Sunday, January 22, 2012

The Nutrition Debate #37: Therapeutic (vs. Prophylactic) Dieting

A prophylactic diet is designed to lose weight and to prevent the health consequences of weight gain: the advent of disease. A therapeutic diet is designed to lose weight and to address the consequences of the onset of disease. A select list of therapeutic diets illustrates how a diet can be designed both to lose weight and to improve your health.

The Ketogenic Diet
The original Ketogenic Diet, developed in the early 1920’s to treat epilepsy in children, was an effective medical therapy. Its popularity waned with the introduction of modern drugs. The diet is 90% fat by calories. Think cod liver oil.

The Atkins Diet
Atkins is considered to be low carb (which it is), and high protein (which it isn’t!), because nobody is willing to mention high fat. It is high fat. Atkins is a modified version of the ketogenic diet at 55-65% fat. It gained favor as a weight loss diet especially for people with medical conditions, such as dyslipidemia (cholesterol issues), hypertension (high blood pressure), and Type 2 diabetes mellitus. It is also an especially effective approach for those just manifesting symptoms of Metabolic Syndrome. Re-read column #9 (Metabolic Syndrome – the American Disease of Civilization) to review the symptoms and to evaluate yourself.

The Bernstein Diet
Richard K. Bernstein, M. D., has been a Type 1 diabetic for about 60 years. He developed a very low carb, moderate protein diet (30 grams of carbohydrate a day: 6-12-12 for breakfast, lunch and dinner). This WOE (way of eating) emphasizes “eating to meter” in order to control post prandial blood glucose levels. This diet program is a very effective way to lose weight, without hunger or lethargy, and to improve your laboratory test results (blood sugar, blood lipids and often blood pressure as well), but it requires major changes in what you eat and strict compliance. It’s challenging, unless you realize your life and good health depend on it. Many Type 2’s and others who wish to avoid becoming T2 eat 6-12-12. By “eating to meter” you learn to maintain glucose homeostasis, and thus avoid worsening insulin resistance.

The Diet Doctor’s LCHF Diet
Column # 35 in this column introduces this program. LCHF stands for Low Carb, High Fat. There, I’ve said it again. Eating high fat is a great way to lose fat for most people. It provides satiety, a sense of fullness that permits you to eat three small meals a day with no snacks and maximize fat burning. According to Dr. Andreas Eenfeldt, the ‘Diet Doctor,’ twenty-three percent of Swedes are trying to eat low carb.

These diets are all safe and effective therapeutic diets. They are mostly designed for Type 2 diabetics (like me), or pre-diabetic, or overweight with symptoms of Metabolic Syndrome. They require major changes in your diet and a lot of self control, but they are life changing in their benefits: dramatic and simple weight loss without hunger and with lots of energy, and most important, equally dramatic improvements in health by all clinical measurements (blood lipids, i.e. cholesterol, blood glucose and blood pressure). But because they require major changes, and strict compliance (no cheating!) most people won’t even give them a brief trial.

Besides, unless your doctor tells you that you are sick, you may not think there is reason to change your lifestyle. And, if you believe him when he says ‘take this pill (and eat less and exercise more) and you’ll be healthy, you won’t think it necessary to undertake major changes. Consider taking responsibility for your own health. After all, most people, still, are not diagnosed with a chronic disease, yet, but they often have unrecognized symptoms, particularly high post prandial blood glucose readings. And if they do have the symptoms of one of the emergent Diseases of Civilization, when a doctor recognizes them, they prescribe a pharmacological solution (a statin, blood pressure pill(s), Metformin). Sure, for the ‘healthy’ population out there (and most of you think that includes you, right?), the easy thing to do is kick the can down the road a few more years. The sinister thing is: the symptoms of these Diseases of Civilization are progressive. A few more pounds, a few more pills. A prophylactic diet today, a therapeutic diet tomorrow. Is there an alternative? I think there is. Think different (sorry, Steve Jobs): The Perfect Health Diet, next.

© Dan Brown 1/22/12

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