Can't get rid of fat - how to deal with carbs? (Type1 Diabetic)

Hi,

I am a quite active cyclist and rower, eat very consciously and believe I do a lot to stay fit and healthy. Moreover I am a Type1 Diabetic. That means I really do know what I am eating and do take care about the quality of food. I do not drink any alcohol, nor do I smoke.
I am 47y, 188cm and around 93kg in average, rather muscular and meaty. Still I do have some fat around the belly I cant get rid off. And I do not understand why.

For years I am training on the rower and on the bike (indoor and outdoor) in average about 5-8h/week, 30-40min on the rower 3-5/week, and in Winter 2-3 times 1-2h/week on rollers or in Summer 2-3 long rides of 2-4h on weekends.

Last year I spent 300+ hours on bike or rower and burned around 150.000cal (I know these cal numbers are not precise, but still an orientation). On the rower I try to go threshold and beyond, on the bile it is mostly base with only hills as a push to higher pulse.

As a Type1 Diabetic I count every carb of intake and inject insulin. I do not eat Junk food, barely snack (mostly only when in Hypoglycaemia). I find myself quite disciplined, maybe even too strict concerning food.

Despite that amount of workouts - which I find much more than an average Joe with none to barely any sports - I find myself being too chubby around the waistline. I do not get it. I try to be disciplined, I try to go minus in terms of cal intake and also try to fuel ok. Still no change.

I am following my workouts on Garmin and my food on myfitnesspal. I am attaching the last 7days for you as an info and my training load of the last 4 weeks.

Any hints?





You should probably discuss this with your doctor, possibly change the type of insulin, less long acting, more short acting because insulin stores fat…

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Thx.

I barely use Basal. Some days none, some days between 10-16 units per day. I went completely without Basal from Jan-Apr and have a HbA1C of 5,9. No impact on the body in terms of the things described above.
My doc is informed about this approach.

You were at a calorie deficit last week, according to your screenshot. Did you lose about .4 kg? If you are consistently showing a caloric deficit, and you aren’t losing weight, you might be overestimating your base caloric need and/or the amount you’re burning during exercise (you admit the calorie burn might not be precise, though 500 cal/hour seems reasonable if you’re putting forth the effort 130w for an hour is about 500cal/hr) and/or the amount of calories you’re taking in.

Looks like you went over your fat macro several days last week. Consumption of fat is important, but eating too much leaves your body with a simple choice…figure out a way to burn it or store it. Maybe go a little leaner on your fat consumption or do more zone 2 work (higher fat burn than carb). *this is general advice rather than diabetic specific advice, you obviously know more about T1 than I do.

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How stressful is your life? I think there is some sort of of effect where chronically high stress levels make you more likely to store fat. It has something to do with cortisol levels, but I’ve forgot the exact mechanism.

I also think that sometimes our bodies will prioritise fat storage over energy availability, which means that your athletic performance will suffer before the stored fat is used. In that case you probably can’t keep up good training and fat loss - you’d need a quite drastic calorie reduction to lose that fat, but it likely means you can’t expect any fitness improvements at the same time.

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Would second the advice to see a nutritionist. Is the graph showing the calories for your week last week? If so my observation would be that your calorie intake and your training are quite out of alignment. You had quite a big training day on Thursday (>100 load), then big training days on Friday (194) and Saturday (238). But your calorie intake on Thursday and Friday was really low at <2000 calories. Then your calorie intake on Sunday where you logged no exercise was your biggest day of the week at nearly 4500 calories. And even on Saturday where you had quite a high calorie intake as well as a big training day, the majority of those calories came from fat where really you should be increasing the carb intake to fuel and recover from that training.

So my advice would be to increase your calorie intake on days when you’re doing a lot of training, and decrease it on the rest and recovery days. With most of the increase coming from carbs. I.e. You still want a decent fat and protein intake on the easy days but you don’t need as many carbs on those days as you’re not training as much.

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Thank you all very much. one quick note:
I hesitate to eat lots of Carbs in advance to workouts and on workout days because I need to inject lots of insulin. Having insulin in my blood going into a workout not knowing how my body will react to the workout, temperature, stress etc can lead to a very high danger of a hypoglycaemia on the bike - which is very unpleasant and even dangerous.
I am still not sure how to do carbs on workout days and keep the risk of hypo as low as possible

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Personally, I’ve found it relatively easy to lose weight at times when I wasn’t training. I think training makes it doubly difficult to lose weight.

I also have a theory based on Herman Pontzer’s work. His work says that the body burns energy in a narrow range per day regardless of what exercise we do. The more exercise we do, the more the body figures out ways to shut other functions down. So when we pile on the miles, we think we are creating more and more of a deficit and we count each kj burned equally. In reality, each additional hour of training offers less and less overall benefit. It’s really hard to starve oneself while training.

“And in fact, when you account for things like body size, fat percentage, age, no matter how you want to sort of slice it, there’s actually no difference at all in daily energy expenditure between Hadza men and women and adults in the US and in Europe and other industrialized populations. So, a total shock. They are 5 to 10 times more physically active, but there is no discernible difference in the total calories burned per day.”

“And what our data are showing is that the calories out is really hard to budge. Your body doesn’t want to change that very much. And so, what that says is that then weight gain, obesity, overweight, these issues that we struggle with in the US, it is about the energy coming in. Right? It’s about the energy in part of the equation, so it is about diet.”

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Simply, if you’re not losing weight, you’re not in a calorie deficit.

If you’re willing to try a different calorie tracking app, check out Macrofactor. It uses your daily calorie consumption and your daily weigh ins to calculate your TDEE. It then uses that base TDEE to calculate your daily calorie targets depending on the weight loss/maintain/gain goal rate you set up.

I’ve used MFP, Cronometer, Carbon, and now Macrofactor. Macrofactor is easily the best tool out of the bunch and worth the cost. You get a free trial too. (Note, the link is not a referral link, Macrofactor doesn’t offer individual referrals so I don’t gain anything from this).

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I get the concept of Calorie Deficit. On the other side I read a lot about “underfueling contributing to the body going into some kind of low power mode”, therefore not burning its fat reserve.

So what now then?

quote=“MikeMunson, post:4, topic:93277”]
Looks like you went over your fat macro several days last week. Consumption of fat is important, but eating too much leaves your body with a simple choice…figure out a way to burn it or store it. Maybe go a little leaner on your fat consumption or do more zone 2 work (higher fat burn than carb). *this is general advice rather than diabetic specific advice, you obviously know more about T1 than I do.
[/quote]

Yes, I regularly prefer fat to carbs. Simply: I need to inject Insulin for every carb I consume. That makes sports and workouts much more complicated. Fat and Protein is no problem, but fat obviously seems to contribute to not losing kg.

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T1 diabetic and have the same issue, I’m in the UK and not on a pump and used to do a lot of my injections in the stomach, insulin build up in that rejoin did cause me a pod :slight_smile: I’ve stopped doing my injections there and there has definatly been a rejection in my wasteline

It seems to me that a lot of the people replying on this thread are treating it like a standard “wait loss thread” have you considered seaking out the TT1 Diabetic facebook group, they mainly ride on Zwift (have their own kit) but do talk diabetes a fair bit of you ask a question

I’m ok with my weight 70kg,181cm tall, but would love to lose a little bit more around the waste, it’s so frustrating when you find yourself on a , “you have to eat more as the diabetes tells you to”, or even worse, less on a long ride

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Just to add to that, during exercise you become far more insulin sensative, so eating carbs, can become dangerous, and you have to react to you’re blood glucose and GUESS what insulin to take, even though you are far more insulin sensative than usaual, for a none diabetic I think the best analogy would to look down the road, and than ride that road blind folded, it’s probably about the same amount of risk

It makes eating fat and protein, a whole lot safer and easier

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Thank you for those thoughts and insights … frustrating as they are, they do confirm my feeling that actually with T1D we are juggling quite a lot of more variables than “normal” athletes.

I am quite lost what road to take:
More carbs as fuel, probably more energy and strength for the ride, but also this means more insulin and more risks.
Or, a lot less carbs, but more fat and protein, means less energy, less strength, but also less (or no) insulin and therefore less/no risk of Hypo. But probably this is also a harder road to loose weight.

This is all very individual, my son is T1 diabetic and I know the way he manages his diabetes is very different to other people he and I know. So that’s the caveat to my following comments…

Not knowing how “slow” your slow acting insulin is, my son - who is luckily youthful and lean - doesn’t have to worry about his diet, and nor do we make it a focus other than the insulin for his insulin sensitivity needing to match the carbs (clearly!). He does Trainerroad low volume but also the odd big ride or other full days of active stuff like walking and orienteering. He eats normally until perhaps an hour before his training or the exercise and then might take less insulin than strictly necessary on any food in that last hour. He then doesn’t have any basal or bolus for food during exercise - but continues to keep a flow of carbs through energy drink; he won’t account for any of that in an insulin dose.

Is there some reason why you are using slow acting insulin in relation to food? As the insulin my son uses for food in the days before training or a big day out, won’t still be active come training day. We don’t plan even plan more than a few hours in advance at most.

Its easier said than done, but I think you need to try separate your diabetes management (to stay alive and keep blood sugar in range) from your training aims (weight loss and/or getting lean). Not to go silly or down a path of bad nutrition, but pure carbs/sugar is actually quite low in calories!

Thank you. I barely use Basal, some times none over weeks, mostly I’d inject Levemir (12h) in the evening to counter overnight rise in blood glucose. I almost never used Basal during the daytime and never related to food but rather to counter natural rise of blood sugar through liver release of glucose.

Hell yes,

But respect, that is impressive score, I got 6.5 and my doctors are always happy, good control is the main aim, but speak to your doctor about is there any wiggle room in that, and allow yourself to go higher before exerice ?

Only think I would suggest is that eating to much fat, can affect your cholesterol levels

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Yes, I am in normal range at the moment. keeping track on it.

I will see about my doctors take on going higher. It is rather me who feels everything above 7mmol is not good and above 9mmol is bad :sunglasses::innocent::face_with_raised_eyebrow:

myfitnesspal gives me a base caloric need of 2060 cal/day. That does not seem to me overestimated for a 188cm active male, maybe even on the short side?!

T1D here so I know where you’re coming from and what you’re struggling with. Balancing insulin with carbs for an endurance athlete is tricky for sure. First, I don’t dose any rapid acting insulin less than two hours prior to exercising. I also don’t consume many (or usually any) carbs in those two hours until exercise starts. I have found through trial and error that I can dose 30-40 carbs per hour while doing endurance work and not have too high or too low numbers.
So a typical day with a ride for me might be breakfast of eggs and ½ a bagel with a smear of cream cheese for a total of about 30 g carbs. Lunch is low carb (<10g). I’ll have a mid-afternoon snack of protein and fat. I’ll eat something with 10-15 carbs right before leaving for a 1.5-3hr ride and then I’ll have my 30-40g/hr on the bike. Post ride I’ll aim for about 40g carbs and dose rapid acting insulin then.
I used to run low-carb/keto all the time (before T1D diagnosis) and it is possible to train and ride in this state. The only time you’ll really suffer is on hard, sustained efforts over 1.5hr. I used to even do centuries on fat/protein only. Granted it was endurance pace but it is possible.
On days off, you might want to consider a protein-sparing modified fast. Do some research and speak with your doctor or nutritionist to see if it might be worthwhile incorporating into your regimen to create a calorie deficit. It might not be for everybody so do your homework.

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