What I eat.

Lately, people seem very curious about how I’m fuelling my swim training using a low-carbohydrate approach. I get lots of incredulous questions– ‘You eat only THIRTY GRAMS of carbohydrates a DAY?’, and people often seem mystified by my food choices. So let’s go there. Let’s talk why, and how, and what on earth I eat on a low-carbohydrate diet that keeps me full, fuelled for long distance marathon swimming, and achieving awesome diabetes control and a stellar HbA1c of 5.1%.

Here’s the story:

I have eaten a low-carbohydrate diet since about a year post-diagnosis, so since early 2002. I have pretty much eliminated grain-based foods (bread, pasta, rice, cereals), processed foods and most fruits in favour of non-starchy vegetables, meat, fish, eggs and nuts, berries, and full fat dairy products. These days, you’d probably call it somewhere between a ‘paleo’ diet and a LCHF (Low Carb High Healthy Fat) diet. Back when I started eating this way it was not sexy or fashionable, it was just a bit weird. Now it’s kind of in vogue, which is nice because it makes navigating social situations easier and I feel the need to explain (or defend) the way I eat far less often. That said, it’s not that  controversial – I’m just eating real food!

Why do I eat low-carb?

To me, it is totally illogical to tell a person who cannot metabolise carbohydrate to eat it constantly. And yet, this is the advice I received on diagnosis: eat according to the Australian Guide to Healthy Eating. This meant eating 8-12 serves of grain-based foods, high sugar fruits, and starchy veges every day, and taking industrial doses of insulin to cover the food. I dutifully ate according to the advice: cereal and toast for breakfast, sandwiches and fruit for lunch, pasta for dinner. My sugar surged high after every meal, because synthetic insulin is a woefully blunt tool – it is simply unable to work as fast or as sensitively as the non-diabetic insulin response. No matter how accurately I counted my carbs, or how carefully I calculated my doses, the insulin could not effectively deal with the tsunamis of glucose charging into my system, so I rode high, and then swung low, after nearly every meal. It was a crazy rollercoaster ride. I couldn’t exercise – all the insulin constantly circulating sent me crashing low. I even feared sleep because of my volatile levels.

Eight months in to my life with type 1, I remember thinking to myself: this is unacceptable. I have had enough. And I am not prepared to do this for the rest of my life.

So at eighteen years old, I took control; I went searching for a solution. I had read about a low-carb diabetes doctor online called Dr Berstein. Bernstein is an interesting cat: an engineer-turned-endocrinologist who lives with type 1 and for a long time was the sole, heretical voice taking on the establishment and speaking to the benefits and logic of a low-carb approach to managing diabetes. He now has a powerful following of people with type 1 who are changing the diabetes nutrition paradigm through a dynamic online community called TYPEONEGRIT. I ordered Bernstein’s seminal text ‘Dr Bernstein’s Diabetes Solution’ from the USA, saving up my $11 an hour wage from the video store I worked in to send away for it. It took six weeks to come, and when it arrived, everything changed.

Loosely following Bernstein’s protocol, I dropped carbohydrate back significantly and almost overnight life changed for the better. My glucose levels stabilised, I dialled back my massive doses of insulin to 25% of my previous total, the error margins in my calculations were vastly reduced, I stopped having wild highs and crazy lows, I stopped gaining weight, and I could contemplate exercise again. I could do things I could not have done if I’d remained on the rollercoaster: sleep through the night without fear, go for a run confidently on my own. It took commitment, creativity and a bit a discipline, but it was worth it a thousand times over.

Fast forward sixteen years and here I am, taking low-carbohydrate eating for type 1 management to the next level: becoming a fat-adapted athlete.

I started looking into fat-adaptation about four years ago when I was contemplating a long distance mountain bike race. Previously, when racing, I’d broken with my low-carb approach and thrown myself on the mercy of accepted sports nutrition advice: carb-loading to force glycogen into muscles, and relying on gel shots throughout races to fuel performance. I was fuelling with glucose, because that’s what athletes were advised to do and I thought it was the only way I would be able to perform.

It was a total diabetes nightmare. I remember starting an Olympic distance triathlon in Mooloolaba with a blood glucose of 17 after a standard-issue breakfast of oats and banana, having had to reduce my bolus so as not to go low while racing, but enduring two hours on the start line of thirst, anxiety, extreme fatigue – and then a crampy, terrible race trying to run my BG down. This happened over and over, race after race.

Then, a book by an exercise physiologist and a doctor (Volek and Phinney) called ‘The Art and Science of Low Carbohydrate Performance’ arrived on my radar. It wasn’t anything to do with diabetes, but it fitted with my food paradigm and it offered up some mind-blowing thinking: instead of relying on glucose to fuel activity, it is possible to eat in such a way that trains the body to burn fat preferentially to glucose. It made total sense. Stored glucose offers up about 2000 calories of energy, totally depleted in a mere couple of hours – whereas utilising body fat provides an almost endless supply of energy, allowing for consistent fuel for performance. The added bonus for me as a type 1 diabetic was obvious: I could fat-adapt, exercise relentlessly, and still achieve stable glucose levels. The holy grail.

I had to try it. It took about four weeks to properly ‘adapt’ by eating according to a modified macronutrient ratio: higher fat, moderate protein, and very low carbs. I upped my fat intake signifcantly, mainly relying on healthy sources of monounsaturated fat like olive oil, avocadoes, macadamias and walnuts – and also slightly increasing saturated fats like butter and coconut oil, satisfied that the heart health/sat fat connection has been roundly destroyed in recent research. I dropped my carbs to less than 30 grams per day, sourced mainly from non-starchy veges. Protein remained pretty steady – protein makes me feel full, and so is pretty self-limiting.

It worked. I remember racing for hours and hours around that mountain bike course, smiling the whole way, with a perfectly stable BG. I watched the others in the race gulp gels and chocolate and sports drinks but I didn’t need to refuel once. I had energy to burn. I smashed that race and I’ve not looked back.

Since then, I’ve used fat adaptation to fuel races, hikes, rides, swims – and life. I know I can confidently take on long exercise sessions without fearing BG fluctuations when I’m fuelled this way. And this way of eating has 100% enabled me to approach a massive challenge like swimming to Rottnest Island.

You want evidence?

A few weeks ago I did an 8km swim. I only had my long acting overnight insulin, Levemir, onboard (I try never to swim with a meal bolus in my system – it is a recipe for a hypo). I made a Bulletproof coffee so I had some fats in my system to use. I checked my ketones (which signal the extent to which my body is burning fat) and they were sitting at 1.1mmol/L – healthy, and showing I was already burning fat after an overnight fast.

My BG was 5.8 when I started the swim, and when I emerged from the water three hours later it was 5.7. A flat, beautiful line. Again, energy to burn. Ketones running in the 2s at the end, showing my body had bypassed glucose and gone for fat to fuel my swim. The stoke was next level.

Pre and post-swim levels:

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pic-1







So – what do I eat?

I keep it pretty simple. I don’t make complicated food, I am an intuitive cook and I am hopeless at following recipes. I genuinely don’t find my way of eating difficult to cook for or stick to. Here are some examples of easy meals I make a lot:

Breakfast: Eggs, a bowl of ricotta with tomatoes and basil, low carb bread (from The Protein Bread Co for example) with avo, low carb pancakes (again from The Protein Bread Co) with blueberries and greek yoghurt.

Lunch: Some type of protein (tuna, chicken, hard boiled eggs, ricotta cheese) with a giant salad or if I’ve been organised, cooked veges from the night before. Olive oil and nuts are usually mixed through.

Dinner: In summer, generally bbq veges – zucchini, peppers, eggplant – with chicken, fish or meat. I make high fat sauces with tahini, olive oil, yoghurt and lemon juice and use lots of spices. Salads also feature a lot, I make lasagne using eggplant instead of pasta, spiralise zucchini often to have with bolognaise, and find subs and swaps for nearly every high carb meal to make it work – even pizza!

I don’t snack a lot but if I do, I reach for olives, tuna, greek yoghurt, cheese, veges and dips, and nuts.

Training food? Nut/protein balls (home made) and 90% dark chocolate.

Easy. Simple. Fresh. Fast. Satisfying. Natural. Delicious.

This way of eating has supported both my health and my sanity. I run an A1C in the low 5s, and I feel I can take on any physical challenge and figure out type 1 to make it work. It’s empowering to feel this in charge of my disease.

Type 1 will always throw me curveballs, but I feel that choosing to eat this way can help me minimise their impact, while fuelling my body in a way that enables me to smash my goals.

Kilometres this week: 30

16522157_10154954591101241_1173147038_o       sswim

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22 thoughts on “ What I eat.

  1. Thanks Bec, this was a really good read.
    Could you consider doing a blog post on your process of fat adapting and what it was like for you,?

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    1. Hi Jodi. The process wasn’t very painful for me because I was already eating a relatively low carbohydrate diet, I just dropped carbs down a bit further. Others report going through ‘keto flu’ which is a period of a week or two of feeling lethargic and generally pretty yuk while their bodies switch over to relying on fat instead of glucose. The answer is discipline and keeping the end goal in mind. Volek and Phinney’s excellent book ‘The Art and Science of Low Carbohydrate Living’ covers keto flu in good depth. The other resource to take a look at is Prof Tim Noakes’ work on ‘Banting’, including the delicious book full of wisdom and recipes he’s produced with Johnno Proudfoot called ‘The Real Meal Revolution’. They point towards increasing sodium as the main answer for some lightheadedness and lack of energy during a transition across, which counteracts the kidneys excreting more fluid due to lower carbohydrate consumption (carbs make you hold onto water). Hope that helps x

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  2. I’m so impressed. I’m a carb addict with T1. Love to bake bread, cakes, make fresh pasta. I would love to have stable BG but I suck at getting rid of the carbs. Summer is okay, since I like salads in summer, but in winter, I like starchy food. I’m so happy to see how well you are doing and I hope one, tables will turn and help me realise the carbs are not worth the rollercoaster… Thank you for your inspiring blog. Love from Belgium, Europe.

    Liked by 1 person

    1. Cathy I am stoked that my blog has reached Belgium! Swapping out some of the carbs for alternatives might be a place to start: for example, spiralised courgette sautéed in olive oil and lemon juice instead of pasta is light, low carb and delicious, and you can still have a rich pasta sauce with it. I even make pizza low carbohydrate using easy swaps for the flour in the base. It doesn’t have to be as extreme as my approach – which is designed to support my training load – but even dropping carb back for one meal per day can help make a difference. I find breakfast time is when I am most insulin resistant, so that’s the time to really make sure I eat low carb, as it sets me up for a stable morning. You might be the same?

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  3. Thanks for sharing this. It is my experience of T1 that keto is the best diet for T1. It seems difficult to convince clinicians of this so your blog will hopefully add to the evidence. How many similar blogs will it take to tip the balance? Who knows but what is important to put the information out there for others to discover. All the best. Ian

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  4. Excellent!

    Although not diabetic I have been athletic all my life essentially powered by ‘sports nutrition’ carbs but been on LCHF for last 4 year. Feel great and can go on ‘forever’ without so called bonking that we took as normal on the sports nutritional concepts!

    One detrimental aspect of LCHF for me is that I freeze in winter and when swimming.

    Is this due to becoming more skinny (lost 3-4kg without trying) or lack of carbs to ‘warm’ me during swim/winter?

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    1. Wow, I’ve not found that I am sensitive to cold like you describe. It’s very possible it’s due to lowering your body weight, but I know that sensitivity to cold is a classic feature of low thyroid – have you had yours checked?

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      1. also not had Raynaud’s disease checked as it is my fingers that really freeze first! They look like they will snap off!

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  5. Wow. This is a really fantastic read. My daughter is T1 and often unstable. I am inspired to take a small step toward lower carb foods, and will definitely try your Amazeballs recipe as an alternative to the Yum balls I already make for school lunches. Thank you.

    Liked by 1 person

    1. I have recently had an amazing breakthrough by eliminating potato from Miss K’s diet. Really wild and unpredictable numbers are suddenly so much more even. And her bloated tummy is lessening. Have you ever heard of potato negatively effecting blood glucose levels before?

      Liked by 1 person

  6. You made reference to short and long acting insulin. Have you ever had experience on being on a pump? If so, how did you manage Diet and exercise? Being on a pump means on only have short acting which means exercise typically means hypos unless I allow my sugars to creep up beforehand.

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    1. Hi Emily. I’ve never pumped. I prefer – for both diabetes management and practical reasons – to use injections. I would struggle manipulating rapid acting insulin around exercise – it’s why I try and exercise fasted, with no meal bolus, on background levemir only. These are the conditions under which I can feel confident. Some people are adept at manipulating basal rates in the time leading up to exercise and during exercise to ensure they remain stable, and this is your challenge. I think though, for both people on injections and insulin pumps, exercising with an active meal or snack bolus onboard (ie within three hours of eating) is a recipe for disaster. Exercising under basal conditions only removes two key variables (food and rapid insulin), which should make things easier. Is that an approach that could work for you?

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  7. Hi Bec – thanks for the informative post. We have started looking into low carb eating for my son (18 Dx at 4) – he has had a really hard 3 years with his levels and getting his hba1c down to an “acceptable” level. He is conscious of his food intake, uses a matrix to calculate his insulin (pens) and exercises every day yet has a consistent hba1c around 11. He is already conscious of carbs and limits his intake – focussing more on proteins – but it’s still not working for him.
    My main question is regarding LCHF and burning fat for energy in exercise. I noticed that obviously does produce ketones but is not of a concern to you? Are your blood gasses acidotic when burning fat for energy? Does it make you unwell in any way as elevated ketones do under normal circumstances (ie not purposely burning fat for energy).
    I am attempting to eat relatively LCHF for my own health journey and it is something that we can do together if it’s going to help get him towards that lovely flat line.

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    1. Hi Tracey. I will preface this response by saying I am not a medical professional. However the reading and experimentation I have done around ketosis versus ketoacidosis makes me feel confident to run in a mild state of ketosis, and that it is not a dangerous state. This is probably the best explanation of the difference I can find: https://nutritionalketosisforhealth.com/what-is-nutritional-ketosis/
      Note the graph about 3/4 down the page – I go for the ‘green zone’ and test to ensure I’m there. I’ve never felt unwell producing low level ketones by burning fat for energy. If ketones accumulate to considerable levels, then of course DKA is something to worry about and you should act quickly.

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  8. Hi Tracey, we have the same experience as you. It’s so good to read about people who have the same approach to health an T1DM. It’s about my husband. He has T1DM and we all eat same as you. We all became healthier. He was diagnosed in 2013 may. After we switched to LCHF/Paleo he was in his honeymoonfase for 2 years (no insulin was used in this time). We also have a blog: https://diabetesmaardananders.wordpress.com (only in our language: Dutch). Thank you for posting your experience!

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