Sunday, April 23, 2006

The Trouble With Fat

Fat gets a lot of press time these days. And navigating which fats are good versus bad can be confusing. We have saturated fats, trans fats, monounsaturated fats, polyunsaturated fats, and cholesterol (which isn't really a fat).

If you are trying to lose weight, it is important to look at the total fat content, since any form of fat is loaded with calories. But if you are simply trying to eat a heart-healthy diet, it is a bit more tricky. The main culprits, of course, are trans fats and saturated fats. Either form can raise your levels of LDLs dramatically over time. Polyunsaturated won't raise nor lower your LDLs much at all, so they are fairly harmless. Monounsaturated fats are the good guys. These are the ones that will actually help reduce your LDL levels.

Yet, sometimes when you look at the food label, you'll add up the saturated, trans, polyunsaturated, and monounsaturated fats, and the total is still significantly less than the "total fat" listed on the label. Why is that? Actually, I'm not sure myself. I know that there are some fats not classified. Take, for example, fully-hydrogenated vegetable oil. This is not technically a trans fat, unlike the partially-hydrogenated cousins. Yet, fully-hydrogenated oils are still bad for you. If you pick up any food with the word "hydrogenated" in the list of ingredients list, chances are you shouldn't be eating it.

But for diabetics, fat plays an even more significant role in managing your disease. A diet high in fat is known to cause increased insulin resistance, even on a short term basis. And my own dietary changes in the past two weeks have shown just how much that is true.

Anyone with diabetes is probably familiar with the pizza effect. This is when you eat pizza, and bolus accordingly, but you see a dramatic rise in BGLs a few hours later. Why is that? The answer is somewhat complex, and not attributed to a single cause. But one major contributor is the fat content in most pizza. Eating pizza actually forces your body to need more insulin than you would have had the same number of carbohydrates in another meal.

Fat, in general does this. Sometimes you don't see it with an individual meal, however. If your diet is consistently high in fat (or, perhaps, higher in fat than is prudent), you may not even realize that your basal rates are tuned for that level of insulin resistance. At least, that has been my experience. Because suddenly, in the past several days, I've been experiencing lows at odd times. Not lows due to miscalculated boluses...but lows because my lower-fat diet has reduced the level of insulin resistance I've been living with.

This means my basals have to be readjusted.

This also shows just how much a small change in your diet habits can affect your body. I really wasn't eating horrible before, by any stretch. A bit too many snack food items from the vending machine, and a bit higher-fat meals, but all in all, I eat fairly healthy.

Since changing to an even healthier diet in an attempt to lower my LDLs, I now get away with less insulin--at least for my basal rates.

So, I have a challenge for you all. For one week, pay attention to fat. Pay attention to how much fat you eat, and how much of that is saturated or trans. I read just recently that just 5 grams of trans fats a day raises your risk of heart disease by 25%! There are alternatives. Sometimes it means a sacrifice, substituting one food item for another. But in the end, your heart with thank you for it. And in the process, you might just be able to get by with less insulin. At the end of the week, review your results. Tally up the types of fats you eat, and see what has to be done to shift more of the fats you eat to the monounsaturated column, and eliminating as many saturated and trans fats as you can. Good luck!

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