I have always been slender. I’m 6’6" and the most I’ve ever weighed is around 190. That was after I became diabetic and went on insulin and developed a little bit of an insulin belly. That’s what it was to me anyway, no one else really noticed it other than my wife.
Since I switched to a low carb diet, I have steadily lost weight, in exchange for stellar blood sugar and no more overnight hypos. My calories have probably increased overall, and I eat a TON of fat and protein, and I exercise, but I just don’t keep any weight on. On top of that, I recently had an emergency appendectomy (right after musing aloud about wanting to put on weight just as a buffer in case of a health problem) and have now lost even more. At my surgical follow-up visit today, I clocked in at 161 lbs. Not ideal.
Now, I don’t feel bad/weak/whatever, and no doctor has expressed any concern over my weight. My friends/family acknowledge I look thin, but no one is worried in any meaningful way. Still, I feel like I need to gain 20-40lbs to be at a safe/comfortable weight. My question is: can I do it without significantly increasing my carb intake?
Anybody have experience/insight with this?
Oo, I can relate.
Yeah, you definitely can. You mentioned exercise but you didn’t specify what type of exercise you do. For healthy weight gain, there is no replacement for weightlifting. On a high protein/high fat diet, you should be able to jump right into the weight room and see excellent results. Generally speaking, you’ll be doing heavy weights, lower reps and, If you’ve never weight lifted before, you can expect some changes to your BG profile. How specifically you need to work out to gain weight and how that will affect your BG is really an individual thing, though, and will take some tweaking.
There’s no reason to think that you’ll automatically have to consume more carbs but it really depends on how much dietary protein you have available to split between increasing muscle mass, minimum glucose requirements, and glycogen replenishment. That’s the trick.
Insulin also stores fat. I would think that if you slightly increased carbs only enough to warrant a little more insulin, while at the same time increasing your fat intake, you would start to pack on a bit more weight. No need to put it on any faster than you took it off.
Sorry to hear about the appendectomy! Given the trauma it’s not surprising that you lost weight, but your BMI is now at 18.5 which just barely puts you into the ‘normal’ weight category. So 20-40 lbs sounds like a good goal! It is possible to put weight on with low carb but it will be pretty slow and you might struggle with it.
Do you know what your total fat calorie intake is? How ‘low’ is low carb? As long as you are running a calorie surplus then you’re in good shape, BUT I suspect you’re going to run into a few problems:
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You’re a tall dude and if you’re exercising a lot then your energy needs are probably very high. It might be tough for your digestive system to tolerate enough fat to keep your body moving. Diabetes might even affect absorption.
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Calculating fat of cooked (from raw) items can be tough. Cooking things like burgers and chicken wings can render off a good amount of the fat from what is on the package and you may not be taking in as much as you think.
Since you’re low-carb, your insulin requirements are probably also low. Insulin is a great anabolic hormone. So you’re also losing some of its benefits with regards to weight gain:
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It shuts off fat burning and promotes storage of carbs as fat
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It promotes uptake of protein and glucose by muscle helping post-ex recovery and building
The low carb thing makes a lot of sense for diabetes management, but it does put you in a bit of a pickle by slowing weight gain. It’s really a tough balance to strike. Weight isn’t a problem for me but I know that my bgs are way better when I limit carb intake, but my running sucks if I cut too much. I don’t think you need to go crazy in increasing carb intake, and it doesn’t even have to be something permanent, but consider:
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Eating more after a workout when you’re more insulin sensitive and your muscles need them most
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Eat mostly complex carbs (and fats) more steadily through the day to avoid bg spikes and improve absorption
Thanks all for the replies. Very helpful stuff. I think that eating more after exercise (once I’m allowed to start back up again) makes a lot of sense, and changing my exercise balance to favor more low-rep weight training is also probably a good idea.
Tom, you’re right, my current insulin requirements are quite low- 6u Lantus every 24 hrs and between 2-4 units of Humalog w/ meals (I don’t really use a carb ratio anymore since I try to keep carbs under 15g/meal). I have been wanting to add a few complex carbs (quinoa etc) back into my diet in moderation- currently I eat no grains.
I think just eating more of what you usually eat, if possible, and adding a muscle building weight routine are good places to start.
Tom brings up some good points, but you just won’t know how those factors affect you, personally, until you get started with your new routine. Your goal is to stay low carb while gaining weight so stick to those two goals until either one is no longer attainable, then reassess.
Best of luck!!!
I totally agree that it isn’t necessary if he can get his intake up enough. Out of curiosity I was just looking at what is known about how much energy it takes to convert protein to glucose. The study I saw had it at 1/3 of the calories of the glucose produced. I never imagined that it would be that high! This probably explains why I was having trouble with running on my brief stint on low carb, I was probably shorting myself a few hundred calories. I wish I had known that when I needed to lose weight. Thinking about giving it another try but will probably just stick to lowish carb.
wow, that’s really amazing. it definitely explains why i am fighting for every pound (and losing!). I basically need to be eating 2 steaks at every meal…which I have to say is unlikely. To make sure I understand, you’re saying that 1/3rd of the energy I get from the protein in my diet is lost just GETTING the energy, so I would need to eat 45 grams of protein to get the same energy that I’d get from around 30 grams of a simple carb?
Just about, except the conversion energy would have to come from fat, so 30g protein (120 cal) plus 7.5g fat (60 cal). The protein need may be slightly less than the 30g, but I don’t know how much less.
The trouble is estimating how much glucose your body actually needs. Probably 70-75% of the calories you burn from higher intensity exercise to replace glycogen and 300-400 cal for the brain. So if it’s something like 900 cal, you’d need 900ish cal from protein and 300 cal from fat. A lot more than I would have thought! And it doesn’t include the rest of the protein/caloric need for other maintenance, muscle building, and putting on a healthy layer of sub-q fat.
I haven’t read Dr Bernstein’s book but am now curious enough to take a look. The body really is an amazing machine…except when it kills your beta cells by accident!
For you sisiay, I think the key is going to be giving yourself enough recovery time. Maybe Tom can add his two cents but I don’t think adding a weightlifting routine is going to add much of a caloric requirement for energy expenditure during your workout if you can keep your glycogen stores replenished.
We’re talking about really short burst of energy output with low reps and sets which don’t burn that many calories. Unfortunately, it’s all glycogen dependent so your fat and ketones won’t do you much good. You’re probably going to need to pound protien during your reecovery phase to have enough to split between muscle growth and glycogen recovery. So you’ll either have to up your daily protien intake a lot to get through daily workouts, or try more modest increases in protein with more time to recover.
I vaguely remember trying to sit down and do conversions for the diet I was on when I was competeing. I honestly couldn’t imagine trying to do those conversions for a low carb diet. It is just so much much more efficient if you account for your energy expenditure and glycogen recovery requirements through carb intake.
I’ve read a bit of Dr Bernstien and he’s actually quite reasonable with his assessment of his diet when it comes to exercise. His calculation for the amount of protein actually converted to glucose is much more conservative compared to most calculations I’ve seen and he’s pretty clear about not trying a low carb diet if you plan on being in athletic competition.
you’re right about that- he definitely recommends eating glucose tablets throughout a workout- i’ll have to go back and look at his actual numbers. I’ll probably just have to experiment a bit. Weightlifting tends to raise my blood sugar as it is (glycogen I guess), so I’ll need to figure out an insulin and carb (probably glucose) schedule for the actual workout, and then, as you say FHS, up the protein during recovery.
Anyway, it’s a lot to think about, and probably something that will take a few tries to get right, but you guys have definitely gotten me WAY past where I was in terms of how to approach this. Thanks a lot.
Trial and error does sound like the most sensible solution. I wish I had more to add but it takes all of my willpower just to get through two 15 min weight sessions a week! As long as you’re not spending hours on it then the calorie intake shouldn’t be bad, and should be a huge benefit. I’m definitely going to order Bernstein’s book, I can’t find any useful information in the traditional medical texts which is pretty frustrating.
It’s worth every penny. He’s spent a lifetime investigating all of this stuff, and even if you don’t decide to go low carb, everything there is still of value.
I think you have gotten great advice so far. Bernstein is a good reference and he of course recommends to his patients that they increase their protein intake to gain weight. He is actually conservative with protein, probably recommending something less than 100g per day for you. You could probably increase your intake to 250 g /day. I use low carb protein shakes, 25g of protein / shake. You can mix them with a cup of milk 12g carb, or do it the Bernstein way with full cream. If the cream scares you then of course you can also just mix it with water, but it does not taste as good. And of course, it is always preferable to gain lean body mass, not fat and heavy weight training is important for that. If you are up to it, I recommend heavy compound lifts, like barbell squats and deadlifts.
What I would also suggest is perhaps reading Nutrient Timing by John Ivey. Although geared towards non-diabetics, it does discuss in detail nutrition for the athlete and in particular for bodybuilding. It does matter when and how you eat. Eating after weight training, using carbs and protein after your workout, timed with your insulin can help in gaining lean body mass. And understand that generally, carbs taken in after a workout can replenish depleted glycogen stores and fuel your recovery. Most people find that they are markedly more tolerant of carbs after workout because of this and those carbs won’t disrupt your blood sugar control goals like carbs eaten at other times. And please understand, this comes from someone who has followed Bernstein for some time.
bsc-
Thanks for the recommendation. I will check that book our right away. Unfortunately, I’m still not allowed to do anything strenuous post-surgery, and it’s definitely starting to feel frustrating. I’m eating a lot, including supplemental low-carb protein shakes, but I haven’t been able to put on a pound. The only exercise I’m really able to do is a brisk walk in the morning, and so I make sure to eat when I get back from that, when I expect my body to be most receptive to food. So far, nothing. Hopefully in a couple weeks when I’m cleared to start lifting weights again, that will change.