What are four things that you don’t discuss in polite company?
Over the last several weeks I have continued to experiment with my own diet, in a public way. My goal in all of this has not been to sell a product or a dietary approach, but rather to see how I can use the food I eat to improve my athletic performance and energy–without compromising my blood sugar control. Such are the challenges of being a Type1 diabetic athlete–there are often seemingly disparate goals that must be organized in order of priority–which is easier said than done! I discussed in a recent blog how I had to overcome some guilt and feelings of failure when I decided to put aside my “plant-based” low-fat diet and go back to a high-fat ketogenic approach, and I will follow up on that in a blog next week, but I wanted to take a moment to frame the discussion of diet in type 1 diabetes. It’s a loaded discussion, especially for parents.
The purpose of this article is not so much to delve into my own dietary experimentation and evolution in detail but rather to explore a specific aversion to dietary discussion that I have encountered (and written about). In some recent work with the Glu team, we began creating some content based around nutrition. Part of this involved a panel discussion of different foods that we commonly eat and how those meals align with our goals. In the discussion it became pretty clear that the perspective of a person living with Type1 was often very different than that of a parent of a child with Type1. Parenthetically, I’d like to add that my recent podcast interview with my Doctor (who is also a diabetes parent) sheds some light on this issue).
Having seen a lot of dust-ups on Facebook between parents and PWD (on many issues, not just diet) it occurs to me that there may be an answer to all of this–and it goes back to setting goals. This can inform the use of diet to get us closer to our goals and can also help moderate the discussion of diet such that there is less feeling of judgement associated with it. One thing I hear a lot from parents of kids with diabetes (regarding diet) is an oscillation between anger at feeling judged by adult T1s and guilt over the feeling that they are stuck with a choice between depriving their child of enjoyment in the moment vs depriving their long-term health.
The more I look at the topic of diet, the more complex I realize it is. It may be relatively simple from a biochemical standpoint, but socially speaking there are a lot more intervening factors that complicate things. I rarely apologize for stating my position clearly and with conviction. In terms of diet, I do believe it is important to eat mindfully–and that holds true for diabetes parents as well as PWD. I don’t know that I have settled on a specific cut-and-dried dietary approach that I think will permanently work for me (let alone one that I could recommend to others).
Progress is the most important goal that should guide our decisions and being aware of what we are eating and staying tuned in–is how we are able to determine if the goal of progress is being met. I know that is a general statement but my picture of progress as an adult T1 athlete is likely going to look very different than a young child with T1. Our goals are going to be very different–our bodies and A1c readings are also very different. It seems to me that it could be useful to recognize that survival and optimization are two major dietary goals in Type1 diabetes–but they are very different from each other and lumping them together in discussions is, in my opinion, the source of a lot of the anger, guilt and judgement.
There is a progression in diabetes that begins with survival–and this is typically the training and “rules” we receive from our medical teams. Over time, many people who are reading this will have graduated from using “rules” of survival to making adjustments towards individual optimization. That is an exciting and demanding journey, with many ups and downs and dead ends. I believe that that even the most conscientious diabetes parent is going to encounter limitations in terms of how far beyond survival they can venture into optimization on behalf of their child. That is a very individual, personal process that must be motivated from within or it will wither under the lights of experimentation and failure.
I write this to absolve the feelings of guilt that many parents harbor deep down for failing to optimize. The truth as I see it, is that there is no failure there, because the process of optimization belongs to each person individually and can’t be ingrained by a parent. The same holds true for issues of sex, religion and politics! The best a parent can do is recognize that the time will invariably come when their child is going to begin the journey to optimize and prepare them for that independence–without assuming the burden of guilt for a task that isn’t theirs to begin with.
The question of balance during the “survival years” is a tough one. I believe that progress is more important than perfection because progress is a sustainable pursuit–and sustainability is very important both physically and mentally. Perfection is generally not sustainable and therefore isn’t the goal although it is a motivation to achieve the goal of sustainable progress, much like the mechanical rabbit which keeps the dogs running around the racetrack. Do you let them eat the cupcake at the birthday party or not? Because you can just cover more sugar with more insulin—should you? The answers to those questions are variable–but they do deserve mindful consideration.
My closing purpose in writing this is to empower parents to know their goals in the short term and to reject guilt over the things they can’t control in the long term. It is also my intent to encourage parents not to give up in their struggle for progress just because optimization may not be in the picture. Keep trying, keep taking those small steps because you are setting the tone for the years to come.
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