It's a beautiful day...

... and I can't stop myself from smiling...

Actually it's grey and miserable out but I'm smiling anyway. So far today I have eaten three crunchy carrots, two crispy crackers and a cup of golden vegetable soup. I'm feeling energised and happy.

I finally got around to watching Michael Mosley's original Horizon programme "Eat, Fast and Live Longer" here:

http://www.disclose.tv/action/viewvideo/110651/BBC_Horizon_2012_Eat_Fast_and_Live_Longer/

(Many thanks to @wiltdnrUSA at thefastdiet.co.uk forums for providing the link.)

It reminded me of all the amazing physiological effects that arise from fasting, for example the brain reacting by producing new neurons. I'm going to be healthy AND clever! The program also revealed that Michael lost around a stone in weight in his first 5 weeks on the diet. While I can't believe I will have results anything like that, I am optimistic about my progress and confident I can keep going as long as I need to.

Happy Monday folks!

Day Eleven - one week to W Day and cholesterol tests

This time next week I will return to my GP to get weighed. There is still part of me that wonders if I'm imagining all the physical changes in a warped version of wishful thinking. It will soon be time to find out!

As a large part of my motivation is to improve my general health, I have been looking for other measures that could help me assess my progress. I found out that my local Sainsbury's is offering free cholesterol testing at the moment, so I have booked myself an appointment for a week today too. I had a full health assessment on 25 April which included cholesterol tests, but other than the fact that my results were outside the recommended range, I didn't really know much about what cholesterol is or why it is important. So of course, I referred to Dr. Google to find out and this is what I learned.

http://www.patient.co.uk/health/cholesterol
http://www.nhs.uk/conditions/Cholesterol/Pages/Introduction.aspx

Cholesterol is a fatty substance known as a lipid and is vital for the normal functioning of the body.Cholesterol is carried in your blood by proteins, and when the two combine they are called lipoproteins. There are harmful and protective lipoproteins known as LDL and HDL, or bad and good cholesterol.

Low-density lipoprotein (LDL): LDL carries cholesterol from your liver to the cells that need it. If there is too much cholesterol for the cells to use, it can build up in the artery walls, leading to disease of the arteries. For this reason, LDL cholesterol is known as "bad cholesterol".

High-density lipoprotein (HDL): HDL carries cholesterol away from the cells and back to the liver, where it is either broken down or passed out of the body as a waste product. For this reason, it is referred to as "good cholesterol" and higher levels are better.

The following levels are generally regarded as desirable:

• Total cholesterol (TC) - 5.0 mmol/L or less. However, about 2 in 3 adults in the UK have a TC level of 5.0 mmol/L or above. Mine was 5.6.
• Low-density lipoprotein (LDL) cholesterol after an overnight fast: 3.0 mmol/L or less. Mine was 3.8.
• High-density lipoprotein (HDL) cholesterol: 1.2 mmol/L or more. Mine was 1.2.
• TC/HDL ratio: 4.5 or less. That is, your total cholesterol divided by your HDL cholesterol. This reflects the fact that for any given TC level, the more HDL, the better. Mine was 4.7.

As a rule, the higher the LDL cholesterol level, the greater the risk to health. So I'm not in big trouble yet but not in a great place either and really need to get it under control. I'm looking forward to seeing some evidence of the health benefits of fasting. 

Any other ideas for measuring progress?

Sugar and sweetener

"Confirmation bias" is a tendency of people to favour information that confirms their beliefs or hypotheses. People display this bias when they gather or remember information selectively, or when they interpret it in a biased way. I am probably guilty of this when it comes to my research on the harmful effects of sugar. I read with interest some further confirmatory stories this week, including this one linking sugar with the effect of cholesterol's ability to cause heart disease. 
http://myscienceacademy.org/2012/08/19/world-renown-heart-surgeon-speaks-out-on-what-really-causes-heart-disease/

"Without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped. The biggest culprits of chronic inflammation are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods."

While acknowledging my confirmation bias, I still find this compelling.

The new villain getting a lot of bad press is fruit juice due to the sugar content:

http://www.theguardian.com/society/2013/sep/07/smoothies-fruit-juices-new-health-risk

But I got to thinking, one of the ways that I, and many others, reduce sugar intake is by switching to artificial sweeteners. I put them in my coffee and I drink low-calorie soft drinks. So I thought I should balance the equation a little by looking at some of the effects of sweetener on the body.

There are many types of sweetener available. The most common ones are saccharin, aspartame and sucralose. Critics of artificial sweeteners say that they cause a variety of health problems, ranging from cancer to depression to headaches.

Studies dating to the 1970s linked saccharin to bladder cancer in laboratory rats. Because of those studies, saccharin once carried a warning label that it may be hazardous to your health. But according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the U.S. cause cancer or other serious health problems. And numerous research studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women. As a result of the newer studies, the warning label for saccharin was dropped.

http://www.mayoclinic.com/health/artificial-sweeteners/MY00073

But the debate rages on, mainly because no long-term studies on humans have been conducted, and many of those short-term studies that have been conducted have been funded by the sweetener industry. The biggest villain appears to be aspartame, which has been shown to trigger headaches and depression in those susceptible.

http://www.onhealth.com/artificial_sweeteners/page8.htm#aspartamecon

We probably don't know the reality from the hype, and I will hopefully view popular research with at least a pinch of scepticism. From a personal perspective, I will continue to cut out sugar wherever possible, preferably without replacing it with an artificial sweetener if I can. But I won't worry too much about getting cancer from aspartame, I think the risk of me getting cancer from being massively overweight is much higher, not to mention the cigarette habit!

Blogging from my phone

Ooh look at me, all technologically mobile.

Very quick update. Another, slightly smaller pair of jeans bites the dust as they can be pulled off without undoing them.

And I still don't have a belt.

Day Ten: the wobble factor

Oh look, double figures! It is actually 5 weeks today since I did the medical fast that started this all off. Go me!

I have noticed over the last few weeks that my wobbly bits have been getting, well, wobblier. (I hope you appreciate the use of technical terms here.) It's difficult to describe and I don't want to give people mental images that require brain bleach, but the fat bits seem definitely softer, with more give. Dream has assured me that this is a good sign and means the fat cells are giving up their vice-like grip on the fat, but the geek in me requires scientific explanation.

The first step was to work out what search terms to enter into the fount of all knowledge, Dr.Google. "Why are my wobbly bits wobblier?" wasn't hugely successful. Further searches turned up lots of articles about what to do with excess loose skin after weight loss - yeurch... something to look forward to...

I haven't found any information that satisfies my need for properly conducted research, but the consensus appears to be that something like this is happening:

When your body runs out of sugar (in the bloodstream from carbohydrates that you are eating) and glycogen (sugar stored in the liver is the next source in line) your body turns to the fat cells for energy (hurrah). The stuff in the fat cells is triglyceride which is formed of glycerol and fatty acids. When the fat cells get the signal to give it up, the triglycerides break into their component parts and enter the bloodstream, where they are cleverly converted to energy and the liver restocks with glycogen.

So now you have fat cells with less triglyceride in them, but they are essentially still the same size - it takes longer for the cell to physically shrink to the appropriate new size. This makes sense as if the sugar deficit is short-lived, as the fat cell is ready to fill up again when the next doughnut appears. If fat usage is going on at a steady rate (we hope) the cell is constantly trying to catch up with the new lower required size. 

What appears to happen (and this is where the evidence gets a bit hand-wavy) is that the fat cell temporarily fills up with water. If no new fat is made to replace what was lost, eventually it releases the water and shrinks. So the wobbliness is due to a higher water content in the fat cells, and will hopefully be followed by shrinkage.

All of which goes to prove that Dream was right and I should just listen to her and accept her wisdom ;)

References
I'm sure that my explanation above is a highly simplified version of reality, if anyone out there knows better please tell me! The are the two main articles I shamelessly plundered are:
http://science.howstuffworks.com/life/human-biology/lost-weight1.htm
http://www.bodyrecomposition.com/fat-loss/of-whooshes-and-squishy-fat.html

Goals

I was talking to my boyfriend about goals the other night - not the football kind, thankfully. Looking back at Day One, I stated my goal as "is to live a life with less pain, less illness, more health, more energy, more happiness."  This is still my overall aim, but it is quite amorphous. How much weight do I have to lose to get to this place? How will I know when I get there? 

This has been brought into focus this week as I somehow managed to pull a muscle in my calf. While the injury is not weight-related (I think), I'm sure my recovery has been slowed by my weight, and the hobbling around has aggravated another previous injury in my hip. It has been extremely frustrating.

My boyfriend asked me if I have a goal weight. Not an unreasonable question. My immediate answer was - "no". There are two reasons for this. Firstly, I find that setting a goal like that makes the journey seem impossible. If I really wanted to set a goal to be in my "ideal weight range" according the the doctors, it involves losing such a huge amount that I can't get my head around it. The second reason is that I honestly don't know what my goal would be, in terms of pounds and ounces. I can't remember being a "normal" weight, I don't know what it feels like.

I might lose a certain amount and feel fantastic and decide to stop there, even though still officially overweight. Or I might keep fasting indefinitely because its the fasting itself that makes me feel good - it is possible to fast without losing weight and many people do this just for the health benefits. Yesterday, by the way, I felt fantastic, very relaxed and content. What is important to me is that my weight doesn't adversely effect my health and mobility, and that is harder to measure.

Still, on reflection, I think it would be helpful to me to have a way of measuring my progress, so that a loss of a certain number of pounds translates into something meaningful to me. I came up with the following:

1. BMI under 40
At the 40 level, a person's obesity is labelled "morbid" i.e. significantly raising the risk of serious illnesses, in particular Type II diabetes. For me to get below 40, my weight need to drop below 105kg (16 stone 8 pounds) - a drop of 3kg (6 pounds) from my starting weight. I'm very optimistic that I can manage this!

2. Lose 10%
This is a common goal for people losing weight. It is a significant amount and has measurable health benefits, but it is small enough to be easily visualised and achieved. I'm particularly looking forward to no.7 on this list.
http://www.sparkpeople.com/resource/wellness_articles.asp?id=528
For me this equates to a loss of 11kg (24 pounds) from my starting weight, to get to 97kg (15 stone 4 pounds). This would give me a BMI of around 37. This seems like a massive amount to me, but I think it's a good one to aim for. If I can get to this I will be pretty damn proud of myself.

3. Reduce waist measurement to 31.5 inches (80cm)
Risk of some health problems is affected by where body fat is stored, as well as by weight/BMI. Carrying too much fat around your middle (waist) can increase your risk of developing conditions such as, guess what, heart disease, Type II diabetes and cancer. The tipping point is thought to be around 80cm for women (94cm for men). This is a huge reduction for me to even think about, with my starting measurement of 47" (119cm). However every inch that goes will take me closer, so its a good number to have in mind. In management speak this would be labelled a "stretch" goal. Perhaps a "shrink" goal would be more appropriate?

There may be other goals or markers along the way, possibly in terms of dress size, or physical activity completed - I will keep the list updated as I go along.

Day Nine: when does it become habit?

The American Journal of Psychology defines habit in this way: "A habit, from the standpoint of psychology, is a more or less fixed way of thinking, willing, or feeling acquired through previous repetition of a mental experience." Old habits are hard to break and new habits are hard to form because the behavioural patterns we repeat are imprinted in our neural pathways, but it is possible to form new habits through repetition.

Deliberately starting any new lifestyle is a conscious attempt to make new habits. What I am finding interesting is noticing my existing habits as I start to change them. One in particular is the tendency to pick bits of food from my children's plates as I am preparing or clearing them away. On a fast day I have to police this habit rigorously, and it is so ingrained that sometimes the food is in my hand before I remember and stop myself. The fun part is that stopping myself has now started to replace the old habit. I find myself doing it on non-fast days too. I can then make a conscious decision as to whether to put the food in my mouth or not. Sometimes I still do, but it is with thought, not an automatic action. I firmly believe that it is small changes like this which support the overall goals and help the strategy to work.

Today I am fasting at home with my children (they are not fasting, obviously) and finding it a breeze. I have spoken to a few different people about the fasting strategy this week, and the common reaction from all of them has been - "Isn't that hard? Don't you feel faint? I couldn't do that." And yes sometimes it is hard, and sometimes I do feel unwell. But it is getting easier. Today I ate a yoghurt in the morning, and by the time I got to lunch the chicken salad I had planned seemed too much. I ate a plate of raw veg and a dollop of houmous - all weighed out to the last gram - and felt fine. I was a bit peckish this afternoon so ate a banana. I'm sure I cruise through to my dinnertime omelette. And honestly, however hard it is on any one day, I know I can eat tomorrow. It is becoming normal for me.

Motivation comes in different places. On Friday I was out shopping with Dream and we noticed a clothes shop I hadn't seen before. I was entranced by the clothes in the window and uncharacteristically went in to look. My usual clothes shopping experience is pretty hellish, and regular shops like this one generally don't go over a size 16, which is depressing for a 20/22 girl. I figured I could take a look at what I might be able to wear a bit further down the road.

Delightfully their range went up to a size 18 and with Dream's encouragement I tried a few things on. I ended up spending rather a lot of money... Even better, Dream slipped into a size 16 for the first time in a long while. I'm looking forward to wearing a smart new dress to work this week - although I do need to invest in some new tights first!

http://www.mistral-online.com/