Saturday, December 13, 2014

Towards a Healthier 2015

In the blink of an eye, we're counting down to the end of 2014. At this time of year, I always find myself reflecting on the year that was. As with most years, Twenty Fourteen had highs and lows for our family. We had many wonderful and memorable moments with our loved ones. The lowest low was V's father passing away. Indeed, all the sad and bad moments this year had to do with serious illness and deteriorating health among some of our close friends and family. Health is wealth, the old cliche says, but how often we take it for granted.

And that's what this post is- a long and rambling contemplation on food and wellness and where my life is headed. There's no recipe in this post but there is some food for thought- for myself and perhaps for some of you reading it. I guess I've been writing this post in my head for over 3 years and this week, I finally decided to type it and hit the publish button.

In the summer of 2011 in St. Louis, I was about two thirds of the way through a fairly uneventful pregnancy. We were happy and excited to welcome our baby daughter. My OB ordered a routine glucose tolerance test- and I failed it. I had gestational diabetes. I was surprised and not surprised at the same time. Surprised because I had the hallmarks of being healthy and low-risk with a normal BMI. Not surprised because I have a woefully strong history of diabetes on one side of my family and I knew very well how the genetic dice was loaded.

Things happened rapidly after I was flagged as having gestational diabetes. The very next day I saw a diabetes counsellor who taught me to finger-prick and test my blood glucose 4 times a day- upon waking (the fasting number) and an hour after breakfast, lunch and dinner. This was torture enough for me- I hate hate hate needles. It was all too much- I burst into tears in the counsellor's office but she was as kind and reassuring as can be. I also met with a nutritionist who taught me the basics of carb counting. The strategy was this: make sure I restrict carbs to 200 grams a day (budgeted over meals and snacks), do some brisk walking for exercise, test blood glucose, record my numbers and make sure they stayed within the acceptable range. If I could manage to control my blood sugar with diet and exercise, fine. If not, they'd dose me with insulin.

My baby's health was at stake. There was nothing I would not do for her. I pulled my act together and I was meticulous. I did everything I was told- counted carbs and walked for 10 minutes after every single meal. Working full time and trying to get stuff done before I went on maternity leave, I set alarms and did finger pricks at my desk. The numbers were always within range. My OB remarked that if all her patients were so compliant, she would see many fewer complications.

I had nine(!) friends and acquaintances who were pregnant at the same time as me. Everyone else was indulging in their favorite foods, eating for two, giving in to cravings. My life looked quite different. But at the end of my pregnancy, at a time when most women are feeling distinctly heavy and encumbered, I was feeling lighter and fitter than I'd ever felt. This whole torture of finger pricks, carb counting and brisk walks in the St. Louis August heat- it was working. Lila's birth was uneventful- although she was a smaller-than-expected baby and my OB and I realized that in my zeal, I had probably been stricter with my diet than I should have been. Two weeks after giving birth, I was back at my pre-pregnancy weight.

Gestational diabetes is situational; it resolves when the baby is born. Or more precisely, when you deliver the placenta, which is what produces the hormones that lead to insulin resistance. But a graduate of gestational diabetes learns some important things about her body's ability (or the lack thereof) to process carbohydrates and sees a big red flag that there is type II diabetes in her future if she's not careful. So in getting that warning sign, I will say that gestational diabetes was the best bad thing that has happened to me.

You'd think this episode would have changed my life immediately and forever. It did not. Humans can be exceedingly resistant to change. There's always an excuse and usually a laundry list of excuses not to change our habits. There was a new baby to care for and the next year went by in a blur. There was no mental space or physical energy to make any lifestyle changes. The year after that we moved to a new state and life just went on as usual.

Earlier this year, we went to visit our families in India for a month. Seeing older relatives is a form of time travel because you can see your future self reflected in them. I was seeing my extended family after 5 long years. Almost everyone I know has diabetes and its painful complications. I'm not just talking about those who are affluent and have unlimited access to food. The nice lady who cleans my aunt's house and who struggles to make a living as a maid also has diabetes. Everyone is on medication and many take insulin shots. Almost no one seems to have received any rigorous counseling about nutrition and exercise. Many have had perilous cardiac surgeries. I saw people with vibrant minds who are trapped in a body that is too heavy, with joints that are literally unable to take the weight. One close relative is losing her eyesight because of diabetic complications. In a nutshell- I was scared straight.

It is not like I haven't been trying to do better all along. I read books and try to nudge my eating habits in the right direction. I've been struggling for years to get into an exercise habit. Part of my resistance to real change has been the feeling that things are not so bad the way they are- after all, I'm not overweight, and I have tons of energy and no debilitating symptoms per se.

But the logical part of my brain knows the evidence is mounting. My energy is more mental than physical and frequently a mind-over-matter thing. Climbing a couple of flights of stairs leaves me panting- this is pitiful for my age. When my toddler wanted me to jump with her, my sister overheard and commented that she hasn't seen me jump since the 1980s. I've been labeled a bookworm and a couch potato since the days of primary school and I fully embraced that label. My BMI may fall within the normal range, but I have no muscle tone. I participated in a research study last year (it was to study the effect of walking on body composition) and the scan showed that I have a very high proportion of body fat. This is called being "skinny fat", where even a person of normal weight has fat deposits coating their organs- a very high-risk situation for a variety of diseases.

Disease is a complicated thing, a subtle interplay of genes, environment and lifestyle factors. But you have to do what's in your hands even if there are no guarantees of dodging major illness. A friend of mine was athletic and robust and healthy as the proverbial horse, that is, until she was diagnosed with lymphoma. She told me that her underlying strong health helped her survive the harrowing treatment and now she's thriving again.

All these things have been running in my head for the last few months, and I sat down and identified two goals. My experience with gestational diabetes was hard at the time, but in reality, it showed that a modest increase in exercise (just brisk walks!) and a modest decrease in carb intake gave me good results in a matter of weeks. So those are my two goals at this time.

Already, I've been exercising more this year than I did before- walking and swimming. I'm gingerly getting into the exercise habit and will talk more about this in a future post if anyone is interested.

As for eating, what constitutes a "healthy" diet is a very loaded question. I'm interested in answering the question for myself, for my own body and its challenges. I don't know or care what the universally best diet is. Humans being omnivores, I highly doubt there is one ideal diet. There are likely many different ways to get to the goal of having a favorable body composition with good blood sugar control.

I eat a mainly plant based diet along with eggs and dairy and that's what I intend to keep eating. What will change is the proportions of foods in my everyday meals. In my case, I've identified the problem as eating excess carbs and for the last couple of weeks, I've started to replace some of the carbs with lots of vegetables. My goal is not to eliminate carbs or even to drastically cut them but just not to eat more than my body capable of handling. Beans, sweet potatoes, lentils are very nutritious and will be a big part of my diet. But I will find ways on cutting down on rice, tortillas, pasta and noodles at least for my everyday meals, while replacing them with a lot more cooked and raw vegetables. There's reason for me to be optimistic because I have several things going for me- I already cook in a "veggie-centric" style and know how to prep vegetables- I just have to ramp it up. I don't have a sweet tooth and rarely eat desserts anyway.

To change my habits, I have to know myself and work with myself, and not fight against my basic nature. I don't like drastic changes. However, subtle nudges in the right direction quickly become habits and stick with me for life. I am a moderator rather than an abstainer.

Publicly stating nutrition goals often attracts criticism. There will be people who think I'm going too far ("Just eat less and you will be OK, why vilify carbs?") and others who will think I'm not going far enough ("You won't be in the fat burning zone unless you cut out all beans and starchy vegetables"). But the reason I'm putting it out there is because making a public commitment is a strong motivator for changing habits. Because I was so sad to see diabetes and other metabolic disorders eroding the people I care about, and would like to talk about it. Because this discussion might strike a chord with someone else who is thinking about these issues.

Happy Holidays and Merry Christmas to all, and I will see you in the new year! We'll continue to eat well on this blog, I promise you. 

87 comments:

  1. Hi Nupur, sadly I have had same 2014 like you & also had to go through GD routine.. Agree 100% that GD was actually a bad best thing.. I would like to read more on how you managed to stick to the exercise part.. Thanks for writing this.. This has struck a chord.. And wish you & your family a healthier 2015

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    1. Trupti- I'll definitely write another post about my efforts to get into the exercise habit. Wishing you the very best for next year too!!

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  2. That was such an amazing post Nupur. Once we reach the mid 30s age, all the hereditary complications start to loom right in front of us -- so I guess the best thing to do is to push them as far as we can with diet and exercise.
    My family has genetic kidney problems -- one that took way too many lives already including my dad -- and keeping a healthy weight and taking care of blood pressure is one of the most important things to do.
    Just like you I have a very normal BMI and I'm quite energetic but I think of myself as 'skinny fat'. Exercising is something that keeps getting pushed back but I guess there is no way of getting around it. Hopefully I'll motivate myself to start an exercise regimen in the new year.
    Thanks to your inspiring post and you have definitely stuck a chord with me :-)
    Here's wishing you and your family a very Happy Holidays. Enjoy!!

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    1. Thank you for this nice note, Pavani. I hope you and I can get moving next year and make it our fittest yet! Happy Holidays to you and your family!

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  3. Nupur this post is heartfelt, having suffered health issue and still suffering health compliance issues this post has shaken me up. I need to do something about my health goals now that I have compelete 2 yrs on medication and have stability. Now I must aim for better monitoring and stricter goals. Thanks for the motivation and inspiration.

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    1. Anjali- I hope we can motivate and inspire each other in the coming year!

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  4. Dearest Nupur,

    This post struck home and close to heart and mind like nothing has before although I have loved, shamelessly copied recipes from, chuckled and LOLed to all of your posts right from your NY student days. I heart you for the baby steps you have and will be taking to avoid the Deadly Diabetes in your future. You see my mum became severely diabetic in her late thirties when we were fairly young and in a time when the disease and its long term implications were very poorly understood. To top it atleast in Goa there wasn't any doctor even familiar with treating it so she was left with no choice but to allow her GP to treat her as best as he knew how which to say the least was poor. Coupled with immense stress in her personal life(to do with my Dad's illness) her disease escalated over the years affecting her nerves and giving her diabetic neuropathy which left her limping and in immense pain all the time. She was and still isn't over weight and intact on the very slim side. Was a national level badminton champ in school and college and the captain of her kabaddi team all thru school so you see always healthy. Yet, very strong hereditary tendency towards type II diabetes from her father's side. Her eating which was pretty normal until then went haywire. She began craving all sorts of banned food and indulged in them voraciously much to our collective dismay and worry. It is ply recently after I began a healthy lifestyle(I suffer from cancer) that I was able to coax her into changing her eating and stress taking habits and am glad to report she has been able to bring her medication down to half of earlier and feels much more healthier and hopeful. It is a dark, dark disease so I pray you will always have the willpower to stay on track and avoid it for all times to come. Sorry for such a long winded comment but couldn't help myself.

    God bless.

    Deepa

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    1. Thank you for sharing your story, Deepa! Your mother has been through a lot. Diabetes (more than most diseases) is very much about management rather than medication. It takes a lot of good information, family support, lifestyle changes. It is a lot of ask of a person. But there it is. I'm very glad your mother has your support.

      On another note, I want to send you hugs and best wishes as you fight cancer. I'm cheering you on!

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  5. Nupur,

    First let me thank you for such a thoughtful, sensible and well-written post. It resonates with me in a big way because, for the first time ever, I am taking a long, hard look at what life could be like if I don't get my health in control. I have been overweight for a long time and while I have lost lots of weight a number of times in the past, I have always slipped back into old habits. All the advice my mother has given me over the years is now starting to make so much sense and I just pray I have no hard lessons to learn. I have a good understanding of nutrition but always espoused the 'what's wrong with carbs' theory. We'll, there's nothing wrong with them but many need to be eaten in strict moderation. I have to work on the relationship I have with rice and bread. Sweet foods were never an obsession, I would go through phases of craving them but now find most of them too sweet and tend to steer clear. So, that part is relatively easy but cutting down on bread and rice consistently is not and this I am working on.

    Sugar in all its varied forms should be a visitor but not a permanent houseguest.

    I wish all of us the best of luck with our health and personal goals in 2015.

    Amber

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    1. Amber- I love that- sugar as a visitor but not a permanent houseguest! Thank you for sharing your story. I hope we're all able to talk each other through making better choices for our bodies in 2015. I suspect that when we start seeing rewards, the choices will stick.

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  6. Hi Nupur, long time reader, rare commenter here. I can relate to some of your experiences - my baby boy is 6 months old, and I have completely fallen off the exercise bandwagon. I was training for a half marathon when I got injured, and soon after, found out I was pregnant. I love the outdoors and hiking, but we live in New York City (your former home!), and I blame the weather. I've gone back to work, and we just moved, so I have also conveniently blamed these changes - mostly positive changes I should say. Anyway, your thoughtful post has provided me with the nudge I needed.

    Heartfelt condolences to V and your family. And best wishes to you for a healthier 2015!

    RS

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    1. RS- Oh how I love NYC. I do agree that winters can get long and harsh! I hope you're able to find a fitness option that fits in with new motherhood and juggling work and all. It is hard. Maybe you have a progressive workplace that will let you go exercise during your lunch hour? Thanks for your kind words and best wishes to you and your family!!

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  7. I am sorry to know about the demise of your father-in-law. The low points in our life make us analyse and reflect on things we take for granted - which includes our health. I have had several lows in the past few years and the demon I have to fight is high cholesterol in our case. The progress in my career has been sadly inversely proportional to my health and I have reached a point where I have to do something about it. We have tried several high protien diets in the past like the south beach diet but we couldn't continue them lifelong as we faced other challenges like gout. We had to switch back to our traditional diets with some healthy modifications like avoiding sugar and processed carbs, preferring whole grains and cooking mostly at home than eating out. We eat only vegetarian food unless we are traveling which is only couple of times a year. We have included seasonal vegetables and fruits in all our meals and enjoy vegetarian protien sources regularly. The challenge was to include regular exercise in our lives. I use to work out regularly at the gym before getting married and had an athletic well-toned body. I lost all that due to negligence over the years but my body retains what is called as 'muscle memory' and surprisingly shows quicker results with dedicated weight training and workout. I also go for Zumba since I love dancing and group exercise sessions. My husband enjoys brisk walking more than other forms of exercise and does weight training with me. We have made these changes very recently but have seen really good results. This year was challenging in many many ways both at work and at home and our biggest accompishment was being able to bring down the cholesterol levels significantly and not having to take medication to lower it. Our doctor had given us a last chance before putting us on lifelong medication and I am proud to say we did well. I can't tell you how happy I was to see the reports, it was certainly the biggest high I have experienced in a long time. I was not this happy even when we bought our first house. Health is indeed wealth and what better gifts can we give ourselves and our families than to be healthy and happy. My best wishes to you on your journey to better health. Cheers to a healthier 2015!

    - Priti

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    1. Priti- That's wonderful that you're getting back into the groove of working out regularly. And yes, it is key to find something that you enjoy doing. I think I'll try some group fitness classes next year as well! Congrats on making changes and avoiding medication! Here's to a wonderful 2015 for you and your husband.

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    2. Hi Priti,
      Great to know that you conquered the cholestrol numbers without any reliance on medication.Really bravo!
      Do you have any tips like specific oil,food etc.Would help me greatly.thanks.
      Thanks Nupur for this inspiring post.Feels good after reading the post and the honest responses from everyone with their experiences.Chees to you for a healthy 2015 and more.

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  8. This is such an inspirational post. Good luck with all your future successes - you will succeed! Three years ago I discovered yoga with a fantastic teacher who makes sure you are doing the poses correctly, not pushing through them. I have lost 20 pounds and gained muscle and stamina that I would not have thought possible as I am in my 60's. Bless you.

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    1. How wonderful!! You are an inspiration! Thanks for sharing this.

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  9. hello Nupur,
    Your post resonates with me like no other at this point in life. This year goes down as the worst in my life. I lost both my parents over the past 2 months; both me and my sibling live in US. For 2 months we were in India taking care of dad; and dad passed away September; we returned end of September to US and end of October, mom passed away all of a sudden. Healthy, but got an infection that took her away in a day :( Devastated and this grief is beyond anyone can put words into. Mental, physical, emotional, psychological, financial, legal and everything else - all in addition to extreme grief and huge, irreplaceable personal loss. Through this experience, I can tell, to be able to live through this stress, it needs a lot of physical strength and a lot more inner strength to bear the loss and I'm getting it from being highly spiritual. I've been a very sick child all my life and after moving to US in 2001, my husband forced me to gym. I hated it but had to do coz he was big into it. From 2008, I've been regular in my gym and trust me, yoga, cardio and strength training all coupled together have given me new lease of life and fitness. Now I look back and wonder maybe God gave me this strength coz He knew what was to come in my life this year and prepared me to face this devastation. Exercises and cardio for physical strength but yoga for inner strength. For what I'm going through now, only physical strength doesn't help; I'm experiencing the true benefits of yoga I've been doing for past 6 years now.The biggest motivator for me to head to the gym is the thought that towards the end of my life, the only thing that'll remain with me till my end is my health; nothing else.

    Can't wait to be done with 2014 and welcome new year with plenty of blessings, peace and happiness from divine parents from next year and onwards....

    Take care and God Bless
    Meena.

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    1. Meena- Gosh, what a devastating year you've had. Please accept my deepest condolences. I hope 2015 is a year of healing and calm for you.

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  10. I am so sorry to hear of your Father-in-law passing away. It is very difficult to deal with such a loss.

    Reading the post,I found myself falling through a spiral of time and going back in time. Maybe that sounds filmy, but I was nodding all the time and thinking, I went through the same thing.I had GD and the last trimester was full of emotional turmoil, the initial part, when I tested and was found positive for GD. My diet routine was strict and all of it was trial ( my dietitian was a flop, and I am saying that mildly) I lot weight in my pregnancy ( not the baby) and was fit, but over time, things changed and I went back to eating anything ( read, left overs, leftover from S's food, it was made of all the good stuff and ghee), emotional up and downs also are a cause of weight gain in my case.
    I am not a gym person, I had joined last year and then the enthu fizzled out in winter.
    I plan and sadly those plans sink into a trench of indifference. In my case, I have lost the will, to do anything. Sounds pathetic, even as I type it.
    My plans are to reduce carb intake ( specially rice and my love for all things pure carbs )
    I hope I can implement it. I need a happier me.

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    1. Manasi- For folks like us, the gym is an alien place. I feel like I don't belong in a gym. No wonder you didn't want to keep going there. But I beg you- don't give up, don't even think of giving up. There are tons of other exercise options. From dance classes to brisk walking, there are many things to try and you're likely to enjoy one of them and continue with it. Make a pact with your girlfriends and try a different activity each month of 2015! Get excited and blog about it. You can do it :)

      About reducing carbs, yes, it is key for us GD veterans. And you'll be surprised at how quickly the cravings vanish when you start cutting down on simple carbs. You won't even miss the pure carbs.

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  11. It takes a to make a public commitment as you are Nupur- Wish you the best!

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  12. What a wonderful post, Nupur! I would definitely love to read more posts in the series :)

    I didn't have GD, but I must admit that I was really nervous from the time I gulped down that ridiculous sugary drink till I got my results, as I too have diabetes running in the family from my mom's side. My mom never had any issues with blood sugar until this year - she was diagnosed with a borderline diabetes (her mom had severe diabetes), so I know I too, am at risk.

    My goal for 2015 is to get back to exercising and take care of my health which I have been ignoring after my daughter's birth. I love group ex classes but I HATE exercising alone. Running around toddlers keeps you moving, but is no substitute to exercise.

    I have a very demanding daughter who constantly wants her mom, and it gets very difficult for me to do anything. It's totally fine if I leave her with her dad for the whole day, but come bedtime and it's an entirely different story. So the only time I possibly can get is on weekends. She is 21 months now and still wakes up multiple times (not for food or drink). It's exhausting as she wants me to put her to bed, and won't settle with her dad whenever she wakes up. It's been close to a year since it started - after she fell sick with ear infection. Now we have resorted to sleeping in her room so that at least we get a good night's sleep. We have been working on it and hopefully it will change soon.

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    1. Amruta- boy oh boy do I sympathize with you! Lila's sleep patterns have stabilized only a few short months ago, and she still wakes up in the middle of the night 3-4 nights a week. It will get better soon for you, I hope. Meanwhile, I hope you're able to carve out some time for me-time and exercise. Maybe exercise/dance videos would be more fun and make you feel like you have company while exercising?

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    2. You are the first person who's had similar problem with their kid as I am facing. Every single person I know with babies my daughter's age sleep like babies. I thought I'm the only person in the world facing this issue... hehe... So did you consult a sleep expert any time? Also, can you share anything that worked for you? Thanks!

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  13. I actually had tears in my eyes as I read this post, simply because so much of it has hit closer to home. Our family also has a history of diabetes from both sides. Add to that, I'm pretty overweight. Exercising for me is never an issue, but cutting back on food is. My doctors think I cannot conceive until I lose weight, which is true as well. They believe I lack willpower but that's not the case. I'm tired of explaining that I just get really, really hungry. You can't expect me to workout for 90 mins and then eat just 1 phulka right? I've always been a big eater and just cannot help it. I become cranky, moody, depressed if I don't get my quota of food. No dietician seems to get this. Do you have any pointers on how I could reduce my hunger? Because that, right there, is the problem. I workout, so somehow if I can get myself to eat less, I am confident of seeing results. You are inspiration, Nupur. I mean it from the bottom of my heart.

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    1. Dear Anonymous,

      I will highly recommend Rujuta Diwekar's book 'Don't lose your mind, lose your weight' to you. Reducing portion sizes is really easy if you split your meals into smaller meals and eat every two hours instead of eating big meals 3 times a day. Since you know you will be eating your next meal soon and you are not starving when you sit down to eat next you will not overeat. This will help improve your metabolism, keep you energetic, will never let you feel starved and you will still lose weight. The moment one should stop eating is when one is not hungry anymore instead of eating till one is full. Another signal our body gives us to let us know when to stop is when the same food doesn't taste as delicious or as fulfilling as few spoonfuls before, if one is eating without any distraction one can sense this immediately. This is especially helpful when indulging in sweets and desserts. Please give it a try. Also, after a 90 mins workout it makes no sense to eat one phulka. Post workout you need something with high protein to help your muscles recover. As Nupur mentioned above try to replace your simple carbs with complex carbs and protien so for example instead of eating more phulkas/bread eat more sides - have vegetables, a bowl of dal and raita/salad on the side. This truly helps one feel fuller for longer. Good luck!

      - Priti

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    2. You're not alone in this! There's plenty of reason to be optimistic. So please hang in there!

      YES- I've been reading about this a lot and there is a reason you're hungry all the time and it is totally possible to fix this easily. What Priti said is absolutely right- after a workout, you need a nourishing meal of slow-burning fuel like raita, dal, subzi. I'd skip the roti and rice altogether because your frequent hunger is likely due to blood sugar highs followed by a crash.

      Don't under any circumstances starve your body- feed it really nutritious food, including good fats from nuts, avocados. 90 minutes of exercise sounds like a lot. I am NO expert on exercise but please don't punish yourself- work out smarter and not just harder.

      Shame on whichever doctor blamed you for a lack of willpower. Shows you how incompetent they are.

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    3. weight loss has two aspects. one physical another more imporatnt related to mind. no its not will power. mind is like a child. it needs big ROI to do something consistently. my exprience, having good weight loss in the beginning helps you to teach ur mind how to not crave for unnecessary food. pl do not starve. to have that kind of a start, there are two things.
      1. do a GM diet. dont woryy abt what ppl say. it will not kill you. traet it as de toxifier.,in 7 days, you are guranteed to lose 3-4 kgs, which is significant. then on start building on doing all right things... one thing u can do is , try to eat food by suset & 2 hrs b4 sleep. wise men hav esaid.. great breakfast , & frugal supper..

      2. option is go for panchakarma. 15 days will knock off 5-6 kgs. more than that all ur body organs get rejunavated.. if u r US ,also, there in house panchkarma treatment centres.. but be prepared for a tortourous diet/ayurvedic concoctions for 45 days :-( but worth it.

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    4. With all due respect, no extreme diets, detox or concoctions are necessary to lose weight.

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    5. sorry, its not my intention to promote extreme diet :-) just said how I motivated myself. I hate exercise & I live to eat :-) btw panchakarma is a proven medical process of ayurveda being prescribed/ practiced since the time of Charaka & Sushrutha. detox is essential part of keeping body &mind healthy. if you see, the weekly fast recommended & follwed in Indian culture, is one aspect of detox. Ayurveda recommends once a year Panchakarma. btw, I am not a ayurveda apologist & not trying to promote on your blog :-)

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    6. Dear Anonymous,
      I can totally relate to what you're going through coz I've been through the same issue few years ago. I started exercising and took it slow and steady until I was ready to start high intensity workouts. The difficulty I had was I ate chapatis with curry right after my workout; but then woke up several times through the night feeling starved. After discussing with a nutritionist and hubby, I figured I was lacking protein. Now my diet is completely changed; especially on the days I do high intensity workouts which I do twice or thrice a week. 3 hours prior to workout, I take a protein bar (I usually get mine from Costco) and drink close 1+ gallons of water a day. And within 45 minutes after my workout, I drink protein shake and also eat a high protein meal. This has worked wonders for me.

      Thanks,
      Meena.

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  14. So sorry to hear about your father-in-law, Nupur. But thank you so much for this post. It makes such a difference knowing that there are other experiences like mine out there.

    I could have written this post myself -- everything you describe has happened with me, including the low birth weight of my son, my post-pregnancy weight re-gain and my skinny fat (my son is a few months younger than Lila, I think my husband Palash told you). I just got back from India ten days ago. I went because my mother had a massive heart attack that it was doubtful she would survive (she has, thank goodness), brought about in part because of diabetes related complications. She's had three close calls in the last 5 years because of her difficulties in controlling her blood glucose (understandable for someone who loves cooking and eating good food, esp'ly given she became diabetic in her early 30s, same as my brother).

    Anyway. One thing that's lit my fire now is that my fasting blood check last week (I do this every month or so after gestational diabetes) came out at 120, the outer edge of prediabetes. The next three days values were between 105 and 110. Yesterday and today they're back to normal. The values seem to be correlated with a bad cold that my toddler gave me.

    This has been the red flag that I needed. I see the doctor for more bloodwork today, and am trying after almost three years to return to my GD regimen of food and exercise (weights and cardio at the gym, with a buddy, since I don't have enough discipline for anything else). I dragged Palash for his too, just to be on the safe side re. health.

    Thanks again for writing about this. It makes me feel so much less lonely and guilty about the ongoing battle.

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    1. Hi Vasudha- it is so good to hear from you! Yes, there are so many of us facing the same challenges with our health. I'm so sorry about your mom but glad she is recovering.

      I have a good feeling about 2015. I think it is going to be a good year for us, with changes for the better!

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    2. This is a good, thoughtful post. I work in the medical field, but I am in a similar spot- except I have gained weight not been exercising, and cholesterol at least has gone up. I am worried about prediabetes too...thanks for the inspiration, this is making me think :-) .

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  15. Thanks Nupur for this post. I am overweight. After the birth of my baby I barely do take care of myself. I am looking forward for a healthy fitter me in 2015.

    Wishing you the best. - Madhavi

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    1. Madhavi- you can do it- we'll do it together!! Best wishes to you too.

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  16. Deepest condolences to your family for you FIL passing away, Nupur. Life gets difficult as one grows up. For the past 5 years I feel this weird sadness everytime I go to India (or my parents visit me here), because I see the oldage setting in, hair whiter with every visit, more wrinkles and more weakness setting in. It is a sad and inevitable truth that all of us need to face, seeing our parents age. Easier said that done, as is always the case :(
    Your GD story resonated with me as well, because I was diagnosed with pregnancy jaundice in my third trimester and which put me on a strict no-fats diet (coz it is a liver disorder). My pregnancy was overall extremely healthy, and even after a c-section my recovery was really quick (thanks to healthy food and exercise). However, I fell off the "healthy lifestyle" rule when the baby was 6 months (and when my mom went back to India). He is 15 months now, and I have been struggling with finding time to devote to exercise. And this is even after cutting out on all the time eating activities (no TV, minimal facebooking etc). Also, I had started eating LOTS of chocolates (one of the major source of un healthy in my life) while I was breastfeeding the baby, because I found that whatever I ate, I was not putting on weight because of all the breastfeeding. Inspite of being in the healthy weight BMI, I was experiencing low energy levels and mood swings because of all the sugar. Only this past month I have shaken myself up again and have gotten back to my favorite activities - kickboxing classes (I used to do these a lot pre-baby) at work and weekend hiking. I have also promised myself a non-food reward if I manage to get in exercise atleast 4 days/week for 1 month. Lets see how far I get. Good luck with your getting fit regimen too. I know you will do well!

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    1. Neha- that's wonderful that you've identified the problem and also started kickboxing and hiking again! One step at a time, we can all do it. Thanks for the inspiration and encouragement!

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  17. your writing is simple, subtle, unpretentious, lucid & finally honest to the core. I am certain ,you must be good person.
    I love your posts. & this one is no different. i am following this for last 7 yrs & always go back with a smile. Your blogs nudge one to think, without being preachy.

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    1. You're very kind to say this. I can't possibly be preachy when I have a long road ahead! :)

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  18. An inspiring post. Motivates me to eat more healthy and exercise more. Do keep posting more such ideas to motivate me further! Thank you heaps and wishing you and family a wonderful healthy new year ahead.

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    1. I definitely plan to post more on this in the coming year. Hoping to share ideas and inspiration on this space! Thanks for the good wishes!

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  19. i have missed out commenting on this blog since we moved back to india in late august. dont get time with the kid's jr. kg studies. do they make the kids study here or what?! anyway...i also had a similar experience. last year i had my gall bladder removed which got me to rethink my health. i was overweight but thought i ate healthy. which was kind of true but now i have truly embraced exercise and grown to love it. I wanted to recommend "Transform You" on sharecare.com. It is a free 21 week workout program which you can personalise a bit. It is really good and got me to enjoy using weights for exercise. I have restarted it for the 3rd time in a row now.

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    1. They do make kids study hard in India! My 4 year old niece had an hour of homework when I was visiting them. Glad to know you've found an exercise program that works for you!

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  20. This post was a real eye-opener.Most of the times we are aware of our problem areas but refuse to notice the elephant in the room.This surely did hit home.I binge on sweets and am trying to give up this habit since the past several years without any success. This post has surely inspired me to try again and endeavour towards eating healthy.Thanks :)

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    1. Yes, identifying the problem habit and acknowledging it is the first step!

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  21. That was a very balanced post, Nupur. So often we get derailed by the amount of information on diets and super foods (what is it this season? kale? blueberry? tiger milk?) that we forget basics. Eat more veg, move more often. That simple, really.

    I have always been active in one way or another. I used to run 20-25 miles/week and that kind of balanced out my indulgence in desserts and I never thought much of it. That was until I had a series of running injuries which meant I barely did any exercise for weeks on end but carried on eating pudding (I think M&S posted a profit in that quarter thanks largely to my patronage of their dessert counter). The belts loosened a little at first and then a whole lot more. I told everyone, including myself that I was fit and healthy and running, only I wasn't. This came acropper after a visit to the dentist (sadly, a tooth was the price I paid) and shopping for clothes where I was buying larger and larger dress sizes. But by then the lethargy had truly set in and I did not want to change status quo.

    It was a chance meeting with a friend who invited me to join her for an Insanity workout session that got me hooked. Apart from realising just how unfit I really was, I was reminded of just how much I enjoy exercise. These days I work out 5-6 times a week getting up early to fit in my routine. Yes, I have become an exercise bore - ready to whip up my top to show off my 4-pack at the slightest show of interest. However, there are no easy solutions and I still crave my sugar fix. Last night I single-handedly polished off two rasmalais and a glug of the sweet milk they came swimming in. I suspect I will always struggle to resist sweets and that's my weakness.

    Thank you for sharing your experience. I think you have managed to get so many of us reflecting on our lifestyles. And that's a small but powerful step in itself.

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    1. Hi Ammani! Thanks for sharing your story. How wonderful and inspiring that you are back to exercising, and more importantly, enjoying it. One day I dream of becoming an exercise bore too ;)

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  22. Hi Nupur,

    Great post. Everything in moderation including moderation is good. When I was in my 20's I felt I could do anything, eat like there is no tomorrow and exercised a lot too. I am a athletic person and now in my late 30's and being so athletic I have damaged my knee cartilages so I have been recommended to reduce the high intensity exercise. That being said, it is still important to keep exercising, at least 4 times a week for 40 mins. Walk my dogs, run and weights is what I do.
    Keep moving and keep posting the yummy recipes! Love your blog.

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    1. Thanks! Yes, having a dog is definitely a motivator to get moving, even for those of us (like me) who are the opposite of athletic.

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  23. I can identify with your post Nupur. I did not develop gestational diabetes during my pregnancy but my PP was high. I saw a nutritionist after my delivery. I lost 5 pounds after a strict carb counting regime- it's difficult when you enjoy mostly veg food.
    Since then I regained those pounds. Since May 2014( my bday) I've started going to the gym in our apt complex- 3-4 times a week. I feel much fitter- I can run 3 miles at a stretch now. The exercise has become a part of my life now. I currently try to walk 2 miles a day :) i have not lost a tonne of weight though ( which I need to get to a healthy BMI).
    For the past 3 months I've been eating gluten free. I don't know if I'm gluten intolerant but some of my health problems have been alleviated by avoiding it ( stomach cramps, weight gain, anxiousness, PMS (TMI). Thanks for sharing. I'm still figuring out the health issues I have- but I believe by trying to address them I'm making progress in the right direction). Here's to a healthy 2015 for all of us.
    Arpita.

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    1. Arpita- Thanks for sharing your story. Kudos to you for making exercise a part of your life. That's what I need to do- make it something I don't have to think about, but something that I do naturally.

      I've been reading up and realized something important about vegetarian food and carb counting that I hadn't before- I'll definitely post about this soon.

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    2. I just thought I would share how I've managed to keep motivated regarding exercise. I know everyone's likes/ dislikes daily routine/ responsibilities are different but here's what worked for me. I chose an activity that I could find no excuse for getting out of eg. due to bad weather etc (walking indoors on a treadmill or running). To alleviate the boredom of walking indoors I watch Netflix or YouTube videos while I walk 2 miles. When I run I listen to my favourite music. I limit my running to a couple of times a week because I'm very wary of injury. My running progress has been very incremental- from panting after 2 mins of running to now running 3 miles. I have done this over the course of a year. I like to reward myself after exercise- I make myself a cup of non sweetened herbal tea or ocassionally coffee. The natural high I get after exercise is a reward in itself. It has often helped me after a long stressful day at work :)
      I am determined to keep this up in 2015. This is now one of my top priorities. Will be interested to learn how you figure things out in the future. I am always looking for ways to improve my fitness routine.

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    3. Anon- thanks for sharing your strategies! You make many sensible points- about choosing an activity where weather won't be a reason for excuses, pairing exercise with something fun like videos/ music, pairing exercise with small rewards.

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  24. thanks for the wonderful post Nupur. I would say there is only three answers for all these questions, First, Yoga, second ,Yoga and third, Yoga..
    The power yoga has, can not be put in words..No side effects,pure magic

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    1. I applaud your love for yoga and glad it has been wonderful for you. But to say to that it is the only answer is everyone's health concerns is something I would definitely not agree with!

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  25. Exacly ! "Because this discussion might strike a chord with someone else who is thinking about these issues."

    having been a diabetic for over 20 years now and now insulin dependent , i regret why i did not follow the doctor's orders- exercise . low carb diet and keep the mind stress free ... bottom line is you control diabetes otherwise it starts controlling ou . Lentils and bbeans are protein rich but they do have carbs too - main thing is portion control - three meals a day and two snacks . very hard . anyway - wonderful article well wriiten .

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    1. But you know, it is never too late, you may regret that you did not make changes earlier but there's nothing to say that you can't make them now. Type II diabetes is reversible. Good luck to you!

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  26. Wow, I could have written this post back in 2008. I went through the same things you write about - GD, family history, skinny fat etc. The preg. joy was marred by frequent trips to the lab and the daily finger pricks. I wish I knew back then what I do know now.
    I had trouble conceiving the second time due to insulin resistance and that is when I completely changed my lifestyle (mainy food) exercise was a huge part of my everyday, but only exercise didn't help much. It is 80 percent food choices .At least in my case.

    I fell pregnant 5 years after my first. The journey was a breeze. I didn't have to step inside a lab in the happy 9 months. I did monitor my glucose levels at home religiously at home, much to my doc's amusement, because you see, this time I passed my GTT with flying colours. But this time around I was wiser and knew exactly what I had to do. Even though much older, I was in much better shape this entire pregnancy.

    Good luck with your journey and I wish you luck.

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    1. Thanks for sharing your story, Shilpa. How wonderful that you turned your health around and got the second baby you wanted. About the role of food and exercise- I find that the same thing is true for me- diet makes a much bigger difference than exercise.

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  27. Such good plans to make and reflect a conversation I was having with a friend just yesterday about having some sort of exercise regimen. I was also thinking how we visited you at this time last year. Love to all of you, have a good holiday season.

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    1. Has it been a whole year since we met- wow, time does fly! Well, I hope you'll make a trip here again soon. Have a wonderful holiday season.

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  28. Wonderful post! Can you please elaborate on how to determine if one is skinny fat? Do you know if there is a test that can measure how much fat versus muscle one has? I try to eat healthy and have actually lost weight unintentionally, but I am not sure if I am losing muscle because I don't get around to exercising as much as I used to in my 20's. My intention is not to lose weight as much as it is to be fit.
    Thanks!
    -Aditi

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    1. Aditi- DEXA scans are used to non-invasively and accurately measure body composition, including fat mass, muscle mass, bone density, etc. There might be other such tests too. You bring up a very important point- that being too thin and undernourished and losing muscle mass is as dangerous as carrying around too much fat.

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  29. Wonderful wonderful post. It's so heartening to hear how you took control of your health and pregnancy and came out so much fitter at Leela's delivery. Diabetes is an insidious killer and I've seen it at close range in my husband's family - its brutal and he is very aware and keen to avoid it at all costs. We're both fairly active and so far that has helped keep us reasonably fit even through our daughter's early years.

    I remember being at my healthiest during pregnancy - I was physically healthy but suffered from severe pre-natal depression. Rather than take medication, I joined a bootcamp and either worked out or ran almost every day - till 2 days before delivery. It kept the darkness at bay throughout the pregnancy and I bounced back to pre-pregnancy weight within 2 weeks post partum. It made me much stronger as well and I ran my best race 4 months after my daughter was born, Depression was tough but it had its silver lining :).

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    1. Thanks for sharing your inspiring story! I've heard from so many people that running has been therapeutic for them. Glad you found the silver lining.

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  30. Thoughtful post. I've always carried excess weight my entire life and at various points dietary (I was always vegetarian but went vegan and gluten free) and exercise (a year of daily hot yoga) interventions have worked but the results were slow and I tended to fall off the bandwagon.I also tried intermittent fasting which I found very effective(I would stop eating after 4pm each evening) .Recently , after watching the documentary "Fat, Sick and Nearly Dead" by an Aussie film maker, on a whim, I went on a 60 day juice fast a few months ago. I lost about 26 pounds to fall within my normal BMI . While there are many pitfalls to going on these sorts of extreme "crash diets" there are definitely behavioural benefits. It was life changing in that made me feel experientially what its like to be in a normal weight body and seeing how people's attitudes also shift subtly. Now of course the challenge has been maintaining it. The reality is there is no silver bullet. And one needs constant vigilance. But I really learnt a lot of lessons about impulse-control and how important diet more than exercise is to maintaining a healthy weight.

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    1. Janani- you hit the nail on the head in saying that the biggest challenge is not so much choosing what diet/exercise changes to make (there are so many) but in maintaining habits and not falling off the bandwagon once you make the change. The way I'm thinking about this is that it will only work for me if it does not in fact require constant vigilance. My hope it to make sustainable changes that are acceptable and "sticky" enough to become a part of my daily life for the rest of my life. That's my goal anyway!

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    2. BTW Nupur: Browsed through this book at the San Diego Public library over the holiday break by Brian Wansink the Cornell researcher who has done some really good work on behavioural hacking of diets http://www.amazon.com/Slim-Design-Mindless-Solutions-Everyday/dp/0062136526 . Highly recommend it... full of really neat ideas

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    3. Janani- I read Wansink's previous book and yes, he has some good ideas that are simple enough to implement.

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  31. Nupur, You are one of the very few blogs I follow regularly for your love of food, variety of cusines and to see what you think about the different books you have read. I also have a 4 year old. So, like to hear what your daughter is upto these blogs as well.

    I also ran into GD issue when I was pregnant and it caught me by surprise. No one in my family has and this was not in my horizon.

    Just like you, I am a vegetarian but usually gravitate towards high carb food - rice, potatoes etc.
    I will tune in to your blog often in 2015 to receive inspiration and experiment with low carb veggie diets.
    Wish you the best in your journey to stay healthy.

    Regards,
    Seetha

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    1. Seetha- Thank you for this nice note and for your kind wishes! For us veterans of GD, we need to work on replacing some of the high carb food with heaps of vegetables- that's my number 1 goal for 2015.

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  32. Hi Nupur,

    I am so sorry to hear that you've had a rough year. This post really resonated with me. This year has been particularly hard for me and a lot of people close to me. My husband and I decided to get married in March this year after dating for 8 years. Unfortunately, his mother got diagnosed with stage 3 Hodgins lymphoma 2 months before the wedding. We managed to have a great wedding even though his mum was undergoing chemo, and she was really happy to see all her loved ones! After the wedding, I lost 2 aunts to cancer and my grandfather passed away too. With all this stress, I put on 20 pounds and food became my saviour! I agree with everything that you've stated in your post. Here's wishing that 2015 brings great joy to you and your lovely family! Looking forward to reading your posts.

    Sher

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    1. Sher- I'm sorry this has been a year of such extreme ups and downs for you too. I do hope 2015 is more smooth sailing. Congrats on the wedding and here's to a great year for us all, with good nourishing food (just not too much of it)!

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  33. Timely post! I have PCOD/hypothyroidism and trying to loose weight for many years. I used to eat moderately. I did not and still don't have any weakness or even inclination towards sweets, chocolates or icecream. I was very active but this weight gain has happened. When the doctors say that because of your weight you have PCOD, I want to tell them I gained weight because of PCOD. PCOD might also lead to diabetes.

    Hmmm,the push to exercise is definitely missing. I have felt that one should have an exercise/diet partner who has same goals as you so that the fire is always there..

    My mother's sister has diabetes with high BP. She is suffering with side-effects of diabetes like nervous weakness, eyesight problem (lost 50% of sight in the left-eye) and some urinary problems. The doctors have advised her to walk 4 kms everyday. My mom also has high BP and she had a para-stroke few years ago. She had a great will power and recovered from it. She is active but on medication now.

    Gender plays a huge role in the food control department of diabetes. When the man in a household has diabetes, the whole family makes adjustments to suit his food requiremnts or the wife cooks something separate for him. But when a woman has diabetes, she has to do normal cooking for everybody and something specific for her. That is a major reason why women can't keep diabetes under control.

    From the numerous websites I referred, the important points to be followed to keep diabetes in control are regular physical activity (especially walking), timely food (fiber-rich) and less stress.

    I will also keep fitness as the top priority from this coming year.

    Thanks again, for this much needed, thought provoking post!

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    1. Shreem- You make an excellent point about gender roles and the challenge that many women with diabetes have in changing the way they eat. The truly ironic thing is that if these women transformed the meals they made, the whole family would benefit.

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  34. Dr. Arya Sharma (blog is Dr. Sharma's Obesity Notes) reported earlier this year that the BMI for people in India and those living here has now been adjusted. He wrote that BMI of 24 considered 'obese' because as you mentioned in your blog post, people are skinny fat. Not enough skeletal muscle tissue to burn the calories. So BMI of much lower is required to prevent diseases like Type 2 diabetes. (Most of his blog, btw, is quite boring.)

    I've read an interview by Dr. Sinha. He was also overweight and getting to becoming diabetic. Very interesting how he took control of his life and diet to improve his health. Maybe his book would be interesting to consider.
    The South Asian Health Solution: A Culturally Tailored Guide to Lose Fat, Increase Energy and Avoid Disease
    By Ronesh Sinha MD

    My blood sugar has also become unstable if I'm not very careful about how I eat. I've found that avoiding easy to digest carbohydrates like rice and fully cooked potatoes helps. I've noticed that eating sour foods with things like cooked pulses keeps blood sugar from going up. One time, from fasting, I did blood sugar testing over a 5 hour period after eating black eye pea salad (vinegared) and the highest reading I got was 5.8 from a fasting level of 4.8. Then it very slowly went down. I waited too long though because I ended up in the high 3s at the 4 hour mark and then into the mid 4s by the 5 hour mark.

    I have to entirely avoid foods like baked potatoes or fully cooked potatoes or my blood glucose will go to 12 - 15 for the first 40 minutes. Then it quickly goes back to normal levels but still, this is not good.

    Yes, I have not one but two glucose meters at home. My grandfather died of type 2 diabetes and I know if I neglect myself, this will also be my fate. It's very difficult when we have the genetic propensity for this horrible disease.

    Acidic fresh chutneys help to keep the blood glucose from ranging high.

    I hope your 2015 is peaceful and productive. It's been a difficult time this year for so many of us.

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    1. I read Sinha's book last month and it was interesting. I'll be reviewing it on this blog soon. Right now a friend has borrowed it and I'm waiting for her to return it so I can write the review. Thanks for sharing your experiences! Wishing you a great 2015!

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  35. an interesting post nupur. it is amazing how much pregnancy can change a body. and I think it is very powerful to see where you have had strength in the past and draw on the strength again - good luck with your healthy eating!

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    1. Johanna- Pregnancy is a time which is typically a great motivator- I made changes quickly that I would struggle with otherwise. I think after mulling it over for a few years I am finally ready to make some lasting changes.

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  36. Nuper,
    Happy New Year! somehow in all the crazieness of the holidays I missed this post. Just found it this morning and want to thank you for writing. I am one of those who look at myself and think - I'm ok, not overweight, eat (pretty) well and am always watching. Your post made me realized that I'm NOT ok. Time to pay more attention! We have been careless over the past month & a half and could continue the downhill slide. Time to take control, get back in the good food groove and pay attention.
    Your posts are so interesting and I do appreciate them!
    Bobbi

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    1. Hi Bobbi- thanks for the nice note and I hope the new year brings you joy and good health!

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  37. I went through something very similar, though not with a pregnancy. A health scare lead me to cut out sugar, white flour, and caffeine. I lost 30 pounds! But it was such a hard diet to maintain. I've gained about half of that back since moving away from NYC. I was fine maintaining the lost weight because I was walking 2+ miles a day and going to the gym. Now, still going to the gym, but I lost that walk! It's made a huge difference. But I know it works and I just really need to go back to it. I was never 100% strict - I would let myself have a meal or two a week that involved carbs. It's really manageable when you do it that way, so I'm just going to have to try harder in 2015. Thank you for the reminder!!!

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    1. Thanks for sharing your story, Lu! Cutting out things is hard for me but cutting down and eating in moderation, I can manage. And I agree, living in NYC was wonderful because we walked everywhere. Wishing you a wonderful year!

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  38. Hi Nupur, I have been a silent reader of your blog and have never posted a comment. But this morning I got diagnosed with gestational diabetes in the 7th month of my pregnancy and i had to re-read your post. As you mentioned there is nothing I would not do for my baby. I am going to take inspiration from your posts and hope that I can get over this phase and make some long term changes to my lifestyle. thanks for your posts!!!

    Kejal

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