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Lost weight and numbers going up???
#21
(05-21-2014, 01:10 PM)DocWils Wrote: The problem is we DO equate.....

What a nice read. Thanks Doc. Even though not targeted at me, since I at 71 still retain my schoolboy figure. Well, plus maybe 50 pounds or so.
But I enjoyed your read and will be sharing it with my wife who has been trying to address these same issues.

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#22
(05-21-2014, 09:54 AM)SleepWrangler Wrote: Please follow up. I am implementing a LCHF diet similar to Atkins, not for weight loss, but instead for glucose management. I am scheduled for my next blood test in a about six weeks. I'd like to compare experience if possible.

That is exactly why I shed the kilos, and yes, it does make a huge difference quite quickly. However, I did not do a LCHF diet - more of a LCLF diet, one that is difficult to explain briefly here, but by and large speeds up the burn rate amongst other things.
(05-21-2014, 09:54 AM)SleepWrangler Wrote:
(05-21-2014, 06:57 AM)DocWils Wrote: Also please be aware that recent research pretty much puts the kibosh on either Atkins or the Med diet - both are good for short term weight loss, but after six months they even out and neither are shown to successfully keep weight off over long periods.

Research shows that junk carbs leads to food craving, and calorie counting often fails. I don't follow Atkins meal planning but how or why do you associate the common reasons for failure to Atkins? Hopefully this does not come across as argumentative. I really have no axe to grind except that careful management using the standard diabetic diet does not work for me.
The problem is that when the two diets were compared side by side over long term metadata studies, what we saw was that one did not really have the advantage over the other, although in short term , the Atkins did show higher weight loss from the outset. It seemed to point to the fact that after six months on either diet, the two diets became comparable in weight loss, and neither had a massive success rate in keeping weight off over a five year period, which is, alas, true of many diets, and that was the point of mentioning the New York Times article, BTW - that long term success may depend on a more complex interaction that just calories in/calories out. I felt you sort of didn't get the point of the entire article and focussed instead on one small paragraph.
(05-21-2014, 09:54 AM)SleepWrangler Wrote:
(05-21-2014, 06:57 AM)DocWils Wrote: Instead you should be examining what effect various portions of your diet are having on your insulin resistance and how to better that - in the process, you will lose weight, safely and healthily.

Yes. The standard diabetic diet often keeps my glucose levels somewhere between 111 mg/dL (6.2 mmol/l) and 122 mg/dL (6.8 mmol/l) postprandial. Spikes in the two hour window are large. Carefully managing carbs has brought that down to 86 mg/dl (4.7 mmol/l) but usually averaging 97 mg/dl (5.4 mmol/l). Following the standard diet is likely to have me on insulin within the next ten years. No thanks. I am looking for something better. I am currently evaluating LCHF. Should have some useful data over the course of the next sixteen months.
I am not sure if the standard diabetic diet in your country is identical to the one in ours, but rather than focus on the actual elements of the diet, you would be better to focus on the thinking behind it, which is to reduce the reliance on certain carbs in the diet. How you adjust that in your diet, if you are not a diabetic, is up to you. We emphasise more the philosophy here of the diet, and educating the patient as to how to approach their diet, making actual menu plans only as a starter, until they get used to the way of thinking and can take if from their on their own.

(05-21-2014, 09:54 AM)SleepWrangler Wrote: I disagree that you can eat all the protein you like. It converts to glucose too albeit through a longer pathway. Scaling carbs according to your glucose meter and protein according to exercise regimen makes much more sense.

I quite agree, and that is what we teach in a diabetic diet - I was pointing to the entire article and other aspect (see above). What Taubes hit on in his books, however, was a good way to distinguish carb from carb (they are not all created equal) and that is a useful educational tool.
(05-21-2014, 09:54 AM)SleepWrangler Wrote:
(05-21-2014, 06:57 AM)DocWils Wrote: A recent trial with twin doctors, one doing a high sugar diet and doing a high fat diet showed some interesting results, and was turned into a quite entertaining documentary on the BBC recently - you might look for it online.

Interesting overall with poor science, lacking real information on what they ate during their dieting month. Again, this isn't a bash on Keto, it's a bash on the intelligence of their diets - Protein and strength training are king in preserving LBM, and if any Keto dieter is using a low carb, low protein, high fat diet, expect muscle loss.


actually, the science was quite sound, just reduced to a "lies to children" level for public consumption, and it was short term - it was intended to inform and raise awareness, which I hope it did, in a country that is getting increasingly fat and ill (yep, the UK, home of the Chip Butty, is heading for the Edge). The two dieters did show what they ate, and in follow up documents published on a web site (forgive me if I cannot remember which site just now), detailed in greater detail their diets, although, to be honest, the specifics were less important that the point that identical diets, in terms of calories, but not in content, had very different effects on the body. And while it did seem that in the short term the high sugar diet won over the high fat diet, it was pointed out very clearly that neither were sustainable diets for health, nor that in in the long term either would produce desirable results. The question that was the central theme of the documentary, which demon was the real demon, the American's demonisation of fat, or the Uk's demonisation of sugar (or was it the reverse?) was the real demon causing the health breakdown in both countries. In truth, it is a bit of both, but just not in the black and white way we are used to thinking about them. And, of course, twin studies is the golden study method in all of this. Good boys!
(05-21-2014, 09:54 AM)SleepWrangler Wrote: Agree that it is entertaining. In the same vein as Morgan Spurlock's Super Size Me where follow-up documentaries like Fat Head say he lied about how many calories he was consuming per day.
I am afraid I don't know who Morgan Spurlock is, but to my knowledge, these presenters on the BBC documentary did not lie as to their intake.

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#23
Very informative thanks Doc and Sleep Wrangler.

Yes, I do have major dietary issues with these drugs. My cardiologist told me that he MIGHT take me off the Coumadin in a few months, I pray he does, I hate it.

I had my pacemaker reviewed in his office 3 weeks ago and he told me that there was no sign of any Afib, however I am on an Anti Arethemia. They seem to think my issue was caused by my thryroid levels being so high and then on top of it, I took a Z pack and was on steroids for pneumonia. The combo is not good.

I ended up having to have a pacemaker put in because the anti arethemia was causing my heart rate to plummet to the 20's and 30's. I feel great now, but want off these meds if at all possible. There is nothing wrong with my heart, they ran all kinds of tests, including stress, echo and more, and they all came back negative.
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#24
(05-21-2014, 01:35 PM)DocWils Wrote: BTW - that long term success may depend on a more complex interaction that just calories in/calories out. I felt you sort of didn't get the point of the entire article and focused instead on one small paragraph.

OK. That would make you entirely wrong. Personally I don't have to re-learn this lesson. Been there and done that, bought the T-shirt.
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#25
(05-21-2014, 04:56 PM)SleepWrangler Wrote:
(05-21-2014, 01:35 PM)DocWils Wrote: BTW - that long term success may depend on a more complex interaction that just calories in/calories out. I felt you sort of didn't get the point of the entire article and focused instead on one small paragraph.

OK. That would make you entirely wrong. Personally I don't have to re-learn this lesson. Been there and done that, bought the T-shirt.

But was the t-shirt a size smaller?
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#26
So, I am at 20lbs lost now, and the apnea events are still going up???? Leaks are great, no issue, but clusters of apnea events that I have never seen and they last at times up to 28 seconds. I am really not understanding this. I am at 1.65 AHI. Not sure what to do, stay with the course, or try an adjustment. Sleeping ok, no problem.
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#27
Marnid,

Your AHI and leaks are good-correct. You still feel good , right. I would be ecstatic to have your numbers. I would not worry about it and I would not start changing anything right now.

Would you please define more clearly "clusters of apnea events".

Take care and don't sweat the details until you know for sure that they are not details.

Sleep well and dream.

PaytonA
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#28
Marnid

With an AHI of 1.65 no doctor would take your complaint seriously - the idea of consistently being at AHI 0 is a fantasy - healthy people don't have that, and it cannot be achieved consistently except by aid of machine - I would not be freaked out about an AHI that low - it is, in fact, brilliant in and of itself. My AHI slides up and down the scale, occasionally hitting 0 or close to it, hovering around 1.5 to 2.5, and on the odd bad night going up as high as 4. Not a big deal, and in fact, what happens in a normal person who has NO apnoea whatsoever and is not aided by a machine. Generally there are cluster events, and almost always I can pinpoint the cause easily.

Now for the break down - are you showing a higher number of CAs than before? Do they correlate to pressure rises or peaks? If so, it may be that your machine needs the pressure adjusted. Even if you did nothing, at an AHI of 1.66 there is no room for complaint - anything below an AHI of 5 is considered sub-clinical and healthy. Period. If you were saying your AHI was 16.5, that may be a different issue. I am not sure why you are concerned at this minor rise in your AHI levels, but if you DO see a rise in CA events, you might wish to tell your sleep specialist next time you see him/her, and see if changing the maximum pressure would help to reduce that, but at your levels, I do not think that one would feel overly concerned. Do you have oxymetry as well? Do you see drops below 85% for any long stretches?

Also, do these "clusters" occur early on in the sleep cycle or very late, near the waking point of the sleep cycle? If so, that is actually pretty normal and part of the body's breathing pattern change as you pass through the levels of sleep.

I really think you should relax, take pride in dropping 20, start to work on the next 20 and carry on.
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#29
(06-05-2014, 05:52 AM)DocWils Wrote: Marnid

With an AHI of 1.65 no doctor would take your complaint seriously - the idea of consistently being at AHI 0 is a fantasy - healthy people don't have that, and it cannot be achieved consistently except by aid of machine - I would not be freaked out about an AHI that low - it is, in fact, brilliant in and of itself. My AHI slides up and down the scale, occasionally hitting 0 or close to it, hovering around 1.5 to 2.5, and on the odd bad night going up as high as 4. Not a big deal, and in fact, what happens in a normal person who has NO apnoea whatsoever and is not aided by a machine. Generally there are cluster events, and almost always I can pinpoint the cause easily.

Now for the break down - are you showing a higher number of CAs than before? Do they correlate to pressure rises or peaks? If so, it may be that your machine needs the pressure adjusted. Even if you did nothing, at an AHI of 1.66 there is no room for complaint - anything below an AHI of 5 is considered sub-clinical and healthy. Period. If you were saying your AHI was 16.5, that may be a different issue. I am not sure why you are concerned at this minor rise in your AHI levels, but if you DO see a rise in CA events, you might wish to tell your sleep specialist next time you see him/her, and see if changing the maximum pressure would help to reduce that, but at your levels, I do not think that one would feel overly concerned. Do you have oxymetry as well? Do you see drops below 85% for any long stretches?

Also, do these "clusters" occur early on in the sleep cycle or very late, near the waking point of the sleep cycle? If so, that is actually pretty normal and part of the body's breathing pattern change as you pass through the levels of sleep.

I really think you should relax, take pride in dropping 20, start to work on the next 20 and carry on.


Also, do these "clusters" occur early on in the sleep cycle or very late, near the waking point of the sleep cycle? If so, that is actually pretty normal and part of the body's breathing pattern change as you pass through the levels of sleep.


How do you tell that? What would I look for?


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#30
Look for them occurring between the time you have masked up and for some time after you have fallen asleep. At the other endo of the night from the time somewhat before you awaken and when you de-mask. Also before and after any times that you have awakened during the night. It is normal to see hypopneas and centrals during these time periods due to the change from awake breathing to asleep breathing and vice versa.

One question. What do you consider a cluster?

best Regards,

PaytonA
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