When I got my Prediabetes diagnosis in 2015 due to an elevated hemoglobin A1C test result, I was told not to worry about it at that time (it was borderline). But I understood what it meant (chronically elevated blood sugar), so I “knew” that in summary I needed to find a way to reduce sugar consumption in my diet. Horchata at the taco truck, and late night treats were the primary suspects. And yet, despite my best efforts to eat more vegetables and less sugar, for years I was unable to improve my A1C test result, and in fact it got worse. Finally in 2020 when the pandemic re-organized my life on several levels, something changed, and in 2021 I was back in the normal A1C range (<5.6%).
I knew what I was supposed to do the whole time, and I even coached people on how to do this. I had no new relevant information between 2015 and 2020 about how to improve my diet around this problem, and like I said the test results got a little worse each year between 2015-2019. My exercise was largely the same that whole time too (I’ll talk about how that contributed later too). Interestingly, I had pretty low body fat levels (10-12%) the entire time too, and was in the best shape of my life from a performance perspective (Deadlift ~500#, mile run ~6:00). But something changed enough in my body between 2020 and 2021 to shift the tide.
I like to use this story to illustrate the limitations of what I will call linear solutions, or more simply taking everything at face value – a sugar problem = a diet problem – and taking a step-by-step approach only within that framework.
For example: it’s a diet problem, so this week I want you to replace any juices with sparkling waters. Next week I want you to have protein at each meal. The week after that, I want you to increase your vegetables at each meal. It’s simple, which early on puts the mind of the client and coach at ease. And it often does not work.
The problem with linear thinking is that it can’t account for a person’s full health picture, and over simplifies the obstacles to the point where the model doesn’t fit with reality. Different aspects of your lifestyle intersect and affect each other in non-linear, feedback loop ways. Your family history, support network or lack thereof, and stress all play unique and intersecting roles in why making change is harder than it seems like it should be.
So when you get a high blood sugar measurement and instructions to modify your diet, your inclination (and instructions if you’re lucky) is to work on your diet by cutting out those “bad” foods, maybe adopt a new meal plan, maybe to start exercising with some focus and intensity.
But the problem with your increased consumption of sugar is that it may be more of an effect than a cause. The increased sugar consumption may actually be a solution to increased work, family, and/or emotional stress: the problem you didn’t see.
With the best intentions, increasing the amount of “stuff” you have to do to change your nutrition and exercise habits can increase your stress for the important period of time it would take to make these changes stick, derailing you just as you are getting started: very demotivating. But because you often hear this advice from an authority figure, and having no apparent alternative, you try your best.
So, you’re going to hear me talk a lot about stress from now on :). My pet theory is stress is basically the gatekeeper for most behavior change because it is the thing we have the least societal support and education in improving holistically.
Trying to change other aspects of your health without either addressing stress at first or in parallel is messing it all up from the start. The challenge with stress management is that there is often a sticky, structural component to it. For example, your work or family situation may be hard to change, and you need the money to survive. Additionally, just for example, if your boss is a tyrant, there is social pressure to remain quiet or at least careful about how and when you talk about it.
In my own experience, if someone asked me to confront my work stress head on in 2015, I probably would have sarcastically brushed them off. I can be very stubborn. But head on isn’t the only way. I find now that taking a more oblique or tangential approach to stress often works best with clients.
That is all to say, I’m not going to try to work on your structural components of stress right away, that is too much to take on and will probably backfire. What I would try to do is something smaller and more neutral, something that just gives you a sensation of what putting the weight down feels like for even 10 minutes. We get hooked on feelings and habits, not A1C scores.
10 minutes of walking, breathing, meditating, listening to relaxing music, getting your nails done. Whichever feels the most doable, start there. Notice any sensations in your body if you can. Then, let’s talk about it and look for ways to expand that precious bubble of self-care to the point where we can work on a small part of your nutrition that makes you feel nourished, or exercise in a way that makes you feel good and sleep better.
You will know it’s working when you are able to stick to the plan most of the time, and that you genuinely feel better during or after you do it. And don’t let that little gremlin voice tell you that you don’t have the time for all of this. You have the time, and taking your time to work on your whole person – in all its non-linear, beautiful complexity – will be what makes this time different.
Coach Mauricio