In April 2015, I was diagnosed as prediabetic, having a hemoglobin A1c just above the 5.6% threshold. I found this result shocking at the time, because I was 32 and had otherwise been in the best fitness shape of my life, recently competing in the 2014 and 2013 CF Games Regionals, and the strongest I had ever been at the time of the test result. I could run a sub 6-minute mile and Deadlift 500 lbs, it didn’t make sense to me at that time.
So I ignored it. Except that my then girlfriend and now wife, Sarah, who is also a Nurse Practitioner, thankfully insisted that I do not ignore it :). I did what I could as an overworked gym owner at that time: I stopped drinking horchata with tacos, asked for one tortilla per taco (yup), and attempted to eat lower carb at breakfast. But otherwise didn’t change much in my day to day. As an entrepreneur who naively launched into the fitness space with little thought for life balance, I found myself perpetually under the gun trying to make the business work. With daily financial pressure to market, make sales, and take care of an increasing number of people, who has time for detailed planning or tracking around food? I would often skip meals, and could barely make it to the grocery store on a regular basis.
Reluctantly, I saw my provider again and re-tested 2 years later (April 2017). My A1c had gone up a little bit more. I once again minimized it, but in my mind I knew that the small changes to my food selection I was making probably wouldn’t swing the pendulum the other way. It also clarified that the first test wasn’t an anomaly.
When caught between my health and financial survival — the proverbial rock and hard place — some interesting things can happen. The gym business was almost 9 year in at this point, so I couldn’t really defer my health to some future time when things would be easier. The future was already here. And stressing about money and health has a compounding effect. You know what sounds great at the end of another long week? Carbs and eating out. Food is a welcome oasis under stress, as it often is now with the ongoing pandemic.
What is interesting to me now, about me in 2017, is that despite the clarity of the problem, and that I technically had an abundance of my own and others’ expertise at my disposal with the subject matter… I could not make the needle move. I perhaps — as the saying goes — “knew enough to cause problems for myself,” because I could rationalize to myself and others that I knew what I was doing while being ineffective at doing it.
The A1c percentage measures how much sugar is attached to the blood’s hemoglobin protein, a slow accumulation process. The A1c test result basically gives a measure of how well your body has controlled the amount of sugar in the blood over the past two to three months. In other words it is a kryptonite for procrastinating or avoidant behavior. While I could brush and floss more frequently a week before a dentist appointment, I could not scramble even weeks ahead to produce a better A1c test result. It had to be a lifestyle change. On the flipside, it is also very validating if you can get it to go the right direction, because it means these habits have improved.
Another year passed (January 2018), it went up a little more. Another 1.5 years (July 2019), it went down 0.1. I was just above the line still. Fast forward to June 2021 (a few months before I’m writing this). Guess what happened? It went down 0.4 points, I was solidly back in the normal/healthy range for the first time ever! How could this be?
Well, a post-analysis is tricky because we live multi-faceted lives, and a lot can change in a year or more between A1c tests. There are always many variables at play, and while my ego would enjoy telling the story of how I got my $#!^ together and determinedly made the necessary lifestyle changes… that is not the case. I was trying as hard as I honestly could before, because nutrition and food was only a small part of my day to day life. In my own subjective experience today, I am currently “trying” less hard now around food. And somewhat contradictorily, I am at a slightly higher body fat percentage too, and yet still lower A1c.
My guess is that Covid-19 — a terrible, ongoing worldwide catastrophe — accelerated structural changes into my life that otherwise would have been further deferred or delayed. Besides dogged determination, do you know what can improve your food habits? Going from 70+ to 40 hour work weeks. Those “extra” hours that food planning and prep takes suddenly become… just another to-do. Those additional hours of sleep that happen — because the work day can end at 5-6pm instead of 8-9pm, and having 15 clients to keep tabs on instead of 150 — are… priceless. And becoming first-time homeowners with the help of generational wealth, that we can coincidentally run our business out of, instead of renting a tiny apartment that was falling apart, with rats and an absentee landlord… yes the fuller story is about privilege too.
We unfortunately still live in a culture where “personal responsibility” is the dominant narrative: that you are the primary and often sole agent of change in your life, and that your good or bad fortune is the product of your good or bad deeds. Just work harder and do more. This is a deceptive trap; the truth is much more nuanced and interconnected.
When you work for an significant amount of time on the frontlines of peoples’ health: as a coach, therapist, or provider; when you talk to the people you are there to help, and really listen to what their lives are like — the subjective and objective parts — with enough “reps” it becomes painfully clear how connected structural inequality is to individual health. And if you are a big empath like me, you stop blaming people, start coaching their whole life including their structural components, and become more interested in peeling back the curtain of intersectionality, where our imperfect human behaviour connects to our highly imperfect systems and institutions. We have the capacity and necessity to change both, and it is the only way forward.
If this makes you squirm in your seat while reading this, that’s ok too. Facing and embracing that the change you seek as an individual is not wholly and exclusively on your shoulders, and that your personal health intersects with a lot of big systems apparently beyond your immediate control — can be an uncomfortable but necessary realization. Through the truth of that discomfort lies a different level of agency and power: it may give you permission to ask for help, and form a team rather than a steely-eyed, individual determination. If my significant other then and wife now had not advocated for me back in 2015, where would I be now?
If I could go back and coach myself in 2015 or 2017, I would say something like: you’re already working hard, but don’t wait for catastrophe to give you permission to better your life. You truly do not know what tomorrow has to bring, so change the structure of your life for better health now. I would also practically advise doing less intensity and volume of exercise (what I do now), the combination is causing you unnecessary stress that through a chain of events is leading to your chronically elevated blood sugar. Sleep more, and sometimes when you would be training, just hang out somewhere nice with your dog instead, it’s all she wants. You don’t have to be a textbook example to be a leader. Just do you.
The answers are often simple, but not easy. Sometimes a catastrophe is the necessary catalyst for change; it was at least in part for me. Other times reading a story enough.
Coach Mauricio