance. And my systems all fell apart.

Some of this was due to schedule changes so it might have happened anyway. But part of it is that, somehow, maintenance is different.

For one thing, the goal is to eat as many calories as you expend, not as little as you can get away with. So you can't eat by rote. You have to actually listen to your body and trust that it's not lying to you. If you are hungrier one day, that usually means you need more fuel. It's a message not a trick. But it still feels like a trick. My body has been lying to me for so long that I can't just suddenly start trusting it.

Then, there is the whole weight thing. When you are going down, an occasional tick up is usually not a big deal since you are almost always down for the week. But on maintenance you go up and down constantly and it's nerve-wracking. I know from past experience that I will fluctuate about three pounds when I get to a steady state, but every time I go up one, I freak out -- even though over all I'm still losing a bit here and there.

I was even in a bad mood on Monday because I was at 116 when I had been at 115 earlier in the week. So even though I was still down a pound over all for the week, I was unhappy. I tell other people not to get suck into tying your feelings to scale, but then I fell right into that trap. I may have to hide my scale again like I did early out when it was driving me insane.

The other problem I am having is making myself eat things that are perfectly reasonable but have been on my list of "avoid" foods while trying to lose. I haven't had a bagel since surgery. We have whole wheat mini-bagels and I could have one and completely stay in within my nutritional guidelines, yet I just can't make myself. Even though I don't believe in "good" and "bad" food, I can't get over the idea that bagels, even whole grain ones, should be avoided at all costs.

Now, it's not all bad. I have been experimenting with different snacks and eating schedules and amounts. When I was losing, I would have a protein shake every morning with 3 scoops of powder instead of two. I've tried not having a shake on some days and having it with 2 scoops on others. So far, 2 scoops has worked the best. I can still meet my protein goals that way, but I don't overshoot my calorie allotment. It gives me more wiggle room to eat real food so I start playing with that.

I've been eating more fruit and more healthy fats too. I'm allowing myself more occasional indulgences, but I'm not going overboard either.

I have to admit that a few weeks ago, I was going overboard. The exercise was saving me, but I still felt out of control with my eating even though my numbers looked good. Then I figured out that having more acid was mimicking hunger and I started to drink more more fluids with flavoring (which seems to help that) and taking a Zantac when I got heartburn instead of ignoring it. That all helped a lot and I think my acid situation will stabilize within the month as Dr. C predicted. (I was doubtful about that at one point and envisioned an future of daily Prilosec.)

I'm doing better with the fueling vs. eating plan too. I have been having fun trying different sorts of fuels. I even made my own protein balls and bars. The recipes I have are not very good, but it's given me some ideas. I'm trying different sports drinks and working on my "special mix" too. I've also found some "real food" sports foods like bananas so I'm not eating so much engineered stuff.

So I often eat a banana before a workout, do gels and/or sports drinks during and then top it off with a protein bar of some sort at the end. This combo tends to come out to the right amount of calories and to have the right mix of convenience vs. natural food. I did try some trail mix in place of the gels but it didn't work out too well for a number of reasons. I may try it again for long bike rides though. I also brought some cheese sticks on my last long ride and that worked well too when the gels were just not enough.

My protein muffin recipe continues to evolve and was a big hit at a potluck my tri club held. They actually are an excellent post-workout snack since they have the exact right carb to protein ratio for recovery. My new recipe has a minimum of artificial ingredients and are much more convenient and tastier than a protein bar. They don't melt in the sun for one thing!

I'm also thinking of buying some bulk maltodextrin and some unflavored 100% whey protein isolate and making my own sports drinks. Then I can control the sodium in them and also the taste without having to mix and match from existing drink mixes.

So I will continue to experiment and work on listening to my hunger and full signs. I hope to develop a good balance between healthy habits and mindful eating. Because, let's face it, a lot of eating is routine even if it's important to also be mindful. Hopefully, I'll also get my head together. I feel a lot better today, though I suspect that's because the scale was back down to 115. But writing this out helped too. It's good to remind myself that I am actually making progress and that there are fun aspects to this part of the journey.

Thursday, June 25, 2009

Nine month report

I feel like I just gave my eight month report so I'll keep this short.

First, here are my pictures:

Note: I am not wearing shapewear of any sort. Yeah! Also, that shirt, which I only bought a week ago, is already a bit big on me.

Here are my measurements:
Body Part 9 mo Since
Bust 32 1 15
Chest 28 0 15
Waist 26 1 14
Stomach 34 3 16
Hips 35.5 0.5 15
Thigh 16 1.5 7.5
Calf 13.5 0 3
Arm 9 0.5 5.5
TOTAL: 7.5 91

In terms of where I am at, I am definitely and officially transitioning to maintenance. I'm still losing and some days I'm not happy about it and others I'm fine with it. I've been eating a lot this week and I think that's a side-effect of weaning off the Prilosec. I think low-grade acid is mimicking hunger. I'm working on that and hoping the effect is temporary.

Also, I'm a size two on the bottom! So now I'm sort of the same size on the top and the bottom. It's hard to find size 0 in most stores so I'm kind of hoping I stay here. Some size twos are a bit tight in the tummy and rear area so hopefully I'll lose a bit more there and no where else.

I'm still in a bra size that can't be bought at most stores. But I am finally losing there so maybe I'll end up okay in that area as well. I really hate buying bras off the internet. Which is why I buy all my bras at Nordstroms. I like that they don't put my stuff in a special section, but you have to be careful there. I almost bought an $82 bra today because I forgot to check the price tag.

I also need a new wetsuit -- my old one is already too big! I knew it would be too big by then end of the season, but I didn't expect it to happen so soon. I really would rather not spend the extra money, but it irritates my neck when I swim in it. At least it's easy to get off now.

Sunday, June 21, 2009

MYTHBUSTERS: Protein Myths

This month's installment of Mythbusters, Fatty Fights Back-style, is all about protein. This is an area where there are tons of myths and misconceptions.

Too much protein

The biggest protein myth is that we can only absorb a certain amount of protein at a time. As the American Society of Metabolic and Bariatric Surgeons says on page 27 of their "ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient" document:

There is no scientific basis for this statement.

In fact, it flies in the face of everything we know about macronutrients (protein, carbs and fat), our personal experience and what science tells us when protein absorption is studied directly.

In terms of macronutrients, our bodies were designed to extract every single molecule of nutrition from what we eat. (This is true of most micronutrients, as well, but with micronutrients, there are exceptions.)

Our original ancestors were hunter-gathers and that means they didn't eat what we think of today as a balanced meal. Their diets consisted of stuff they could forage regularly (mostly plant-based foods and, in some locales, fish) and once in a while they killed something big and gorged on meat until it was gone. (They had no refrigerators so they had to eat it all as soon as possible.) So our bodies were designed to process a lot of protein at once.

This is borne out by studies where subjects were given a large "bolus" (scientist-talk for an enormous blob) of protein and then their blood was measured two hours later to see how much of it was digested and got into the body. These studies show that it all gets absorbed.

Finally, we have our personal experience. If our bodies only absorbed 30 g of protein at a time, that means the rest is pooped or peed out and those calories are not stored in our body. So everyone could eat a 16 oz. steak for breakfast lunch and dinner, only absorb 30 g of the protein (120 calories) instead of the 87 g of protein (348 calories) that it contains. What a great diet aide! Except we all know that eating too much meat causes us to gain weight just as much as eating too much of some other food.

Some nutritionist (who should know better) will amend their statement that you can't absorb more than 30 g of protein an hour to say "well, you do absorb it, but it's not all used" or they invoke the dreaded "it will turn to fat!" threat that seems to be so common when talking to dieters.

Now, it's possible that the amount of protein you consume in a day contains more amino acids than your body needs to build muscles and repair body tissues. But that's okay, as long as you are not eating more calories than you burn. If you eat less than you burn, any protein that isn't used to repair muscles and other tissues will be used for fuel, just like the calories from fat and carbohydrates.

Finally, it's not realistic to think that your body will not use anything over 30 g of protein per hour for tissue repair. First of all, even if there is some upper limit, it's going to vary based on individual factors such as body weight, age, and activity level. It won't be the same for everyone.

However, everything I've read and seen tells me that, if your body needs the protien and you give it the protein, it will be used. As an example, body builders routinely down more than 30 g of protein at a time and, the more they down, the bigger their muscles grow. If there was some sort of arbitrary limit, that wouldn't happen.

A related misconception about protein is that you have to be careful not to get too much. Technically, this is true: Too much protein is hard on the kidneys. But "too much" protein isn't going over the recommended RDA. Unless you have some sort of kidney problems, you have to eat enormous quantities of protein for this to be an issue.

In one study, participants ate 2.8 g of protein per kg of body weight with no ill effects. For a 150 pound person that works out to 190 grams of protein! A typical recommendation is to not go over 2 g per kg of body weight though. You can also lessen the impact on your kidneys by drinking more fluid as water helps the kidneys perform more efficiently.

The rest of the protein myths revolve around shakes. There are a lot of misconceptions about protein shakes and the protein used in them. Such as:

You should only consume 100% whey protein isolate - all the other stuff isn't any good.

100% why protein isolate is the most bioavailable, but that doesn't meant any other types of protein are automatically no good. Eggs are more bioavailable than chicken, but no one suggests we shouldn't eat chicken. I say: use the kind of protein that you can stand and don't worry so much.

If you heat protein powder, it breaks down and the protein is destroyed.

Protein powders designed to be used with cold water will clump up if you add hot water. But it's an aesthetic thing, not a nutritional thing. The protein is just fine -- digusting to eat, but still protein.

You can get around this by adding your protein powder to lukewarm water, getting it to dissolve, and then adding the resulting sludge into your hot drink. For baking, just add the powder directly.

Blending your shake breaks down the protein so use a shaker bottle instead.

Once you add liquid to a protein powder, it starts breaking down. This is why you aren't supposed to mix up all your shakes ahead of time. However, blending vs. shaking makes no difference in the process.

You should get all your protein from "real" foods. They are empty calories.

This one isn't a myth so much as it is an opinion that some programs turn into a "rule." It's not an opinion I tend to agree with and I certainly don't think it should be a rule.

First of all, protein supplements are not empty calories any more than a steak is. They can be more bioavailable than a steak too. So they are a good quality protein and they are easy to get down in the required quantities.

Which can lead some people to have problems. Some people don't feel full on shakes and so eat more calories than they should. But lots of people don't have this problem. While most programs don't want you to drink your calories, this really applies more to things like Vitamin Water or juice -- stuff that is mostly sugar and has more calories than it "feels" like it should have. A high quality protein drink is not in the same category at all.

Other people don't like them because they can be full of unnatural ingredients. But there are shakes out there that don't use artificial sweeteners. You just have to read the labels and decide for yourself if a particular shake meets your own standards for what you are willing to put in your body.

So, if a protein shake or protein drink works for you, I say: go for it! If they don't, then don't worry about it; there are other ways to get your protein in.

Some links about how much protein we can absorb:

30 grams of protein in one meal rule

Protein grams per meal

Friday, June 19, 2009

Summer, protein shakes and why I love my support group

I had another great support group meeting on Wed. I always go thinking that I'm mostly going to help the pre-ops, but every month I get energized and I learn something new even when we talk about stuff I've heard many times before.

This month we talked about Summer.

So we talked about how to avoid dehydration, taking advantage of the weather to be active, and also about traveling and vacation. Next month we're going to be making protein shakes and summer drinks, but I won't be there. Because I'll be traveling and on vacation. So it was a timely topic.

I got a new idea for my protein shakes too. I generally make one in the morning and drink it while I get ready and on the drive into work. But that hasn't been working too well on the days I go to the gym at 6 AM. I can't drink the whole shake before I get there and then I have to decide what to do with the remainder -- leave it in the car, put it in my locker -- and, either way, when I get back to it after working out, it tends not to be very appetizing.

Dr. Awesome suggested we fill up a thermos with our shake in the morning and take it with us. This was in answer to a question about going to Disneyland. But it will work for the gym too! I picked one up on the way home from the meeting. (And an immersion blender, too, since I've managed to kill another Magic Bullet.)

I haven't had a chance to try it out, but I will tomorrow when I go to our "New to the Sport" workout. That's another time where I bring a shake, but often don't finish it. Plus, we're having a picnic after our swim and run so then I'll get to practice the other things I learned.

Tuesday, June 16, 2009

Food idiot

What is it about food that makes us turn into illogical idiots? I don't think I'm this way about anything else in my life. Well, maybe boys when I was younger. But that doesn't count, right?

Anyway, while I was losing, I worked out a pretty good routine. I ate three times a day at first, then four times, then five times, as my workouts increased in duration, quantity and intensity. I had breakfast in the form of a shake around 9 AM, protein and veggies for lunch around noon and then pretty much ate every 3-4 hours after that with a bedtime around midnight. It worked out to a reasonable amount of calories and my hunger was controlled.

But then I threw a wrench into that routine by deciding to train for a Half Ironman. Suddenly, I'm getting up at 5 AM and getting to bed at 10 PM (okay, I'm trying to go to bed by 10 PM). By coincidence, this happened just as I decided it was time to maintain and not lose any more. So I'm trying to become a maintainer while simultaneously completely changing my schedule.

Which would probably not be a problem if I truly had a "thin person" brain. But I still don't trusted myself to eat when I am hungry and eat the right things. So I have been stubbornly sticking to my old eating schedule and routines even though they no longer make any sense.

As a result of my new schedule, I've been hungry between breakfast and lunch, which never happened before. But I wouldn't eat because I didn't want to graze and I don't have an AM snack in my plan. Then, by the time lunch rolled around, I was starving and my lunch only lasted me a short time. So all afternoon, I'm having a handful of this and nibble of that, while trying desperately not to eat too much, but trying to tame the hunger pangs.

I was starting to think I wouldn't be able to maintain because I'm just too hungry all the time. Until I had a "d'oh" moment and realized that, if I get up at 5 AM and eat breakfast by 6 AM, then 3-4 hours later it is 9-10 AM and so it's perfectly appropriate to eat then. Before there wasn't room for an AM snack between breakfast and lunch, but now there is.

Which means all I have to do is move my evening snack to the morning and I'll still be doing three meals and two snacks a day and only eating every 3-4 hours, just like before. Problem solved.

Which leads to the question: why did it take me two weeks to figure that out? Shouldn't it have been obvious? I can't help believing that if I just ate when I was hungry and stopped when I wasn't hungry any more, I would have naturally done this.

Bottom line: I need to learn to eat intuitively and also to trust myself.

Anyone have any recommendations on a good book on intuitive eating? I'm thinking I'll start with "The Rules of Normal Eating", but I suspect that I'll need more and the choices on Amazon are a bit overwhelming.

Sunday, June 14, 2009

Eight month pix

Finally got around to prepping and uploading my eight month pictures.

Man, does my pooch above my belly button annoy me. I got that mostly from having babies and I'm pretty sure only plastic surgery will get rid of it. Time to invest in some really good shapewear for the upper body, I think!

Friday, June 12, 2009

"Nine" month visit

I saw Dr. Awesome today for a check-up. I'm 8.5 months out so I think of this as my nine month check-up.

Anyway, he was very happy with my weight loss. As am I, of course.

Their scale wouldn't measure my body fat, which was annoying. I want to see if my trainer's measurements were accurate.

We talked about maintenance and when I would be done. He said he'd be fine if I didn't lose another pound but also I could go down to 110 or even 105 and be fine and that it's better to go down 5-10 lb. more than you wanted than stop 5-10 lb. above where you wanted. (I think he's worried about bounce back.)

I do think I could get down to 110 and be fine, but 105 seems a bit much. I was 110 in High School but I was also shorter. And a B cup. Then again, I wasn't particularly fit back then either. I guess we'll see.

He also said I can get down to the low teens in body fat and still be healthy since I'm not trying to get pregnant. (Good. I was thinking my new goal should be 12 % body fat. I want to see if I can hit that. Just for grins.)

On the acid front, he said I should go off the prilosec for a month and see what happens. If my acid situation doesn't stabilize, then we can consider an X-ray to see if the hiatal hernia reoccurred. (I am having some back pain reminiscent of the hiatal hernia back pain.) But he thinks I'll be fine.

We talked a lot about eating and maintenance:

If I keep up the triathlons, I won't have to worry about regain, but lots of people work out a lot and eat a lot and are fine, but then they stop working out and don't stop eating a lot and gain. This is a big worry of mine, actually. I told him I planned to do them until I was too old. And I do. I want to be the oldest person to do Kona.

He also liked my idea of "fueling" around workouts as separate from "eating" the rest of the time since, when I don't work out, I don't consume that stuff. So, if I stop working out, I won't be eating like crazy. But he thinks I should eat mostly before as afterwards I might not be that hungry. I think that's a good idea as some days I have been having trouble getting it all in.

He also said I need carbs when I'm working out. While this is true, I just about died when he said that. I think of Dr. Awesome as the anti-carb king! He suggested doubling from their 40 g start point. I cracked up because I'm up to 110 g a day these days already. He said I need to experiment to find what works for me. I'm going to see what 120 g a day does. I suspect my "craving point" is somewhere in the 120-150 g range, based on past experience.

He also suggested I add in whole grain breads and pasta. Honestly, I don't like bread -- never have -- and whole grain pasta is gross. I think I'll stick with fruits and veggies and the occasional potato. Another suggestion was avocado. I didn't have the heart to tell him I eat it already. I eat lots of healthy fats, in fact, but in very small quantities to stay under my fat gram allotment. I guess maybe I can up my allotment.

He wants me to come back in Aug. since I'm now in the fine-tuning stage. I was surprised by that, since I figured the time between appointments would get longer at this point, not shorter.

Finally, he said he wished more of his patients were like me when it comes to weight loss. Aw. Truly, I don't feel like I'm doing anything particularly spectacular. I know lots of people who had WLS and turned into athletes and plenty more who got to goal and are maintaining just fine.

Monday, June 8, 2009

I'm a Mermaid!

I did the Mermaid Triathlon yesterday. It's an all-women event and I had a great time, which I wasn't too sure I would before it started, because it's a very short triathlon (1/4 mi. swim, 10 mi. bike, 2.5 mi. run) and I'm turning into a tri snob now that I'm going for the longer distances. Heh. (I was angsting about how doing a race right now would mess up my training like a big bozo who forgot that the whole point is to have fun.)

It was great to see woman of all different shapes and sizes instead of the usual buff athletes you see at the co-ed events. I felt more comfortable in that crowd even though I'm more on the buff side these days. (But I still don't think of myself that way -- I only focus on the flab and loose skin!)

Plus I got to hang out with a bunch of my friends... some women from our "New to the Sport" group shared my rack and I saw others from our club, plus some of my friends from my bariatric support groups and from the Obesity Help website.

I am also very happy because of the 300-400 people who had completed it at the time I checked, I was 171st! Now, the 20-somethings were still out on the course, so my overall ranking will go down, but I was only 10 min. behind the winners of my age group and this will be my first MOP finish. I really pushed myself since the distances were short enough and it paid off.

But the best part is that I talked Mini-Mac into doing the "Mini-Mermaid Fun Run" just for girls that took place at the same time and now she wants to go to the gym with me and maybe even enter a triathlon too (or at least a duathon, she's not 100% sure about the swimming). She only wants to do women-only or kid events though because she doesn't like it when the "old dudes" walk around in their tight shorts. I tried to tell her that "old dudes" walking around in tight shorts is actually a known benefit of doing tris, but she's still pretty young and wasn't buying it. She'll learn.

I've been concerned about Mini-Mac because she used to be pretty athletic and lately she's turned into a big couch potato so I am happy she wants to do something that involves moving her body. The week leading up to the run were a bit tense. She kept trying to back out of it and was convinced she'd make an utter fool of herself. But we had a talk on Sat. and she decided to have a better attitude. Then, after she ran, she wanted to know her time and was disappointed they didn't keep times. She's so competitive -- just like her mom!

So now I have a tri buddy. Next year we can do it together just like some of the moms and daughters I saw out on the course.

Monday, June 1, 2009

Camping = eating?

I can't believe how much I ate on the DVS camping trip this weekend! I was actually mostly making good choices and I ate a lot less than I did last year. But it still added up. Something about traveling seems to excite the "eat it" part of my brain. I was just constantly putting something in my mouth and it wasn't all fruit and nuts either. There was definitely some candy in there!

Maybe it's being away from all my normal external cues. I guess it could be being outdoors in the fresh air, but it happens to me when I take plane trips to cities too. So that's why I suspect it's an "external cue" thing.

Plus there was tons of food around. I don't think that helps. There is something about abundance that triggers me.

I ended up eating almost 1500 calories on Friday, almost 2100 on Saturday (yikes!), and 1400 on Sunday. But I still lost three pounds this week and I got in my protein and operated at a calorie deficit for the weekend due to a very long bike ride I took on Saturday that totally kicked my butt. I also went to the gym on Sunday and fit in my long run for the week.

I also took Mini-Mac and two of her friends out for a little run on Saturday morning. They started out way too fast and I thought I was doomed, but they had to stop and rest and I caught up and then I got to teach them about pacing and training your body to run. That was fun. One of them is a natural runner too. I was a bit jealous as I think she could have schooled me if she wasn't being polite.

I'm still struggling with the whole "maintenance" thing. I keep thinking I need to eat as little as possible even though my weight loss tells me otherwise. If I want to stop losing weight, I need to eat more, but when I eat more, I beat myself up about it. I look back at what I ate this weekend and I remember my calculations saying I probably need to eat somewhere in the 1800-2000 range and I realize that I didn't actually eat all that much compared to what my body needs.

I think the real problem is that I felt somewhat out of control and wanting to eat junk. I had a Tootsie Pop both days, a handful of Tootsie Rolls and some squares of Hershey's chocolate from the s'mores. It wasn't a lot but it was more than I told myself I was allowed.

But as we were driving home, I kept looking at the last Tootsie Pop I had saved out and I couldn't even imagine why I wanted it. Which is how I normally feel about such things since my surgery. I ended up putting it the snack drawer and someone else ate it.

So I go out in the woods and want to eat junk all day and I come home and it has no appeal to me? I just don't get that.