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Surprise (possible) Diabetes - what do I eat for sport?


AceVixen

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First up, sorry if this is the wrong place to post this. But it's certainly related to diet!!

 

I'm a clinical biochemistry PhD student (soon to be Dr I hope, handing in my thesis next week!), I do medical research on gut hormone cells. As such my work directly relates to diabetes and obesity, so I know a fair few things about these conditions. To set the scene, I've always been an 'active' person (swimming, running, cycling, roller derby, climbing), and I tend to eat fairly well without all out bothering to actively control my diet (love my fruit and veg, not a fan of junk food).

 

So it was a complete shock when I volunteered for my friend's study, and found out that my oral glucose tolerance is total and utter trash!!! I've always been way above average on any test anyone's cared to throw at me. Blood pressure low, resting heart rate low, cholesterol low, fat percentage low, iron high, bone density high etc etc etc. As a biology grad, I've volunteered for an awful lot of tests in my time!

 

But now this, of all tests, I fail. And now I have to have extra tests (insulin, antibodies etc). And my friend (she's a medical doctor who specialises in endocrinology) says that at the moment I just have impaired glucose tolerance, but given that I'm lean etc, this could be the first sign that I might be progressing towards type 1 diabetes.

 

*lip trembles*

 

So, any diabetic nerds hanging out here got any tips for me?? I've been told (for now) to avoid all sugary drinks and sugary foods. My friend actually said I should avoid cakes etc on an empty stomach, but could eat them after a meal, but I'm an all or nothing kinda girl, and I'm like NO SUGAR EVER AGAIN NO. (I'm prone to anxiety, and I think if I start freaking out about my blood sugar that could set off an attack). But plenty of you guys here who are perfectly healthy avoid cakes and stuff, right?

 

Have any diabetics ever tried paleo? I was wondering if that was a good idea. My sister has been all over paleo for a while now (but I've been resting on the laurels of my many better than average tests and not bothering).

 

What do you eat when you work out, and you bonk? I dunno if that's what everyone calls it, you know when you run out of glycogen and you go all shivery and cold. I'm guessing I won't be on insulin yet, so I can't cram myself with sugar, right?

 

You know what though, if I thought telling people I had impaired glucose tolerance would be the perfect excuse for getting out of eating whatever sugar laden snack they are offering. I WAS WRONG. Last night some dude was trying to get me to eat some cake, and I was like 'oh yeah, blood sugar etc', and he's all 'Oh my cake is worth losing a toe for.'

Vixen

Assassin Level 2

Challenge #1, #1.5, #2 , #3 , #4, #5 (current)

 

 

 

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I am a diabetic nerd who is also prone to anxiety, and I'm sorry it took me so long to see this post. I hope you've found some good information in the meantime, but I can help you out at least from a Type 2 perspective.

 

Do lay off the sugary drinks and foods if you have them a lot. Relegate them to treat status. They're more fun and taste better that way. The first 40 pounds I dropped after being diagnosed was due strictly to chucking the sodas and just enjoying the occasional diet variety. Regarding cakes and such, I tend to avoid them for the most part, but I've found that if I have them after a solid meal, I feel less spikey.

 

I have not tried paleo, as I haven't felt a need to. Balance has been much more important for me than dropping entire categories of foods, and I sure feel better now that I pay attention to my macros instead of carb-loading all the time. Paleo works great for a lot of people, but it's a personal preference. Try it out to see if it works for you.

 

I tend to either have a protein shake or banana before working out. If I haven't eaten recently enough and end up bonking, I have a delicious regular soda or glass of juice and am right as rain soon after. It took some experimenting to figure out my limits, but I did and now very rarely bonk.

 

And WTH is up with that guy?! No cake is worth losing a toe! Keep your feet, my friend! And keep your chin up. You'll be fine. :-)

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Wharrgarrbl!

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Paleo is really a broad brush. Some people say they are paleo but make all kinds of paleo deserts and load up on sugar in the form of honey and maple syrup. 

 

However, the whole9/whole30 version of paleo is excellent for diabetics. The goal is to regulate and balance hormones, reduce inflammation, and increase insulin and leptin sensitivity. While not strictly "low carb" most people find paleo to be inherantly lower in carbs than a regular diet due to eliminating grains and junk food. By sticking to a low-carb diet, where you carbs are coming from veggies and small amounts of fruit, it really helps to sensitize the cells to the effects of insulin and leptin, as well as preventing blood sugar spikes and drops. Many people report much better control of type 1 diabetes, and near or total elimination of symptoms of type 2 diabetes. Read "It Starts With Food". It explains things very well and has a few "sciency" chapters that get into the details of how everything works and why.

"When I can no more stir my soul to move, and life is but the ashes of a fire; When I can but remember that my heart once used to live and love, long and aspire - O be thou then the first, the one thou art; Be thou the calling before all answering love, and in me wake hope, fear, boundless desire." - George MacDonald

 

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I was pre-diabetic and experienced "dawn phenomenon" until I went paleo, eliminating all grains and dairy and drastically reducing legumes. Now, my blood sugar stays in the 80s and 90s, even after a large meal. I've also lost 44 lb. since February.

 

You might want to read Wheat Belly, written by an MD.

"Everybody has a plan until they get punched in the face." Mike Tyson

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Hey, thanks all for the replies. :-)

 

Got my insulin results back, and it seems I am insulin resistant. I can't tell you how relieved I am not to have type one! The advice I've been given is exercise more (no problem!!), eat less sugar (I'll just cut it out completely), and reduce saturated fats. It's the last one that I'm concerned about. I eat a lot of curry with stuff fried in ghee, and I don't really know what my husband will think about it if I want to change my diet and how much he will go along with that. To be honest I've never really given fats much a of a thought. Some research needed I guess.

Vixen

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What's the logic behind reducing saturated fats? Doesn't really seem related to me. Other than the fact that most Dr's just blindly think all fat is bad.

"I've torn a hamstring tendon and re-injured my knee, lower back, and upper back while doing yoga. Don't get me started on shin splints. You're damned if you do and you're damned if you don't, so might as well be strong." - Some guy on the SS forums.

"Heavy is dangerous, but light is no fun." - Mark Rippetoe

"Squats are a good assistance to bring up your curl, as a bonus you can do your squats while your are still in the curl rack." - SJB

 

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and reduce saturated fats.

 

This one makes no sense. Fats do not raise your blood glucose and do not cause insulin problems. The real problem is the high-glycemic carbs that are eaten along with fats. Those carbs are what raise blood glucose and cause insulin problems. The solution is to eliminate grains and other high-glycemic carbs and to eat real foods, e.g. foods that include saturated fats naturally. The recommendation to reduce saturated fats is flawed "conventional wisdom" from the nutritionally misinformed and ignorant.

 

Read Wheat Belly, written by an MD. Grains are used to fatten cattle and are bad for many of us.

"Everybody has a plan until they get punched in the face." Mike Tyson

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"Overloading of adipocytes with SFAs, transported from the bloodstream presumably by CD36/FAT, results in accumulation of diacylglycerol (DAG), which in turn activates protein kinase C (PKC) θ and desensitizes adipocytes to insulin stimulation (26, 27). "

 

https://www.jstage.jst.go.jp/article/jmi/56/3%2C4/56_3%2C4_88/_pdf

 

I don't know much about it at this stage, but I will say that my friend/doctor who has given me this advice is an MD specialising in endocrinology, who is now taking a PhD in type 2 diabetes related research... she might have a different view to you - and at this stage without research I won't take sides - but she certainly isn't nutritionally misinformed or ignorant.

Vixen

Assassin Level 2

Challenge #1, #1.5, #2 , #3 , #4, #5 (current)

 

 

 

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I don't know much about it at this stage, but I will say that my friend/doctor who has given me this advice is an MD specialising in endocrinology, who is now taking a PhD in type 2 diabetes related research... she might have a different view to you - and at this stage without research I won't take sides - but she certainly isn't nutritionally misinformed or ignorant.

 

I definitely wasn't saying she was wrong, I was just curious as I was probably the misinformed one! I'm glad you have someone you can trust who IS well informed. Best of luck!

"I've torn a hamstring tendon and re-injured my knee, lower back, and upper back while doing yoga. Don't get me started on shin splints. You're damned if you do and you're damned if you don't, so might as well be strong." - Some guy on the SS forums.

"Heavy is dangerous, but light is no fun." - Mark Rippetoe

"Squats are a good assistance to bring up your curl, as a bonus you can do your squats while your are still in the curl rack." - SJB

 

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The main problem with this "meta" analysis is that it says absolutely nothing about the role of carbohydrates in raising blood glucose and causing insulin problems, nor about how the elimination or restriction of high-glycemic carbohydrates alters fat metabolism, blood glucose levels, or insulin problems. I mean, can you tell whether any of the underlying articles studied these issues? Frankly, as a meta analysis, the article you quote is the epitome of the regurgitation of "conventional wisdom."

 

Look at the scientific authorities cited in Wheat Belly, written by an MD. Many of those citations appear a lot more relevant.

 

BTW, did you notice the "presumably" in the quote you gave?

 

In any event, as I mentioned before, by going paleo, eliminating all grains and high-glycemic carbs, and severely restricting legumes (i.e. starches), I have lost 44 pounds since February, reduced my blood glucose to the 80s and 90s, and cured myself of pre-diabetes, all while doing essentially nothing to limit saturated fats (beyond trimming excess fat from meats). Did I mention that my cholesterol factors are at their best levels in more than 10 years?

 

Keep an open mind.

"Everybody has a plan until they get punched in the face." Mike Tyson

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I provided that quote in particular as Bolson had asked what the logic was behind reduced sat fats. It wasn't meant as an endorsement of said view, and it wasn't trying to say anything about insulin levels. I appreciate what you are saying, that all these different factors intersect, but that wasn't the aim of that particular study. Oh and of course, scientists always cover their ass with a 'presumably'. It's totally OK to have theories!

 

I'd be interested to know what your reasons are for being against meta analysis as a method (presuming those were sarcasm quotes?), or if not, what it was about this particular meta analysis which made you say it was a regurgitation of conventional wisdom. My boss is always saying that stats just ways of lying, but I was always thought meta analysis was pretty sound, a good way of taking a broad stock of all the evidence with high power. I suppose it all depends on your inclusion criteria, and I've never been much of a statistician, and I usually just accept the mathematical workings of those older and wiser than me. ;-)

 

What I usually don't 'just accept' are scientific theories without looking at the evidence, so yes, absolutely I will keep an open mind! If I get time today I plan to totally literature review the crap out of the 'don't eat sat fats' concept, and I will report back here. While of course case studies (like your story) have their place, I've always been more interested in the basic science. If I can get hold of that book somewhere (I hope to hang out in the medical library this morning, so fingers crossed!), it will be interesting to see what research they cite. 

 

It's really awesome that you have dropped all that weight, and sorted your blood sugar and lipids.  :rolleyes-new: Most the evidence for paleo points in the direction of it being super awesome for longer better quality lives, so believe me I have no beef with that concept! (although legumes, could I really give up legumes? Am I that strong??) I think our situations are a bit different though, and perhaps that could have affected the advice my friend/doctor gave me? My fasting glucose and Hba1c are both fine, my lipids are excellent, my BMI is 21.5, my body fat is 25 % (which I think is WAY above some of the other lasses on here, but not too shabby on average), and it doesn't sit around my belly. I think we're looking here at some mutation or other that is giving me insulin resistance. All very fascinating!

 

Can't wait to come up with my X-men team name. :playful:

 

Vixen

Assassin Level 2

Challenge #1, #1.5, #2 , #3 , #4, #5 (current)

 

 

 

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I'd be interested to know what your reasons are for being against meta analysis as a method (presuming those were sarcasm quotes?), or if not, what it was about this particular meta analysis which made you say it was a regurgitation of conventional wisdom. ...

 

While of course case studies (like your story) have their place, I've always been more interested in the basic science....

 

If I can get hold of that book somewhere (I hope to hang out in the medical library this morning, so fingers crossed!), it will be interesting to see what research they cite. 

 

I'm not opposed to meta analysis as such. Rather, that article struck me as irrelevant to the issue of high-glycemic carbs like grains causing the trouble with saturated fats. I saw nothing in that article addressing this issue.

 

The conventional wisdom is that the problem is saturated fats and not the carbs eaten along with saturated fats. The conventional wisdom does not accept that saturated fats are okay if grains and other high-glycemic carbs are eliminated. Clearly, paleo eating and thinking are on the fringe.

 

I'm not the only one who has benefited tremendously from paleo eating. There are lots of us out there (and here on this web site).

 

Wheat Belly was written for popular consumption because its MD author wanted to help people. I doubt it would be in a university medical library, but you never know. Here's an Amazon link:

 

http://www.amazon.com/Wheat-Belly-Weight-Health-ebook/dp/B00571F26Y/ref=sr_1_1?ie=UTF8&qid=1380695832&sr=8-1&keywords=wheat+belly

"Everybody has a plan until they get punched in the face." Mike Tyson

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stats are not just ways of lying.  That's ridiculous.  It's like saying math lies.  People might misuse statistics and most people don't know how to interpret statistics, but statistics themselves are incapable of lying. 

 

meta analyses are not the gold standard in research and should be approached with caution.  They are not without value, but they are not the gold standard, nor are they near the top in the "best way to do research" category. 

 

Here's the thing - you might be pre diabetic.  That's hardly a diagnosis.  You had one test.  What did you eat the day before?  Get retested at some point.  and the fact that you might be pre diabetic is hardly worth a total immersion into obtuse medical journals.

 

Paleo is awesome for a lot of people.  Cut back on the fruit if you are worried about sugar.  Nothing says paleo is a high fat diet.  It includes a sufficient amount of healthy fats but it is not an all fat all the time diet.  Many many paleo people use olive oil and eat fairly low fat meats simply out of personal preference.  You can totally find a way to do it that fits with your current interests - go for fish (but eat meaty, fatty fish - tuna, salmon), chicken, pork, and olive oil. 

 

No sugar of any kind ever will probably be impossible.  That means no honey, no maple syrup, no fruit, no tomatoes, etc.  Some sugar is just fine if you are mindful of it and limit it.  And yeah, if you were diabetic (which you are not!), cake on an empty stomach can spike your insulin.  But you are not diabetic.  Fruit on an empty stomach would do the same thing. 

 

I workout and train heavily without bonking.  I've never bonked in training and I keep a fairly strict paleo diet.  Paleo allows for carbs and you can certainly have some honey in your tea if you want. 

 

"Guessing I won't be on insulin yet" <- You might be pre diabetic.  That's a far far cry from insulin dependent. 

 

If you want to try paleo, try it.  One of the nice things about it, if done properly, is you avoid a lot of dips and spikes in insulin.  And yes, you can have a piece of cake now and then.  It's just fine.  Even insulin dependent diabetics eat cake now and then.  Read the paleo bibles - read Robb Wolf.

 

Go to your primary care physician.  Find an unbiased source for your care and testing (friends should never never treat or medically advise friends).  Get retested being mindful of your diet the day before. 

I AM going the distance

 

'Cause all I wanna do is go the distance. Nobody's ever gone the distance with Creed, and if I can go that distance, you see, and that bell rings and I'm still standin', I'm gonna know for the first time in my life, see, that I weren't just another bum from the neighborhood.

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Hi... I've had the oral glucose tolerance test on three separate occasions, with a standard meal the night before. On each occasion my glucose was > 11 mM by 2 hours, and my insulin levels were very high too, so yes prediabetic insulin resistance I imagine. We're going to try it all over again in three months time.

 

I mean obviously friends shouldn't treat friends - we work in the same lab and that's how I came to volunteer for her study and that's how we noticed that I had an impaired glucose tolerance. Part of the ethics of doing a clinical trial is that you are obliged to follow up on any health problems that you notice, and that's how come she's investigating it. She'll be writing to my GP very soon, and referring me on to a diabetalogist.

 

I will happily submerge myself in the literature, I've been doing so for the past five years for my PhD, and that's before I knew that it might be personally relevant to myself! Total immersion in obtuse medical journals is like my job. ;-)

 

I feel this thread has got a bit off topic. I posted a while back just wondering what people who might be in my situation would do for eating for sport when you've been advised to not have sugar, because I've always eaten chocolate bars and sports drinks to get through long distance events. There was no reply for ages, and then suddenly a flood of replies some of which (but by no means all) have made me feel like I'm on the back foot, having to defend advice a doctor has given to me or even now that I even have this condition at all.

 

I will still be open to any advice people can give me about what they eat during sport, but I'd appreciate going lightly on the criticism. As I said in my original post I have an anxiety disorder, and I can get a bit worked up and worried about discussions on the internet if they seem like they are headed in an antagonistic direction.

 

I hope nothing I have said has offended anyone; it certainly hasn't been intended that way.

Vixen

Assassin Level 2

Challenge #1, #1.5, #2 , #3 , #4, #5 (current)

 

 

 

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Hi... I've had the oral glucose tolerance test on three separate occasions, with a standard meal the night before. On each occasion my glucose was > 11 mM by 2 hours, and my insulin levels were very high too, so yes prediabetic insulin resistance I imagine. We're going to try it all over again in three months time.

 

I mean obviously friends shouldn't treat friends - we work in the same lab and that's how I came to volunteer for her study and that's how we noticed that I had an impaired glucose tolerance. Part of the ethics of doing a clinical trial is that you are obliged to follow up on any health problems that you notice, and that's how come she's investigating it. She'll be writing to my GP very soon, and referring me on to a diabetalogist.

 

I will happily submerge myself in the literature, I've been doing so for the past five years for my PhD, and that's before I knew that it might be personally relevant to myself! Total immersion in obtuse medical journals is like my job. ;-)

 

I feel this thread has got a bit off topic. I posted a while back just wondering what people who might be in my situation would do for eating for sport when you've been advised to not have sugar, because I've always eaten chocolate bars and sports drinks to get through long distance events. There was no reply for ages, and then suddenly a flood of replies some of which (but by no means all) have made me feel like I'm on the back foot, having to defend advice a doctor has given to me or even now that I even have this condition at all.

 

I will still be open to any advice people can give me about what they eat during sport, but I'd appreciate going lightly on the criticism. As I said in my original post I have an anxiety disorder, and I can get a bit worked up and worried about discussions on the internet if they seem like they are headed in an antagonistic direction.

 

I hope nothing I have said has offended anyone; it certainly hasn't been intended that way.

 

I also do a lot of journal reading, etc. for work.  Honestly, avoid it with respect to your own medical conditions.  It has a tendency to not help.  I know.  and yeah, I have a graduate degree and yeah I read journals daily and yeah, I've had medical issues.  I get it.  But you have to be careful about the slippery slope here. 

 

Have you done a fasting glucose? 

 

Anyhow, pre diabetic is totally something you can manage rather easily with your workouts and your current diet (you said you eat healthy already). 

 

Okay so for back on topic - you do not need all that sugar to get you through a workout unless you are training as a high caliber competitive athlete.  Which despite what people on this forum believe about themselves, most of us are not.  You do not even need that level of sugar to get through a marathon.  If you ran a marathon, you might want some level of carbs, but you can do it without all the gatorade, etc. 

 

I've done heavy obstacle course races completely fasted and finished strong.  I almost never snack before a workout and I never bonk.  You just need to experiment and find what's good for you. 

 

The paleo diet is neither super high fat nor super low carb.  It's a continuum.  You want some healthy fats in your diet.  These are easy to track and you'd probably be surprised with how easy it is to do.  Again, fatty fish, olive oil, etc.  If you like red meat, eat it.  No need to consciously avoid fat.  Fat becomes the best fuel for your body.  BUT that being said, paleo is not bacon and lard at every meal.  I think you'll be very comfortable with the fat. 

 

Paleo helps you switch your body from simple carb burning to fat burning.  This is like building a fire with coal instead of newspaper. 

 

This does not mean no carbs however.  Many paleo people eat plenty of carbs.  It depends on your goals and your energy needs.  So, let's say you are a gal who tries this out and decides, yup, I need 150g carbs on days I run.  Okay.  Easy to do - eat low GI carbs throughout the day and make sure you get what you need.  It's a matter of swapping out chocolate bars and gatorade for sweet potatoes and maybe white rice.  And if you are doing it with intention on days you run, that's a lot different than at every meal. 

I AM going the distance

 

'Cause all I wanna do is go the distance. Nobody's ever gone the distance with Creed, and if I can go that distance, you see, and that bell rings and I'm still standin', I'm gonna know for the first time in my life, see, that I weren't just another bum from the neighborhood.

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I'm sorry, AquaDash. Seems I opened a can of worms with my reply. I didn't mean for people to have a go at you; I just wanted to help and didn't want you to worry. I really don't think you offended anyone. :-)

 

Regarding the sport foods, I would listen to Cline. Cline is wise.

Level 3 Harpy Ranger


5 STR | 3 DEX | 5 STA | 4 CON | 8 WIS | 5 CHA


N.A.G.42!


Current Challenge: Roll On • Previous Challenge: Sing-a!


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Wharrgarrbl!

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This looks like another crack in the wall:

 

http://annals.org/article.aspx?articleid=1846638

 

http://www.npr.org/blogs/thesalt/2014/03/17/290846811/dont-fear-the-fat-experts-question-saturated-fat-guidelines

(because I do not have access to the full article)

 

BTW, thanks to my paleo diet, my lipid profile improved so much that my doctor took me off my cholesterol medication earlier this month. Also, my blood glucose (as measured by HgA1C), which has fluctuated in and out of the pre-diabetic range for years, recently tested right in the middle of normal.

 

I hope you are doing well.

"Everybody has a plan until they get punched in the face." Mike Tyson

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you definately dont need to eat sugar during a workout.

 

Since starting IF, I get up to workout at 5am ...and we arnt talking half arsed workouts, 3 days a week is heavy lifting, 3 days a week cardio.

 

I dont eat anything until 13:00 and that first meal is Protein + green veg

 

your body has plenty of glycogen to keep you going and your body can easily turn to using fat as an energy source .... the fist few weeks WILL be hard work, but its mostly mental, once you get used to it, it becomes acceptable and the norm.

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Hey everyone, thanks for all the replies while I was AFK. <3

 

I wanted to come back with an update. This 'pre-diabetes' thing sent me into a tail spin thinking I was on the path to an early death. After the initial freak out, it was quite good for me, sorted my diet out, started eating more paleo etc, and I got fitter than I had been in a long time!! However, it turns out it was all crap anyway!! You all were right when you said I didn't have diabetes. The doctor who did my glucose tolerance told me that after studying many more people, she thinks that actually I'm at the high end of normal. Pheeeeewwww!!! She just said I need to be careful if I get pregnant, but since I don't want kids I'm not worried. 

 

Although, after hearing that, I just went SUUUGGGAAARRR and ate all the bad stuff all of the time because now I am 'allowed'. And err, yeah I put on a bunch of weight. Idiot.

 

So now I am back again to have another bash at eating 'right', not because of any diabetes thing. But because I just want to be healthy. And thanks all for all the papers and advice that I don't need to eat sugar to work out. Having spent a year and a bit working out now, I've figured that out. I used to think if you didn't cram energy gels down your face all the time you wouldn't be able to move a muscle...

Vixen

Assassin Level 2

Challenge #1, #1.5, #2 , #3 , #4, #5 (current)

 

 

 

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Hey Aqua, welcome back.  That feeling of being told "oh...you're much better than we thought" and immediately face-planting into all the bad stuff you've been avoiding?  Yeah...totally know how that feels.  And it's damn hard to stop, too.  lol

 

Good luck with eating healthier and making improvements.  You were doing it before, now you just have to do it without the Sword of Damoclese hanging over your head.  :)

-Kinger

 

I leave this as a declaration of intent, so no one will be confused.

One: "Si vis pacem, para bellum."  If you want peace, prepare for war. 

Two: The old me is dead...he died with his old habits.  The new me will be stronger, faster, sharper, better.

 

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