I was on my (conservatively) 93rd go at giving up sugar when shit got real. I had missed a series of phone calls from my GP, leaving each other increasingly cryptic and rambling voicemails like some second rate podcast.
After a week of missed calls, I had basically assumed I was dying.
After two weeks, I had decided it was probably nothing, and if I was dying they wouldn’t just stop calling. They’d probably send someone to knock on my door and poke my corpse with a stick. The Student Loans Company would have been round to repossess the flat.
So I’d sort of forgotten about it when the phone rang again.
It was the doctor. It was about my test results. There was something wrong.
Actually, it wasn’t too serious. There was a problem with my liver, but the blood tests weren’t terrible and there wasn’t any permanent damage and I could probably get it back to health with diet. My pancreas was fine. My blood sugar and insulin levels were fine. I wasn’t diabetic or even pre-diabetic yet. Yet. They knew and believed that I wasn’t a big drinker. I have what is known as NAFL (naffle? naff-all?) Non Alcoholic Fatty Liver Disease. I was human foie gras, except that no one had forced grains down my gullet except me. Ethical foie gras. The literal goose voting for Christmas. I bloody love Christmas. Eat me.
I know all about NAFL. My dad had NAFL right before he had NASH right before he had cirrhosis, right before he had liver cancer.
I was going to die.
OK, maybe not right away, but unless I made some drastic and medically-sanctioned changes to my already drastic and medically-sanctioned diet.
The fact that I had already lost 65 kilos meant nothing. My 10 portions of fruit and veg a days meant nothing. My swimming and stretching and running and lifting meant nothing. And for all my self-loathing posts about how I’ve been comfort eating and regaining weight, I really haven’t been eating that much. Sure, I’d let sweet things back in to my life despite my suspicion that my body didn’t handle them well, but I wouldn’t want to suggest that I've been mainlining the white stuff. I’ve not been snorting it or rubbing it on my gums. But despite my best efforts, the powers of genetics and sheer malevolent bad luck have conspired with my GP (who has in the past blamed my hayfever, heavy periods and a broken toe on my weight) to put me on a diet.
I was going to diet.
Nothing concentrates the mind like the threat of impending death, so getting and sticking to the diet this time was a doddle. At least it was for the first week. Then I went to a party and ate half a bagel washed down with half a bottle of pink fizz. Then a few days later I got hungry and was far from home so succumbed to the charms of a bowl of cereal, despite the availability of a low carb snack (prosciutto) in my handbag (hambag).
But generally I’m adjusting well to life without carbs, and really without much food at all. The regime will get less strict as my condition corrects and stabilises. What has been shocking is that in learning about NAFL and the metabolic disorders, is how widespread is, and how poorly understood - and how poorly communicated - the dietary advice is. From extensive reading and consultation, it would seem that there are two routes you can take to reigning control of a runaway metabolism (NAFL, elevated blood sugar, Type 2 diabetes, hyperinsulinism): Very Low Calorie or Very Low Carb. I’ll report on low carb diets in later posts, but in the mean time…
The Very Low Calorie Diet
Also known as liver-shrinkage diet, Cambridge Diet.
The most mainstream and version of this is The Blood Sugar Diet by Dr Michael Moseley of 5:2 diet fame.
I have mixed feelings about this book because a) it completely changed my life for 8 weeks, and b) I have been entirely unable to repeat that 8 week experiment, even with medical supervision, in the 2 subsequent years.
But if you have been diagnosed with blood sugar disorders, and you can get your gp on board - it can help get you in control of your condition. For me, a cluster of abdominal conditions leaving me with chronic pain often triggered by food and drink - it left me pain free. And it can do the same for a spectrum of metabolic diseases.
It's based on the Mediterranean diet - lots of veggies, healthy fats like olive oil, nuts and seeds, moderate amounts of lean meat and fish, yogurt and other dairy. And light sprinkling of whole grains and and fruits. You can imagine assembling beautiful dishes as the sun pours through the window, the air scented with sea salt and lavender and the gentle sound of waves lapping in the fisherman's cove, as you tear basil leaves over the tomatoes you just picked 5 minutes ago. It's an idyllic and healthy way of life, and if you want to live forever this is the way you should eat. Spread the Good News.
The bad news is that it's just 600 kcals a day so good luck with that.
When I embarked on the Quit Sugar project, this was the direction I turned. In part because I’d done it before so knew it worked and was doable, and in part because it feels healthy. Your Instagram pops with blueberries and tomatoes, set off fetchingly by creamy yogurt and suggestive drizzles of oil.
The reality is that it’s not enough bloody food, and gawd help you if you want a glass of wine. After a couple of months of trying to get on and stick to this regime, I had failed to lose weight, and was sick of the sight of yogurt. I was hungry, hangry, and with not much to show for it. And I worry about the people who don't have a medical reason for cutting back this drastically. I have friends who would love to be given medical permission to stop eating and just Instagram their lunch instead. If you have a diagnosed metabolic disorder, crack on. If you if suspect that you have an eating disorder, or even perhaps a disordered relationship with food, step away now.