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- [00:00]
A
Welcome back, friends. You are listening to the Juice Box Podcast. In every episode of Bolus 4. Jenny Smith and I are going to take a few minutes to talk through how to bolus for a single item of food. Jenny and I are going to follow a little bit of a roadmap called Meal Bolt. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM tweak for next time. Having said that, these episodes are going to be very conversational and not incredibly technical. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of Meal Bolt in every episode, we. We will be thinking about it while we're talking. If you want to learn more, go to juiceboxpodcast.com Meal Bolt. But for now, we'll find out how to bolus. For today's subject, Nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan. Number four on the US Top most consumed vegetable list. I thought this was gonna be number one because of how many people I see eating salad. I just thought lettuce has gotta be up there. And I mean, number four is pretty high on the list, obviously.
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B
Well, and it's also not just salad, but it's used in sandwiches.
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A
It's everywhere.
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B
It's everywhere. Right.
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A
But here it is. Some of the other ones have been talked about, about, like, the pounds that people take in a year. This doesn't get spoken about this way on my list. It says it's one of the most purchased leafy greens and about 20% of all vegetables consumed. Iceberg and romaine. Leave it out. So that's it. So mostly people are eating romaine or iceberg lettuce or iceberg. Yeah, that's a lot. So carbs in lettuce. I don't know. Like, how do you even want people to think about this? Is it like when we're doing this, you know, when we're measuring, is it like, am I counting leaves? Am I just trying to, like, see the size of the bowl and get, like, a vibe, you know what I mean?
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B
Because it goes along with that fist again.
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A
Yeah.
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B
A fist is a cup. A cup of greens that are either romaine or iceberg, which are primarily, like. Especially iceberg is primarily Hollywood and, like, fibrous structure, really.
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A
Right.
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B
It's like one or maybe one and a half grams per fist size portion. It's really not.
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A
Mm.
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B
It's not countable in the grand scheme of things. Like, if you've got a lettuce leaf on your sandwich. Are you counting a gram of carb? I can guarantee it's probably from a legal standpoint. Counted in the carb content in nutrition facts for a chain type of restaurant. Right. Should you be adding. Oh, added three lettuce leaves to my burger today. Really?
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A
Right. Yeah, that's the way I'm. I'd like to talk about it. Like, how much leafy lettuce would you have to eat to get to. Like, this is five carbs. I need. Like, would it be a. Like a Ziploc bag of it? Like a lot.
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B
Five fists, really? If you consider. If you just dull it down to 1 gram per fist, like 5 cups of greens that are not really nutrient. It's a lot of just iceberg lettuce.
- [03:43]
A
Okay. So we don't need to think too hard about that, but let us think about the rest of it. So I just randomly picked one chain restaurant that I happened to drive by the other day. So sorry, Red Robin, if you're offended by this, but I have here a Red Robin Caesar salad. 230 calories. 190 of those calories are from fat. There are 21 grams of fat in this salad. 4 saturated cholesterol, not bad. 15 sodium, 368 carbs, 4 protein. That's their little Caesar salad. Right. But they have a list of salads here. And there's an avocado. Excuse me, there's an avocabo salad. I don't know who named that, but well done. 25 carbs, the Caesar, like I said. Eight chicken tortilla soups. Hold on. Going back down the salad. Crispy chicken tender salad. We've all seen that ordered. That's got 60 carbs in it.
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B
I was going to guess about 50.
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A
Yeah.
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B
And where do you think all the carbs come from? It's not from the iceberg lettuce.
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A
No. It's going to be the breading on the chicken. The protein itself. There's more. Although protein in that salad is. Let's see. Crispy chicken tenders. There's 38 grams of protein in that.
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B
So 38 grams. They're about. What is that? That's like seven. That's about five ounces of protein. And so if I consider the carb content being where it is, there's gotta be something in the dressing. That's pretty carby.
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A
I'm gonna guess. There's also in this crispy chicken tender salad, 50 grams of fat. Yeah. And sodium. Wow. Go ahead and guess the sodium in this salad.
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B
I'm gonna guess either it's probably about 1200 milligrams.
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A
Almost 1500. Yeah, almost 1500 milligrams. So. Yeah. Anyway, that's it. Now you go down here and you say, oh, well, there's the mighty Caesar salad. Because there was a little side Caesar and that didn't seem bad. It only had a certain amount of carbs in it. But the mighty Caesar salad, first of all has 760 calories in it. I don't think you're buying a salad for to get a thousand. Like, that's a lot of calories.
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B
Yeah.
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A
18 grams of fat. It's got a lot of cholesterol on it. 70 milligrams of cholesterol, 1480 milligrams of sodium, 36 carbs, 28 protein. It doesn't say there's chicken in it though. Anyway, like, this is the kind of stuff that I'm talking about, like the Southwest salad. 910 calories.
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B
I think the big picture or the behind the scenes that I see in terms of how to bolus for lettuce. If you have eaten something like this, this was your meal choice and you really go off the rails blood sugar wise after the meal. You shouldn't be blaming, not counting the lettuce.
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A
Yeah, it's.
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B
I guarantee it's not the miscount of five grams of lettuce.
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A
Yeah, that's the point of putting this one here. Your lettuce is a delivery system for something else. That's it. Like, I once heard somebody describe baked potato as a delivery system for butter or in sour cream. Like that sort of it. Like, I. There are items on this menu, I'm not picking on them. I just literally randomly came to it. But there are items on this menu that you would think of as not healthy for you and some of them aren't better for you than the Southwest salad, I'm sure. Yeah. Which, you know, 910 calories, 61 grams of fat. Gosh, that's crazy. 1850 milligrams of sodium, 47 carbs. That's a lot like that. Literally. There's whiskey river barbecued chicken wrap. Ain't much worse for you. And like, so.
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B
Right.
- [07:39]
A
And again, a lot like just rolling down here. Like, I'm not even, like, forget what I'm looking at. These are just Their menu stuff. When you get into the meals, the carbs, everything is 40, 50, 60, and you go out to dinner and you do your gazentas from home, you're not getting up to that. You know what I mean? No.
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B
Well, and even 40 grams for a restaurant meal, that's actually pretty low in carb.
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A
Not bad, right?
- [08:05]
B
For a typical today restaurant meal, usually it is much heavier. And unfortunately, that is the place that a lot of people get frustrated because they may use their whole meal as a comparison tool. They might say, well, when I eat pasta at home, it's 45 or 50 grams of carbs. So then they get to the restaurant and they count that and they end up not with the results that they had at home. Well, you knew all the ingredients at home. It was a good base, it was a good place to estimate or swag from. But there are so many more pieces to it. Like the portion probably was double what you would normally put on your plate at home. But the sauce absolutely was made with more sugar than maybe your no sugar or homemade marinara sauce at home. Did you eat the bread before the meal that maybe was miscounted? And at home you don't have the bread before the meal.
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A
Grease, you know, everything, everything's fatty because it tastes better. So I just, you know, I know this isn't lettuce, but because we're talking about going out real quickly, there are two different size chocolate shakes available. They call them malts, but there's a monster size and a kid size. The monster size has 160 carbs in it and the kid size has 83.
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B
And that's a kid size.
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A
The kid size is 83. Yeah, yeah. So the monster size is 1080 calories. So that's pretty much half your calories for the day. Right. Anyway, that's the kind of stuff, like, I just think when you're in a restaurant, you look at that salad, you don't think about everything else. And you know, I'll throw in this little piece here because I don't. I think it's hard to count carbs in a restaurant. You know, you're fighting with your kids. 250, 300, 350 blood sugar, and you're nickel and diming it with like, I'll give them another half a unit. Like, you know what I mean? Half a unit. You're. You missed by 40, 50 carbs here. You know, like, this is gonna be all day. And then people are like, I don't know.
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B
It wasn't from the missed.
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A
Lettuce and it wasn't the lettuce. If you want to, if you want to just eat a hand, like Jenny said, if you want to have a fistful of lettuce, you know, it's a carb.
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B
It's a carb.
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A
You can evaluate that and do everything you want to do. But anyway, it's not the lettuce that's getting you. That's the delivery system for whatever is getting you.
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B
Yes.
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A
All right, I'll see you, Jenny. Thank you.
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B
Thanks.
- [10:32]
A
In each episode of the Bolas 4 series, Jenny Smith and I are going to pick one food and talk through the bolusing for that food. We hope you find it valuable. Generally speaking, we're going to follow a bit of a formula, the Meal Bolt formula. M, E, A, L, B, O, L, T. You can learn more about it@juiceboxpodcast.com Meal Bolt but here's what it is. Step 1. M Measure the meal. E evaluate yourself. A, add the base units. L layer A correction. B build the bolus shape. O offset the timing. L look at the CGM&T tweak for next time. In a nutshell, we measure our meal. Total carbohydrates, protein, fat. Consider the glycemic index and the glycemic load. And then we evaluate yourself. What's your current blood sugar, how much insulin is on board, and what kind of activity are you going to be involved in or not involved in? You have any stress, hormones, illness, what's going on with you? Then A, we add the base units, your carbs divided by insulin to carb ratio. Just a simple bolus. L layer a correction, right? Do you have to add or subtract insulin based on your current blood sugar? Build the bolus shape. Are we going to give it all up front 100% for a fast digesting meal? Or is there going to be like a combo or a square wave bolus? Does it have to be extended? Offset the timing. This is about pre bolusing. Does it take a couple of minutes this meal, or maybe 20 minutes? Are we going to have to again, consider combo square wave boluses and meals? Figure out the timing of that meal and then l look at the cgm. An hour later, was there a fast spike? Three hours later, was there a delayed rise five hours later, Is there any lingering effect from fat and protein? Tweak, tweak for next time. T. What did you eat? How much insulin and when? What did your blood sugar curve look like? What would you do next time? This is what we're going to talk about in every episode of Bolus Work. Measure the meal, evaluate yourself, add the base units, layer a correction, build the bolus shape, offset the timing, look at the CGM tweak for next time. But it's not going to be that confusing, and we're not going to ask you to remember all of that stuff. But that's the pathway that Jenny and I are going to use to speak about each bolus. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. The episode you just heard was professionally edited by wrong way recording wrongwayrecording.com.