My Healthy Diet Refocus

Time off from training is certainly enjoyable but as a type 1 diabetic my diet remains very important to me. Cutting back from 15hrs+ training per week to a few social mountain bike rides and walking the dog is a big change which requires some significant changes to my daily insulin plan (about a 25% increase). To help me manage this big change I have worked hard to keep my diet in check, counted my carbs closely and tried not to over indulge too often (which usually results in some challenging BGL fluctuations).

For me it’s all about eating healthy, getting in all of the macro nutrients that I need and feeling satisfied throughout the day. I usual think about food as fuel and follow a strict plan to eat what I need and also maintain stable BGLs. Fundamentally I still follow this approach as it is healthy, I feel good and allows me to easily track carbs and insulin requirements. I also keep to eating at regular times during the day (breakfast, lunch and dinner) and ensuring that my main meals are substantial and include all of my nutritionally requirements.

I have generally broken each of my meals down to the following:

  1. Protein – lean protein (100grams per meal)
  2. Carbohydrate – Unprocessed and low GI
  3. Fibre – Leafy vegetables which should also be used to fill you up
  4. Fat – healthy fats (only a small amount each meal)

As a rule of thumb I also vary my sources of each component with each meal and throughout the week; that is to not eating the same protein, carbohydrate or fat too many times. I do not count calories but eat a healthy portion of protein and fats with each meal, my carbohydrate intake is relatively low by nutritional standards but this assists with my BGL stability and I load up on fresh vegetables with every meal. Fruit is important but can be high in more High GI carbohydrates so I choose low GI fruits and keep them to two pieces per day.

When you break your meals down into these simple components it is then always easy to put together a healthy meal which ticks all of the boxes. The components are also not complicated making most meal quick to put together (<30mins). I have provided a very simple meal options plan below.

Breakfast

  • Eggs with whole grain toast, tomatoes, spinach and mushroom
  • Rolled oats with berries, seeds/nuts and yoghurt
  • Crumpets, natural peanut butter, low fat cottage cheese and fresh mashed blue berries
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An open steak sandwich cuts the carbs but is full of protein and salad.

Lunch

  • Lentil and vegetable soup
  • Roast chicken or tuna with mixed salad and legumes (chickpeas/kidney beans/four bean mix)
  • Whole grain sandwich or wrap with salad, cheese/avocado and lean meat (turkey/ham/chicken)
  • Vegetable frittata and fruit salad

Dinner

  • Grilled chicken with corn tortillas, avocado and salad
  • Seamed fish with potatoes and vegetables
  • Roasted vegetables with natural yoghurt dressing
  • Tofu/egg and vegetable stir fry with soba noodles
  • BBQ lamb/beef with roast sweet potato and salad/grilled vegetables
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One pot/pan meals are a favourite of mine and roasts are a perfect winter meal!

Snacks

  • Mixed unsalted nuts (30-50grams)
  • Low fat yoghurt with frozen berries (100grams)
  • Fresh fruit (banana, apple, pear, melons, etc)
  • Carrot and celery with hummus dip/natural peanut butter/low fat cottage cheese
  • Rice cakes with low fat cottage cheese, tomato/beetroot

I’ll admit that I keep myself on a pretty tight leash but during my current break from training I have been trying to indulge myself as much as possible. There’s been plenty of ice cream, some hearty winter pub meals and plenty of glasses of red wine. The thing for me though is that through both my diabetes and my years of training I have learnt to enjoy eating healthy and I now choose to eat this way because it really makes me feel great. Eating should be an enjoyable part of our lives, you should choose things that you and your family enjoy eating and you should create dishes that look, taste and smell amazing!

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T&D June 5

After such a good week this was not such a good week. Recovery from my previous big training week didn’t go to plan and to get to the end of the week still feeling a bit fatigued and working on some BGL stability is a little disheartening. The catalyst for my not so successful week has been the instability of my BGLs particularly overnight where high’s and lows haven’t allowed me to get restful nights. Subsequently I haven’t fully recovered from my large run volume last week and with my legs feeling heavy all week I wasn’t able to complete my planned sessions fully. On top of this the mental demons and negativity started to creep in again over the week and by the weekend I was in a bad mood, training poorly and my BGLs were all over the place. It’s a vicious cycle for me and one that occurs more often than I would like.

I wish that I didn’t let things spiral out of control like this but trying to balance training, nutrition, diabetes and personal life can be difficult and one poor decision seems to lead to another and another. I do realise that this is happening but it still takes a couple of days for me to draw  line in the sand and really pull things back into line. To do this I go back to absolute basics, make a plan and follow it 100%. My plan for Sunday to get back on track included:

  • Wake up as naturally as possible around 7am
  • Set insulin for morning exercise (2hrs prior) and complete exercise within set time
  • Do about 2hrs moderate exercise (ride) including time with my girl friend in the morning
  • Enjoy one coffee in the morning begin aware that caffine is an insulin inhibitor and cosumption should be minised through the rest of the day
  • Eat a basic breakfast with known carb content and BGL response; for me this is oats with berries and yoghurt
  • Ensure plenty of incidental activity throughout th day like walking to the market, walking the dog, cleaning the house; I find that this assist with my BGL stability as oppose to speanding the day on the couch
  • Follow a strict meal plan throughout the day including lunch, dinner and snacks, all food to have known carb content and BGL response; it is critically important to count cards and bolus dose correctly, NO cheating today!
  • Don’t react too quickly to rising or dropping BGL’s, allow them to settle before treating correctly (bolus correction or sugars and BGL testing)
  • Check BGLs regularly during the day
  • Stay positive knowing that a lot of hard work has already been done, not further improvements can be made training so close to a race and by getting this right my performance will be the best that it can be

All of this is pretty simple and in hindsight I feel a little silly that I can’t stick to what I know works all of the time and make my life a little easier, but that is just one of the challenges of type 1 diabetes.

So it’s certainly not the end of the world and after a good day today I am feeling both refreshed and positive for the coming week and the race. Getting through work, training, packing up my race kit and my bike for trip up to Cairns will make this shortened week fly by. Winter has finally struck Melbourne and I am looking forward to some tropical weather in Cairns.

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New race suit from Scody with Type1Athletic, DSP and JDRF logo’s. Colour worked out perfectly with the prominent blue circle for diabetes!

On a really positive note this week I received my new race suit from Scody which I will be racing in at Ironman Cairns 70.3. As my first suit with logo’s I decided to support the diabetes organisations which I am associated and my local bike shop (The Freedom Machine) which is like my second home. The purpose of these logo’s is to promote type 1 diabetes within the community, get people asking questions and talking about type 1 diabetes. The organisations that I am support are:

I am looking forward to working with both organisations in the future promoting, educating and inspiring people with type 1 diabetes and I am proud to race with these logo’s on my chest.

Also a quick update on the Abbott Libre Flash Glucose monitor which I have now been using for two weeks. I have so far been really impressed with the unit, the accuracy has been spot on for me and the easy of use during every day life and also training is fantastic. I am really looking forward to racing with this device and I believe that it will provide one less thing to worry about come race day. The Flash Libre is now available in Australia and I can highly recommend it.

If you happen to be racing at Ironman Cairns please come and say hello, I will certainly be looking out for other type 1’s when I am up there!

T&D April 17

It has been my biggest week of training in 2016! It certainly feels like it and Training Peaks also tells me that it is. This is a massive achievement after suffering from illness, a broken collar bone, mental fatigue and diabetes challenges over the last 6 months. With two weeks until Port Macquarie 70.3 I am feeling in a really good place and hoping that with my revised training methodology and my recent time-off this will result in a positive performance in the race. This may be positionally, a PB or just getting through the race with no diabetes complications or impacts on my performance.

It has been another challenging week managing my BGLs. After lats week regular hypo’s this week my overnight BGL’s kept running high and really affected my sleep. Multiple bolus corrections were required overnight and trying to get my BGLs to stay stable for morning training sessions was a real challenge. Luckily I got through all but one of my sessions without too many issues, the “one” resulted in a long slow hypo walk home.

T&amp;D April 17 Image

TSS tells the story this week with some work still to do on the bike.

This past couple of weeks have present some of the biggest diabetes challenges, particularly trying to figure out unexpected BGL and subsequent basal pattern changes. Having essentially the same routine these variations are so frustrating and very difficult to control. Trying to manage them I’ve done a several things well and a couple of things badly. With hindsight the best management is easy to figure out but at the time getting it 100% is neigh impossible.

What I Did Well

  • Assessed high and low BGLs each day and adjusted basal rate accordingly (used CGM effectively for this)
  • Made adjustments that would be tracable the following day, that is I would be able to review if the changes worked or didn’t work (recorded basal changes and kept bolus the same)
  • Managed training sessions around high BGLs so that I still got something out of the training session (reduced effort sets when BGLs ran high)
  • Kept my diet really simple and avoided sugars and Hi-Gi carbs (expect when I over-treated a hypo).
  • Generally didn’t stress out when BGLs didn’t track as planned

What I Didn’t Do Well

  • Over-treated a couple of hypos and high BGL episodes which resulted in a see-saw of BGLs for the following hours. Hypo cravings can be difficult to manage especially when coming off a high where you haven’t eaten very much.
  • Drank too much coffee when BGLs were high, I find that coffee seems to reduce the effectiveness of my insulin doses in these situations. I also find that I drink more coffee when my BGLs are high because I don’t eat as much.
  • Made a bolus/basal plan for training and then didn’t follow it resulting in a significant hypo. I got scared by at rapidily rising BGL and gave a small bolus correction, BGLs stabilised and during the next part of the session I hypo’d.

After such a big week I’ve got a couple of days off to let my body recover and then it’s 12 days to get in some final race intensity work on the track, plenty of active recovery, finalise my diabetes and prepare for race day. Great opportunity to be physically and mental 100% for Port Macquarie 70.3 and I really want to get this one right.

Diabetes & Sports Nutrition

As an athlete and a type 1 diabetic nutrition forms a very important part of my life. In terms of sports nutrition I have to think as an athlete first and then as a diabetic to ensure I am fuelling my body adequately. This is easier said than done and trying to get in all the nutrition that an endurance athlete needs whilst also trying to get insulin doses right and manage blood glucose levels (BGLs) is very challenging. Maintaining stable BGLs is critical for me to be able to train/race effectively and also get all of the nutrition in which my body requires for recovery, fuel and everyday life.

The amount of carbohydrates (CHO), protein and fats required by athletes is pretty well understood along with the timing of nutrient intake around training, recovery and racing. Although there are many diet variations and everybody (especially diabetics) has a different approach, I require an amount of CHO in my diet. As CHO consumption directly relates to insulin requirements I do manage the amount of CHO I consume so that I do not need too higher dose of insulin which would increase my risk of hypoglycaemia. This is by no means a LCHF diet that I follow but I would be consuming on average only 300 grams of CHO daily as oppose to the 500 grams plus which may be recommended by sports dieticians for someone training as much as I do.

I find that the biggest challenge nutritionally as a T1D is that you cannot just eat whenever you want and everything needs to be specifically planned for including timing of meals and snacks, timing of training, BGLs and insulin doses (insulin on board). This planning can be 2hrs before a session or 12hrs before a race and the impact of poor BGL control can last for 24hrs as the body recovers from high BGLs or missed fuelling. It goes without saying that keeping BGLs stable and within a good range it critically import to achieving your best athletic performance. My focus and often stress is on this point in particular but I have figure out how I can best manage all of these aspects and get it right, most of the time.

Some things that I try to maintain from a nutritional point of view include:

  • Consume majority of CHO before, during and after (around) training sessions as this is when less insulin is required to process CHO due to the physical activity and I am still able to fuel my body
  • Eat my main meals within 1 hour of training sessions to avoid having to have a post session snack (with insulin) and then another meal (with more insulin) within a short time. This meal timing also always me to get sufficient recovery nutrition in and reduce the hypo risk.
  • Consume low CHO snacks between meals which do not require additional insulin doses (this is along the lines a low carb high fat diet with a focus on protein and good fats)
  • Maintain a low GI diet which I find assists with keeping BGLs stable. This generally involves including low GI CHO in my meals and also adding protein to assist with BGL stability
  • Understand everything that I eat and matching my insulin doses accordingly – how much CHO, how much protein and what type of fat
  • I generally do not have more than 50 grams of CHO in a single meal as any greater than this increases my insulin dose to a level that I find creates BGL instability
  • I always have two hydration sources with me when I train – one is a 6% CHO mix and the other is a no sugar mix so that I can choose which one I consume based on my BGLs and also maintain adequate hydration
  • During race’s I generally consume about 30-50 grams of CHO per hour and include some protein to assist with slowing the processing/glucose release. This can both be from solid food s and liquids. As the duration of an event extends I am able to consume more CHO per hour.

These points are easy to put down on paper but definitely not easy to get right every day. I’ll be the first to acknowledge that type 1 diabetes is difficult but if you put in the effort you can achieve great results.

**All information in this post is from the authors own experience and does not represent professional medical advice. Please refer to disclaimer.

T&D 31 Jan

It has been a good week of training! Energy levels are back up and I think that I have figured out my lack of power on the bike. One week until Geelong Ironman 70.3 and I am super excited to get back to racing 14 weeks after my last race and my broken collar bone.

Having really worked hard on my nutrition and recovery my energy levels have come back this week which was an enjoyable change from the fatigued state I’d been in for the last two weeks. On the bike I focused on a smooth pedal stroke rather than trying to push out power and amazingly I felt stronger on the bike and my power was actually up! Win win there.

My diabetes was pretty good this week with only one major uncontrollable high BGL incident and no significant hypo’s to mention (a small hypo prematurely ended my Saturday run resulting in a slow 3km walk home). The balance of training harder and also eating more balanced out my BGLs nicely. I was able to complete all of my planned sessions and  my afternoon session were especially satisfying as I’ve had difficulty keeping my BGLs up recently and have had many mid-session hypo’s. I have also picked up that I need to adjust my bolus doses when I adjust my basal rates to keep things level.

T&amp;D Jan 30

This week was all about just doing what needed to be done and not being scared of my “perceived” consequences which aren’t always reality:

  • Pre-training bolus insulin dose; I have long been hesitant to bolus dose before a training session but I  need to eat before a session. In the past an increased basal insulin rate and the exercise would keep my BGLs stable, but not the case any more. I am working on a one-third bolus dose for the carbs consumed 30 minutes before a session and it is working well. During longer sessions (+1.5hrs) I also have to consume carbs during the session.
  • Post-training bolus insulin dose; I have a very strong BGL pull-down during my afternoon sessions and to counter this I need to reduce my normal basal rate by at least 50% for 1.5hrs before the session starts. I then have to consume carbs during the session to maintain stable BGLs. Unfortunately when I finish the session the low basal rate and carbs consumed pushes my BGLs up. To counter this I am now giving a small bolus dose immediately post the session to stop the BGL rise. A larger bolus dose is required if I am eating immediately following the session also.
  • Training hard means eating lots; Like a lot of endurance athletes the power-to-weight holy grail weighs on me heavily and I often do not eat enough for fear of putting on weight. The reality is though if you are training 15hrs per week you’re going to need to eat a lot to fuel up and recover. I really focussed on this over the last two weeks and the results have been excellent. This hasn’t meant that I am eating everything and anything in sight but I am just consuming more quality foods and feel better for it. An increase in carbs has also meant an increase in insulin at some meals and although I fear giving too greater dose, I have trusted my pump settings and my BGLs have been pretty stable.

Body feeling better, diabetes under control and I am on track to race next weekend. Some nerves to overcome during the week but I know that I only need to focus on getting through the race and using it as a test and platform for the rest of my season. I’d like to swim comfortably without any shoulder issues, feel strong and smooth on the bike and then push the run hard to really see where I am at. Forget times and places, this is a race against myself and an important learning experience after the disaster of 3 months ago.

Some further race prep planned for this week along with recovery and fuelling to be tip top for next Sunday. Game time!

Happy Birthday?

I have a love/hate relationship with three significant annual occasions; Easter, Christmas and my Birthday. I love them for the obvious reasons; family holidays, presents, food and chocolate. They make me really anxious as a diabetic because of food and chocolate.

As it’s my birthday today I’m going to focus on this and the birthday treat, the cake.

Pana Chocolate deserts on show, had a selection of six for my birthday cake!

Pana Chocolate deserts on show, had a selection of six for my birthday cake!

One of my rules (see my tips) is to avoid refined sugar which means that generally deserts and cakes are off the menu. It’s not that I don’t like them, in fact I have a real sweet tooth, it’s just that I find it incredibly difficult to keep my blood sugar levels stable when I eat them. The moment’s sweetness isn’t worth the after effects for me.

So how do I manage to steer clear of these and if I don’t, how do I keep things under control.

  1. Just say no – the hardest but best solution, I often fail with this one (including last night).
  2. Know what you are eating – by knowing exactly what I’m going to be eating and allowing a little extra insulin for a small piece of cake I can have my cake and eat it too.
  3. Have someone to support you – it’s always hard to say no to temptation so I ask my partner to give me a nudge when I am tempted by something that I shouldn’t eat. She reminds me how sick I will feel in a couple of hours and that usually is enough to then say no thank you. She is fantastic support!
  4. Find an alternate desert/cake – forget the chocolate mud cake, a favourite of mine is a watermelon cake with ricotta, nuts & mint inspired by Team Novo Nordisk team rider Chris Williams (watermelon cake link). I was presented with some beautiful raw deserts last night (pictured above) which are raw, organic and have no refined sugar. These are a great alternate but still need to be eaten in moderation.
  5. Just a taste (if you can stop at that) – last night’s birthday deserts were perfect to slice up in small pieces and just have a taste of everything. This is a perfect middle ground so long as you get your insulin requirements right which can be difficult with these type of deserts where you are never 100% certain of the ingredients.

I don’t like to think that this is putting restriction on me but I know what is important to me and that the sugar hit really isn’t. Keeping my blood sugar levels stable and feeling healthy are more important and in the end spending that time around a table with family and friends provides the best pick me up.

If you are in Melbourne check out the Pana Chocolate store in Richmond or order their chocolate bars online (http://www.panachocolate.com/) for your sort of healthy chocolate hit.

Products and thoughts in this post are the authors only, see Disclaimer.