The Importance of Changing Ernest

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Ernest had high triglycerides and his blood glucose was rising. He thought he was doing all right, so you can imagine what he thought when I recommended that he increase the amount of fat and protein in his diet and decrease his carbohydrate intake.

Prior to our first visit, Ernest started his day with what he believed was a healthy breakfast: high-fiber cereal, skimmed milk, fruit and orange juice. He ran seven or eight miles a day with his dogs, and he ate what he thought was a heart-healthy, low-fat diet for the rest of the day.

At the time of our first visit in February 2001, Ernest weighed 195 pounds and had a BMI of 28.8. His A1C was elevated at 8.3%, and his other numbers left a lot to be desired.

I talked with Ernest and his wife, Pat, about insulin resistance, which can cause high insulin levels, high triglycerides and type 2 diabetes. He began to understand how his diet had been working against him rather than for him.

Ernest knew about “good carbs” and how to choose them. As for vegetables, he ate all he wanted of the non-starchy vegetables. He added nuts and olive oil to his meals. We agreed that he should continue with his running and keep his positive inquisitive spirit. He gave his new treatment plan a try.

Ernest has followed his individualized plan for five years. He has lost 40 pounds and has kept it off. As a side benefit, Pat lost a few pounds that she had trouble taking off before. Now that Ernest has his diabetes under better control, he and his wife feel more confident of living long and healthy lives together.


Ernest’s problem
“In hindsight, I now realize it was the starchy carbs I was eating—pasta, rice, potatoes—and the juice I was drinking.”

Ernest’s reason
“I want to receive my pension check for more years than I worked. I want to enjoy a fun, healthy retirement with my family.”

What was in Ernest’s way?
Following a plan that was not improving his numbers—triglyceride levels, blood glucose or weight.

Method
Ernest changed the way he ate. “We mostly omitted ‘starchy’ carbs and high glycemic index carbs. We now eat low glycemic index carbs, fresh vegetables, more protein from lean meats and eggs, and we make sure we eat good fats and oils. I continue to be active, running 7 or 8 miles per day, 6 or 7 days per week.”

Ernest’s Stats: Before and After

  February 2001 November 2005
Weight 195 pounds 155 pounds
BMI 28.8 21.4
A1Cs 8.3% 5.5%
Blood glucose range 180 mg/dl–210 mg/dl 90 mg/dl–110 mg/dl
Total cholesterol 228 mg/dl 174 mg/dl
Triglycerides 500+ mg/dl 53 mg/dl
HDL - 91 mg/dl
LDL - 70 mg/dl
Blood pressure 120/56 mmHg 90/50 mmHg

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