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Bright Spots Lab – What I’m Trying This Month

By Adam Brown

Easy low-carb bagels and a Mexican “rice” skillet, the awesome Waking Up app, why nutrition studies are so confusing, and Motivational Interviewing

Welcome to “Bright Spots Lab” – a short-form column that shares the most helpful diabetes tips, tricks, and reading I’ve discovered of late. Each update will be added here at the same link, with all previous editions below for easy reference.

Like my book, Bright Spots & Landmines (free PDF, paperback, free audiobook), this column will focus on food, mindset, exercise, and sleep. Please let me know what you’re trying and finding helpful this month!

June 2019

FOOD

1. Easy Low-Carb Bagels Made with Almond Flour – Recipe

I rediscovered this phenomenal low-carb, almond flour bagel recipe in the Elana’s Pantry Paleo cookbook, and it is also posted on her blog. The recipe makes six bagels, takes about five minutes to prep, cooks in the oven in 20-25 minutes, and uses straightforward ingredients that were already in my pantry (rare!). Two adjustments I made for simplicity: I mix the ingredients by hand instead of using a food processor (I don’t own one), and I spoon the batter into the baking tin instead of piping them with a plastic bag. Making one bagel batch on Sunday provides enough for the week (they store well in the fridge), and these end up less expensive than the store-bought Mikey’s low-carb muffins (see Lab #1). Sliced in half, I’ve been topping these bagels with sliced avocado or an egg, with little impact on blood sugar. (For me, 1U of insulin covers one bagel, equivalent to ~10 g of carbs.) This recipe is also sustainable – I’ve baked them four times in the past month. I own a pan like this one, but I’d guess the same batter could be cooked in a bread loaf tin or a muffin tin. Get the recipe here!

2. Low-Carb Mexican “Rice” Skillet – Recipe

The All Day I Dream About Food blog really delivers on low-carb creativity. Looking for ideas to share in this column, I attempted a Low-Carb Mexican Cauliflower Rice skillet recipe – it turned out fantastic and easy to make. As soon as my girlfriend and I took a bite, we looked at each other and said, “Wow – this is a keeper!” We used less cheese than the recipe calls for, and, when we cook it next time, I’ll use a bit less chicken broth.

In case it is useful: I save “keeper” recipes in Evernote for easy on-the-go access and searching.

MINDSET

3. App I’m using nearly every day: Waking Up

I’ve followed Sam Harris’s work for a long time, and I highly recommend his new meditation app – Waking Up, available on Apple and Android. I try a lot of health apps, but end up deleting 98% of them. (Apps must add more value than burden, and that is rarely the case.) I’ve not only stuck with Waking Up, but paid for a one-year subscription – it’s that good. The app has a free trial and a money-back guarantee. Sam is a neuroscientist and approaches meditation from a slightly different perspective – mental training for life and a tool to understand how the mind works, rather than simply “stress reduction.” I’ve found meditation to be the most powerful tool for recognizing diabetes thinking traps and negative thought spirals. Waking Up’s three-minute lesson on gratitude is also incredible; I’ve listened to it alone at least ten times, and it immediately improves my mood. Try Waking Up if you are even the least bit intrigued; I also recommend Buddhify, Calm, Headspace, and Ten Percent.

      

READING

4. Why are Nutrition Headlines So Confusing?

The other day, I was explaining to someone why nutrition headlines in the media are so confusing – how can one diet or food be “healthy” one month and “unhealthy” the next month? Chris Kresser answers that question pretty well in a two-part blog: “Why You Should Be Skeptical of Latest Nutrition Headlines.” Dr. Peter Attia’s weekly email also has an amazing step-by-step rebuke of a recent breakfast study. These two articles provide a thinking toolkit to separate rigorous nutrition science (rare) from sensationalist headlines (common). Personally, I try to combine data from different sources: test different diets and observe the impact on my own health data (time-in-range, hypoglycemia, insulin needs, heart health); read the research; and learn from other people with diabetes.

5. A remarkable book – Motivational Interviewing: Helping People Change by William Miller and Stephen Rollnick

This incredible book is written for healthcare providers and mental health professionals, but is loaded with gems for becoming a better listener and having more effective conversations with anyone. Motivational interviewing (MI) is all about helping people find their own solutions, rather than just giving advice and expecting it to be followed. MI is grounded in a powerful premise: many of us are “ambivalent” about change, meaning we have reasons for and against changing. Interestingly, when a “helper” provides a bunch of reasons in favor of change (“the righting reflex”), an ambivalent person will naturally respond with several reasons not to change. Avoiding the “righting reflex” is a central focus of MI, and it is both conversational art and science. Here’s a thought experiment early in the book that resonated:

  • Choose something that you have been thinking about changing, but haven’t done so yet. Now, imagine a friend (“helper”) who tells you how much you need to make this change, gives you a list of reasons for doing so, emphasizes the importance of changing, tells you how to do it, and tries to motivate you to get on with it. How would you be likely to respond? Most often, the “helped” person feels defensive, uncomfortable, powerless, or angry. Sometimes, the person being helped even concludes that he or she actually doesn’t want to make the change. That was not the helper’s intention; it’s just how people normally respond to the “righting reflex.”

  • Motivational Interviewing is more person-centered, anchored in the belief that people are the experts on changing themselves. Imagine the same thought experiment, but instead of the approach described above, the helper asks these questions: Why would you want to make this change? How might you go about it in order to succeed? What are the three best reasons to do it? How important is it for you to make this change, and why? The helper listens, gives a short summary of all the reasons you just shared, and then asks one more question: “So what do you think you’ll do?” With an ambivalent person, there are reasons in favor of change; MI just helps call them out. 

This is a hefty book, but it’s one I’m going to save and re-read many, many times. If you are a healthcare provider and never received training in MI, I highly recommend this read.

Previous Editions

#1

FOOD

1. Best New Find: Mikey’s Low-Carb English Muffins

I stumbled across these in the frozen section of a nearby grocery store – wow are they awesome! Each Mikey’s English muffin has 8 grams of carbs total (50% from fiber) and seven real-food ingredients: Eggs, Almond Flour, Water, Apple Cider Vinegar, Coconut Flour, Baking Soda, Salt. They have minimal impact on blood sugar in my ten experiments so far. These muffins make a killer breakfast egg sandwich – I put one fried egg on each half and eat it open face. My girlfriend, Priscilla, also enjoyed my grilled cheese attempt (see above). Since the muffins are sold in a frozen four-pack, I thaw one in the refrigerator overnight and then toast it in a hot pan before eating. (I don’t own a toaster oven, though that’s probably the best way to make them.) 

The one downside is price: a four-pack ran about $6, meaning each muffin comes to about $1.50 – more expensive per-serving than breakfast chia pudding, but a nice way to mix it up. Mikey’s has a store locator here, and it seems they are available at Whole Foods and Safeway. This past weekend, I found a way to make a similar version of these at home – higher hassle, but far less expensive – and I’ll share that in the next Bright Spots Lab. 

I don’t generally eat a lot of packaged foods, but these muffins are great to have in the freezer when time is crunched.

On a related note, La Tortilla Factory’s low-carb, high-fiber, whole wheat tortillas are excellent for breakfast egg burritos, tacos, etc. They have a yellow-branded package (“Low Carb”), are sold at many grocery stores – search your zip code here – and are much cheaper than Mikey’s. Since over 70% of the carbs are from fiber (8 grams of fiber, 11 grams of total carbs), they have a similarly small impact on blood sugar.

 

2. Favorite New Recipe: Ground Turkey + Broccoli “Rice” Bowl

Broccoli and cauliflower rice are sold pre-blended at stores like Trader Joe’s, offering a low-carb, rice-like, vegetable-only side dish or main course. This recipe is a serious winner – with broccoli rice, it tasted just like a stone-bowl rice dish. We skipped the maple syrup, used soy sauce instead of coconut aminos, and added an egg on top. The recipe says it works with cauliflower or broccoli rice, but it was far better with broccoli rice in my view. If you prefer, you can make cauliflower or broccoli rice at home in five minutes – see here.

MINDSET

3. Outstanding books:

Digital Minimalism by Cal Newport: This book makes a compelling case for re-evaluating one’s relationship with smartphones and social media. The average person spends three hours per day looking at a smartphone screen, with only 12% spending less than an hour. Note: three hours per day = 46 full days per year! I’ve long used related tools like RescueTime, Freedom, and the iPhone Screen Time report. This book provides a good high-level strategy (and tips) for thinking about the place phones and social media should have in our lives. I see huge diabetes opportunity in cutting even 20 minutes per day in screen time, freeing that up for self-care – walking, more sleep, morning breathing, etc. Taking long walks without my phone has been a great addition to my toolbox after reading this book.

Atomic Habits by James Clear: This book has a crystal-clear structure and great stories for explaining how habits work. I loved the emphasis on tiny (“atomic”) changes – e.g., if you get 1% better each day, you will be 38-times better in a year! Atomic Habits builds nicely on the 2012 classic, The Power of Habit by Charles Duhigg. Combined with Switch by Chip and Dan Heath, these are the three best books I’d recommend for anyone trying to improve their habits. The Mindset chapter of Bright Spots & Landmines has many similar themes.

I’ve also been re-reading and recommending Cognitive Behavioral Therapy Made Simple by Dr. Seth Gillihan, especially the chapter on negative thoughts and thinking errors – it is stunningly good for combatting unhelpful diabetes thought loops.

EXERCISE and SLEEP

4. Switching back to Fitbit from Apple Watch.

I used Fitbit from 2011-2016 and loved the motivation to walk more, to encourage my friends, and to get sleep data. In 2016, in a Black Friday moment of inspiration, I splurged on a discounted Apple Watch Series 1; I was mostly excited to get Dexcom CGM data on my wrist. In January of this year, however, I was feeling extra device fatigue and decided to switch back to Fitbit. It’s been an awesome change! I find Fitbit’s wrist-worn tracker and app more motivating and less naggy than Apple Watch. Fitbit has valuable, built-in sleep data, whereas Apple Watch requires third-party apps. Fitbit excels on battery life too, needing only one charge per week. I haven’t missed getting CGM data on my wrist, as it’s one swipe from the iPhone lock screen. In fact, I do less micromanaging and less stressing about my blood sugars now. My time-in-range is identical since the device change.

 

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