Sanity check crazy idea - titrating calories based on blood sugar.

[Adam Levine]

Hoping for some advice on if an idea of mine is insane.

I'm underweight, need to gain weight, but can't because last time I tried (LP), my type 2 diabetes went out of control. I've got it in the high-normal/low-prediabetic range now with
- A low carb (but not keto) diet that is a slow cut
- HIIT.
- Intermediate programming.

Yes, I'm underweight and losing about two pounds a month - it sucks, but my lifts are still going up, at least for now.

I'm thinking of testing how much I can "get away with" eating. Titrating calories based on rate of weight change is common around here. I'm considering titrating based on blood sugar, but keeping carbs low. Basically:
- If average morning/fasting blood sugar for the week is <105, add 100 calories per day of fat and protein.
- If >110, cut 100 calories per day of fat and protein, but no lower than 2000 calories.

Basic body/diet stats (actual numbers from last week, which is a pretty typical week for me lately):
Age: 48
Height: 5'10"
Weight: 175.4lb
Waist: 33" around navel
Body Fat (by Navy Calculator): 14.6%
Body Fat (by InBody scan): 14.1%
Average morning/fasting blood sugar: 101
Average calories/day: 2,140
Average protein/day: 290g (yes, excessive!)
Average carbs/day: 168g (including fiber)
Average fiber/day: 59g (heavy supplementation here...)
Average fat/day: 41g (increasing might be wise, but protein satisfies me better than fat)

Any help is appreciated.

-->Adam

[Robert Santana]

How much are you currently lifting?

[Adam Levine]

Dangit - I've read enough of these to know you would ask that...

Most recent AMRAP or near fail attempts are:
Squat: 225# x 6
Press: 122.5# x 3
Deadlift: 297.5# x 5
Bench: 195# x 4

I know those are low for intermediate - but BLOC made the decision to end my LP, and I'm assuming they were right. I've toyed with the idea of restarting and trying to milk some more out of it (they didn't end it by the book), but not on this diet.

-->Adam

[Robert Santana]

It is unlikely that your percent body fat is influencing your glucose levels given that it’s pretty normal and your waist to hip ratio is also normal. Chances are that your meal timing and meal composition may benefit from a more regimented approach. I’d experiment with lower carbs and thus higher fat, on your non training days while keeping fiber at ~40 g or more

[Balazs Egerszegi]

Adam,

I'm close to your age, h/w and have been monitoring my blood glucose diligently for the last 4-5 years and having been able to keep it in the mid-normal range for a long time now. Robert mentioned meal timing and meal composition and that's possibly the single most important thing that worked for me. Everyone's different, but I can get away with more carbs for breakfast and lunch to fuel my day and I keep dinner lean, high protein, moderate fat, low carb.

[Adam Levine]

Thanks Bob and Balas,

I'm already pretty good at meal timing - about 6 meals per day, each under 500 calories.

Per Bob's advice, I'll try to cut carbs a bit more (although I'm close to my tolerance now - I'm not giving up my blueberries for breakfast!)

My current targets, which I'll adjust based on blood sugar results (probably adding/removing fat, but keeping carbs stable):
- On non-workout days, shoot for <90 net carbs and 2000 calories. I don't need to watch protein - I'll get enough if I stick to that (though MFP will record it).
- On workout days, <120 net carbs and 2200 calories.

I'm thinking about how to cut carbs further, but it'll be tough. MFP says my top carb sources are Benefiber, Blueberries, and super-high-fiber tortillas. Oatmeal clocks in at #5. Not really liking the idea of giving up any of those... I don't like the idea of Keto, but I have no idea how those folks do it...

-->Adam

[Robert Santana]

Those carb totals are too low. There is no reason for a male lifter to eat under 200 g carbohydrates unless you are on an extreme cut. You should eat more than this and divide them into to equal boluses, mixed with protein, across all of your meals.

[Adam Levine]

Thank you, but now I'm more confused.

Originally, I said my net carbs were around 110, and you told me to cut them. I know that's way lower than you usually recommend, but I assumed it was the diabetes. I interpreted that as if I need to titrate calories, add fat.

Then, when I said I'd target around 90 net carbs, you told me to increase them.

That's not much of a range to work with... And wouldn't upping to 200 total (prolly about 150ish net) totally blow my blood sugar out the door? I'm willing to try it and see what happens - I'd certainly be happier with more carbs.

-->Adam

[Balazs Egerszegi]

Adam,

By meal timing I meant more like 3 meals a day and I think Robert will agree with me here. Breakfast, lunch and dinner, 4-5 hours apart. No snacks between meals.

[Robert Santana]

I said experiment on non training days and this was the first mention of net carbohydrates in this post. Again, you are asking for medical nutrition therapy on a board post. This is specialized and highly specific so if you want me, or another professional, to develop something specific to your needs you will need to hire that out. My general advice for this post is that you need to eat relatively equal amounts of carbohydrates every 3-5 hours, combined with protein, and consume 40 grams of fiber per day. I don't know what your total carbohydrate intake should be but I do know that the human brain requires ~130 grams, hence my previous comment that you are too low on your training days and I'd contend that you are also too low on your non-training days.