When it comes to food, I consider myself lucky in that I have no allergy or intolerance, apart from lactose. Of course, being diabetic, I have to minimize, if not avoid, carbohydrates (especially simple carbs) to have better control of my blood glucose. That said, I can choose to indulge if and when I wish; of course, with full knowledge of its effects. This is the case with rice. I generally do not eat rice because rice of all sorts, white, brown, red, polished and unpolished, raises my blood glucose really really quickly. But now I have to avoid rice for another reason. It seems that I have developed an intolerance for it. Continue reading
I had recently performed in a summer recital which my teacher mounts annually for her students. Although preparing for the recital can be stressful, I look forward to performing every year. This year, I was especially excited because I would be singing a really famous Italian aria which for years my husband had been asking me to learn. My excitement spilled over to what I would wear, what make-up I would use, and even to what color I would paint my nails. I actually had my nails done, something I’d never even bothered to do in the past recitals. I wanted to look my best. Continue reading
Note: Day 5 DBlogWeek. Taking a cue from Adam Brown’s recent post, write a post documenting what you eat in a day! Feel free to add links to recommended recipes/shops/whatever. Make it an ideal day or a come-as-you-are day – no judgments either way. (Thank you, Katy of Bigfoot Child Have Diabetes for this topic.)
Pardon me for deviating from the topic but I thought this DBlogWeek prompt would be an apt opportunity to answer a question I often receive from friends and strangers, diabetic or not: What do I eat for lunch? I get this question because I live and work in Tokyo, where rice and noodles are among its staples. Since I do not bring my own lunch to the office, many wonder how I manage. Actually, it is not that difficult to find suitable dishes and restaurants in Tokyo, which is among the world’s top food meccas. In most cases, rice is either served in a separate bowl or placed at the bottom of the bowl (as in rice bowls). Instead of describing food options, which I’ve done before (here), I’ll let you see for yourselves some of the reasonably priced choices available at restaurants and food courts near my office.
First attempt at low carb
I tried low carb a few years ago. I ate around 50 grams a day for the first three months. But due to miserable results, I progressively raised the carbs for the next four months until I was eating around 100 grams and had to accept that my trial was not successful.
The results were not all bad, though. I had two good results, namely, I achieved two consecutive A1cs below 5% and my GP considered taking me off meds. But the good results were overshadowed by the not-so-good ones:
I want to introduce you to a new acquaintance of mine.
During the very recent three-day weekend in Japan, my husband, I and a couple of friends stayed at an old Japanese farmhouse in Niigata. Our host was a Japanese man called Mr. Kato. Kato san is a crazy (in a really good way), lively, open, enthusiastic, and sociable man who does not seem to have an ounce of ego, arrogance, insecurity or machismo in him. His surname Kato is actually his wife’s surname, which he adopted when they married. That’s not unheard of in Japan, but not that common either (at least I don’t think so). He has had different jobs, all people-oriented. In the short time we stayed with him, I could tell that he loved people.
He now works as a cab driver in Tokyo. What’s more interesting is that his own car is a 40-plus year old black London taxi cab, which he used to take us around to see the sights in his neighborhood and town. He loves fishing, among a host of other hobbies. He can out-talk any Japanese or non-Japanese person I know, and is prone to outbursts of infectious belly laughs. He is happy to share family photos and stories (family members were unfortunately elsewhere working), experiences, and adventures. He also has an appetite for learning, and is genuinely interested in people (in case I haven’t mentioned this trait yet).
He has also been diagnosed with pre-diabetes (and the first one I’ve met in Japan). He volunteered the information when he saw that he and I were taking the same brand of metformin. He was quite nonchalant about it. Come to think of it, the few Japanese Type 2 diabetics I’ve met since I was diagnosed were all relaxed about their diagnosis. I do not mean that they don’t care. I mean they do not hyperventilate about it and assume that the world revolves around them and their diabetes. I don’t know if it’s because they were older when they were diagnosed, and so have a better perspective about life’s challenges, or it’s their culture.
Anyway, Kato san and I shared information, from our A1cs at diagnosis to current A1cs, to what foods we had to reduce or avoid, to what foods we miss (beer and ramen shared the top spot), and what foods we absolutely refuse to give up (both of us named chocolate and ice cream). We shared secrets over what alternatives we may have to high-carbohydrate commercial simple carbs. He has lost close to 8 kilograms since his diagnosis. He shared both his worries over possible complications and his bottomless optimism for the best. He may be pre-diabetic but he considers himself fully diabetic for all intents and purposes.
We shared information. I want to stress the word “share”. We did not try to outshine each other. We did not judge each other. We did not lecture each other. Also, we did not spend too much time talking about our diabetes. We spent more time talking about other things.
It was a relief to be able to exchange thoughts, fears and yes complaints to another person who not only empathizes but knows what I’m talking about. It was equally refreshing to not have to talk about diabetes and food all the time (one reason why I have reduced my presence in diabetes online boards). And I would not have had that opportunity had I kept my diabetes only to myself.
When I was diagnosed, I told only a handful of people, and I tested my BG and took my medications very discreetly. It took me a long time to start opening up, and testing and taking my meds in public. I do not make a big deal of my condition, but neither do I hide it anymore. I’ve even started blogging and tweeting about it. Not only is openness liberating, but it has created opportunities for me to meet and interact with fellow diabetics, both in the flesh and online, and be part of a larger family. The knowledge, support and energy one gets from others who have similar experiences and who can offer their hard-earned lessons to save us from highs, hypos, and other diabetes-related mistakes they have gone through, cannot be matched. More than that, being part of a community is empowering as one sees the potentials of concerted efforts. Take the Strip Safely campaign for example. That’s a good representation of channeling our frustrations to something more productive than just complaining.
I would not have met all the wonderful diabetics in Japan that I’ve met (although they are just about a handful of people at the moment), and outside Japan as well, not just through online boards but through blogs (see my blog roll) and websites, or in person, had I been content to keep to myself.
I do recognize, however, that being open about your diabetes may not all be good, as it invites the food police, judgment, unsolicited advice, and even threat to your job. But I think that these problems can be dealt with by choosing who you reveal your diabetes to, timing, and not making a fuss over it. I do not advice disclosing your diagnosis the second you hear it from your doctor. I think that you need to find your way and have a clearer picture of how you will approach diabetes, before you throw yourselves to a larger circle of people who each has his own views, beliefs and prejudices. But, it is not a healthy choice to keep everything to yourself. At some point, you need to let people know, lest you explode like an over pumped balloon.
Memories have a funny way of popping up when you least expect them and without provocation. While I was out running Saturday morning, the name of a college friend, Tonette, and a brief conversation we had more than a decade ago came to mind. We had both been living in Japan for at least two years by the time we had our little chat. I was here for work, while she was here earning her PhD in engineering.
A few months before Tonette completed her doctoral thesis and went back home, she came over to my place to be my food tester (I was just learning how to cook and she agreed to share my table – one brave woman). She brought a box of strawberries, which led me to comment on how expensive fruits and vegetables were in Japan. Our conversation went something like this:
Me: Thanks for the strawberries. I still can’t get over how expensive vegetables and fruits are.
Tonette: True. Which ones do you often buy?
Me: I don’t buy much. Too pricey.
Tonette: Do you buy chocolates?
Me: Yes I buy chocolates, but now I’m trying to cut down on chocolates.
Tonette: How much is an apple?
Me: Between 150 yen and 200 yen depending on the season.
Tonette: Do you find that expensive?
Tonette: How much is that bar of milk chocolate sitting on the table?
Me: That brand is about 150 yen.
Tonette: Do you find that expensive?
Me: I don’t think so. Actually, I never thought about it.
Tonette: We usually complain about the price of fruits and veggies but not the price of chocolates. And we buy more chocolates and potato chips than we do apples. Why is that?
Yes, why was that?
I’d like to say it’s finances, that apples are more expensive than chocolates and potato chips. But it really is a question of value and choice. At that time, I placed more value on chocolate (and milk chocolate at that) than I did on fruits and vegetables, and my distorted sense of food value dictated most of my food choices. I didn’t consider the fact that cheap milk chocolate provides short-term enjoyment for a lot of calories, while an apple (also sweet and can just as easily ease a sweet tooth) is also enjoyable, has fiber and is more filling, has fewer calories, and has vitamins and nutrients that a bar of milk chocolate does not have. Looking back, I also remember getting all excited about going to buffets, because I thought that I was getting a lot of value for my money. But plates of mediocre food, gallons of soda, and tons of calories, not to mention an aching stomach, later, one had to ask whether that really was good value at all. For the same price, can a mountain of forgettable food really trump a much smaller meal of wonderfully cooked food? More than ten years ago, I would have said yes.
Quality food usually costs more than commercially manufactured meals, which makes it tempting to grab frozen dinner or a doughnut. We are not all financially well off and most of us live on a budget. This, however, does not mean having to sacrifice real value in favor of cheap imitation, at least not most of the time. But we have to do some research on where we can find cheaper ingredients, do our homework on what healthy meals we can prepare, and learn to cook, with the aim of minimizing our reliance on processed food, and fast food diners and chain restaurants, while keeping within whatever financial limits we may have. For example, my husband and I have no qualms at looking at the “has been” bin and buying a cheap bruised or warped zucchini instead of its “perfect” but more expensive brother. We can also be more adventurous in trying unfamiliar animal parts or vegetables, as many of them can be cheaper than the usual fare. In the process, we help minimize food waste (but that’s another topic).
What many of us may not be aware of is that we may not need so much food to be satiated. From my experience and those of people I know, good quality food is usually more gratifying (taste-wise and nutrition-wise) than processed food, such that you don’t need to stuff yourself to the gills to be satisfied.
Paying attention to quality food also translates to better health, which in the long run is where true savings lie. It is false economy to eat cheap commercialized products that are terribly lacking in nutritional substance in the hope of saving a few dollars (or yen, in my case), only to have to shell out more later on for doctors, hospitals and medications to deal with failing health and nutritional deficiencies. Plus, who wants to spend most of their later years unable to go anywhere or enjoy life because of bad health?
By the way, I remain a chocoholic, but a reformed one (yes, that’s not impossible). Only, I no longer eat cheap milk chocolates. I now only go for 75% (or higher) chocolate, for at least three reasons. First, it’s so rich and filling that I don’t go through a bar in one sitting anymore. Second, it’s more expensive, so I make a bar last. Third, it’s chocolate, so I get my fix. My weight stays the same, my taste buds are happy, and I get my chocolate-induced endorphins with just a small piece of good quality dark chocolate.
Quantity, not quality, has become the standard of value for one’s money. Let’s try to flip that and instead focus on quality, not quantity. Quality eating takes time and effort, and may test our budgetary limitations, but our health and that of our family, quality of life, and in the long run our bank accounts, will be grateful for it.
I recently took a Delta flight where I decided to try its diabetic meals (DBMLs). I had tried Delta’s DBML before and I wanted to know if it has improved.
This was the first Delta DBML meal I received.
My DBML consisted of chicken breast with some sort of sauce (still not sure what it was) on a bed of a lot of rice, with carrots and snap peas, bread, vegetable oil spread, green salad consisting mainly of lettuce and cucumber, balsamic vinaigrette, and pineapple, cantaloupe and honeydew for dessert. My jaw dropped when I saw my tray. Delta should fire its dietitian for serving a DBML that will crank up any diabetic’s blood sugar level. Rice, bread, pineapple, cantaloupe and honeydew?! And vegetable oil spread?! Was Delta trying to kill me?
In addition, the meal was bland and unappetizing. The chicken breast was tasteless and dry, although it was served really wet as if someone poured water over it. The salad was in such a state that only a famished rabbit would have touched it. Delta was obviously also trying to starve me.
Compare my food tray to my husband’s.
He also had chicken breast but with ale sauce, cheddar mashed potatoes and broccoli, shrimp cocktail, green salad (that looked better than mine), bread and dessert (cookie or brownie). I tasted the chicken, and it was so, so much tastier and juicier than mine. He had shrimp cocktail, which was absent from my tray. He had butter! I never thought I’d say this, but I looked at his airline meal with blatant, unconcealed, obvious, make-no-mistake-about-it envy.
Before we landed, we had a smaller meal. Mine consisted of a cold zucchini with onion sandwich (yes, bread!), green salad (thankfully, no lettuce), and grapes and pineapple (yup, high sugar fruits again). Again, whoever designed this meal should be sacked pronto. The only redeeming thing I can say about that meal was that it was marginally better than my husband’s egg, tomato and cheddar cheese breakfast croissant (trust me, it sounds better than it tasted or looked). That’s small consolation though.
My requests to Delta
Based on this enlightening experience, as well as similar experiences reported by fellow diabetics online, I ask Delta (and all other airlines which offer DBMLs similar to Delta’s) to please just stop serving diabetic meals. Just give us regular airline chow, which may be as high-carb as a DBML but at least tastes better. We’ll just pick what we can eat.
But if airlines insist on offering DBMLs, then these are my requests – please:
- Serve a low carb meal. Regardless of a diabetic’s everyday diet, a low carb meal is the best bet on a long haul international flight. If a traveler is crossing several time zones, his body and hormones will most likely be out of whack and stressed out, both of which contribute to an elevated blood glucose level for diabetic travelers. Help us minimize this elevation by not stuffing us with a high carb meal that is guaranteed to drive our blood glucose even higher. We diabetic travelers, like other passengers, are strapped to our seats and are in a confined space that severely limits our physical activity. This means that we cannot lower our elevated blood glucose levels through exercise.
- Serve us delicious food. All right, it may be too much to ask for delicious food since even regular passengers do not get delicious meals on Delta (or many other airlines for that matter). But, don’t serve us something worse than your regular meal. We may have diabetes, but our taste buds work just fine and can tell the difference between bad food and really bad food. We do not deserve the really bad food.
- Give us butter. Why would you give regular passengers butter and us vegetable oil spread? Yuck! Many diabetics do not need to avoid butter. At least, give us the choice.
- Do Not Announce to Everyone that We Are Being Served a “Diabetic Meal.” No one needs to know what special meal diabetics are having. In fact, no one needs to know that we are diabetic. Please tell your attendants to just give us our DBMLs quietly, or at least use a low voice. Plus, you do not have to serve us way ahead of other passengers. There is no reason for that. The flight attendants have an idea which seats they are serving – come on, it’s not as if 4 people are serving the entire plane. Hence, there should be no reason why my DBML cannot be served at the same time as the other passengers’ meals.
To my fellow diabetic travelers
Skip DBMLs. You are better off with regular meals. The carb contents of a DBML are not that different from a regular meal, but at least regular meal has some semblance of taste. DBML just means bland, no-salt, no-fat, high carb meal. It seems to me that the airlines’ idea of a DBML is just to serve a lot of carbs albeit in smaller portions. But there is no doubt in my mind that a meal of bread, rice, grapes and pineapple, even at small portions, will drive our BGs up, especially with limited physical activity during the flight.
Also bring your own snacks. On the way to the US, I had eggs with me in case I became hungry. On my way back to Japan, I had cheese which kept me from starving after being served untouchable DBMLs. My own snacks also made it easier for me to say no to mid-flight snacks of brownies and ice cream.
I also usually eat before getting on the plane, so I’m not that hungry. If I there is a menu of flight meals, and I decided to skip a meal, I sleep through meal time. These may help you avoid (or eat only a little of) high-carb airline meals.
Traveling is fun, but traversing several time zones can be harsh on the body, especially for diabetics. If an airline claims to have the interest of diabetics in mind, then it should do more to serve true diabetic friendly meals. On the other hand, for us people with diabetes, if we want airlines to serve us food that our body can process during the flight, then we should be more vocal in letting them know what we need to eat, because no food expert will know our bodies and our needs better than us.
I love food. I love the different textures, aromas, flavors, tastes and presentations of food. Food is sensual, seductive, warming, comforting and satisfying. It is a source of enormous pleasure. Thus, it saddens me to hear people say that to them food is just fuel.
I am a gourmand. By gourmand, I mean someone who enjoys eating and drinking, and appreciates good food and good wine, without the pretense and elitism that I associate with a gourmet or a foodie. Maybe it is more accurate to say that I’m a gastronomic hedonist, maybe not in a philosophical sense, but in a real, day-to-day dining and imbibing sense. My love for food is matched only by my love for wine and spirits. I’m not talking about overpriced dishes in expensive restaurants. Good food does not have to be high-priced, and inexpensive dishes do not have to rotate only among three tastes (bland, too sweet or too salty). I’ve had excellent meals in fine restaurants as well as in rundown dim sum houses, makeshift street-side eateries, hole-in-the-wall restaurants and people’s homes. I love to try new places, new recipes and new dishes. I don’t just eat to live, I live to eat.
Appreciation of food came late to me. I’m from a country the cuisine of which, despite having Spanish, American, Chinese and Southeast Asian influences, is sadly eclipsed by the spicy, exciting and visually pleasing cuisines of its Southeast Asian neighbors. Although my mother made sure her children had fresh meat, fish and produce, I did not grow up on exceptional cooking. It was after I moved to Tokyo, at the age of 31, that I came to discover and fully appreciate the pleasures of good food. I felt that I had a lot of catching up to do, and tried my best to make up for lost time.
Just in case you are speculating that I became obese with all this good eating, it was in fact the other way around. Before I took up food appreciation as a serious pursuit, my life revolved around work, and the pressures of building a career steered me towards junk food, soda and rice, noodles and pasta. At that time, food was indeed no more than fuel to me. Naturally, my weight started piling up. But, when I started eating for the sheer pleasure of it, I lost weight (at the same time, I quit smoking and returned to running). I found that really good, fresh, whole food does not have to be eaten in heaps to be satisfying and filling, is best eaten slowly and is definitely best when shared with good and equally appreciative company. Not only did I lose weight, I was also enjoying myself immensely.
Thus, I was devastated, depressed and angry, when, a few years later, my doctor diagnosed me with Type 2 diabetes. I researched and visited online diabetes boards and forums to learn about my condition and how to live with it. A few months after my diagnosis and research, I became convinced that I had to adopt the diet that everyone promised will save me from becoming blind, hooked to a dialysis machine and legless, and from taking medication for the rest of my life. That also meant turning my back on many types of food and dishes. My blood glucose numbers were to die for, and my A1c even plunged below 5% a couple of times. But instead of rejoicing, I was extremely unhappy.
This diet is boring and restrictive. I feel deprived.
I’m sluggish and always sick. I’m no longer enjoying running and socializing. Where’s the boundless energy that everyone on this diet is talking about?
I have lost my appetite. I don’t enjoy food and eating anymore.
I can’t stop thinking about food and eating.
I’m turning into a cantankerous food cop. I detest people who can eat anything they want.
Heck, that fake low-carb margarita mix looks tempting.
After more than half a year of trying to make this diet work for me, I had enough. Although that diet was effective for many people (especially diabetics), it was clearly not the diet for me. I realized that I was looking at things the wrong way. The question I should have been asking was not “what do I eat” but “how do I want to live and die,” and the latter question leads to the bigger question of “who and what am I.”
I’m a hedonist and a diabetic. I cannot choose between them, and neither takes precedence over the other. I am a gastronomic hedonist to the core. Eating and drinking well are a big part of me. I draw immense pleasure from them. At the same time, I am also diabetic and there is no use denying it. I know that I need to find a way of eating while minimizing the risk of complications. But I do not have to allow the fear and paranoia of diabetes complications to hang over my head like the Sword of Damocles and run my life. Yes, the risk of complications is real, but I cannot spend my days as if I were already afflicted with these complications. What was it that Benjamin Franklin said? “Many people die at twenty-five and aren’t buried until they are seventy-five.” I have no desire to live that way.
Instead of ditching certain foods, I experimented with portion control, timing and food combinations. Exercise became an even more important part of my life. I have accepted that I would need medication, and that being medication-free was not the right goal for me to begin with. My A1c, though still in the 5% range, will never dip to 4%, but that’s ok. It has taken a lot of experimentation, testing and introspection to find that delicate balance between an acceptable BG level and my love for eating and drinking, and this is and will be an ongoing process. But that is all right, because I regained my energy, my interest and zest for life, and my old self back. I was happy again.
My husband and I very recently attended two Japanese matsuri (or festival): the Ome City Matsuri and the Tamagawa Genryuu Matsuri in Kosuge, Yamanashi Prefecture.
Like most, if not all, festivals in Japan, food and drinks played a central role in both festivals. After all, what good is a festival if it keeps you starving and thirsty?
Only very picky eaters will have nothing to eat or drink at a matsuri. But what about a diabetic who wants to keep his blood glucose under control, will he have to starve, bring his own food, or settle for a high BG? Nope. A diabetic will have no difficulty finding food that will not send his BG skyrocketing, unless he does not eat meat of any kind.
It is true that most festival food stalls sell high-carb offerings, such as:
- yaki soba (noodles)
- grilled corn
- okonomiyaki (a kind of pancake with various toppings)
- takoyaki (ball-shaped batter with octopus)
- choco banana (chocolate-covered banana)
- cotton candy
- jaga bata (potatoes with butter)
- kakigori (shaved ice with colored syrup)
- taiyaki (fish-shaped pastry with some kind of sweet filling)
- candy apples, strawberries and other fruits
I ignore them. Well, almost all of them. I sometimes enjoy a small portion of okonomiyaki (that is, I eat the toppings and little of the pancake, and I ask the vendor to put very little sauce), or one or two takoyaki balls. So, what do I eat? Well, plenty.
Japanese festivals are very kind to meat lovers. Among the choices you have are:
- yakitori (grilled chicken parts on stick)
- ikayaki (grilled squid)
- karaage (fried chicken)
- grilled fish
- hotateyaki (scallops grilled in butter)
- sausages and frankfurters
There’s kebab which seems to have increased in popularity over these past few years (I leave the bread untouched). If, like me, you like soup, you can find (during the colder seasons) oden (which consists of various ingredients in soy-flavored broth) and miso tonjiru (miso soup with pork and vegetables). If you are not
squirmish squeamish, you can try buta motsu nikomi (simmered pork innards or intestines and vegetables), which I thoroughly enjoyed at the Kosuge festival.
If you are vegetarian, you can always find cucumbers which are widely sold, especially in summer.
See? Japanese festivals offer a lot of delicious diabetic-friendly food. I have never ever left a Japanese festival hungry.
What about drinks? Water and an assortment of teas (by this, I mean unsweetened teas) are always on sale. But alcoholic drinks are a different matter. Beer, in almost limitless supply, is the most popular alcoholic beverage in festivals. You can also find sake but, like beer, it is not low carb. The possible low carb choices are happoshu, a low malt beer, and chu hi, a combination of fizzy lemon or grapefruit juice and shochu. But be careful with chu hi because, depending on which brand and type you pick up, it may not be as low in carbohydrates as you would like it to be. As someone who does not add sugar to her beverages, I find chu hi too sweet for my taste. Do not expect to find whiskey, gin, vodka or good quality shochu. I know because I looked. As I happen not to enjoy happoshu or chu hi, if I want to imbibe, I settle for sake, which I drink slowly and alternate with water or tea. I get the buzz without getting smashed.
So, the next time you stumble upon a Japanese festival, do not despair when you see all the flour- and sugar-based offerings, because you know you will find something suitable.
Enjoy your matsuri.