Sunday, June 24, 2012

The Nutrition Debate #56: Metabolic Disregulation

Readers of Dr. Kurt Harris’s Archevore website may have noticed that at the end of the Archevore Diet tab there is a footnote, the last clause of which is “…or it may just be too late.” Since Dr. Harris is not currently blogging, this cryptic remark has me wondering: “just…too late” for what? Can he mean too late to restore “normal” carbohydrate metabolism? And, most importantly (naturally), I’d like to know if this alarming news applies to me. I wonder if Dr. Harris ever explained that comment in one of his posts. It is a hard subject to Google. What are the key words: “Just too late”?
Anyway, I have noticed that many bloggers in the ‘nutrisphere,’ including many of the most cutting-edge, scientific ones, have drifted away from low-carb to Paleo to Paleo with “safe carbs.” Most of these bloggers do not clearly differentiate between “healthy people” and people who have developed issues with metabolic regulation. Significantly, neither do the American Diabetes Association, the USDA’s Dietary Guidelines for Americans or the public health establishment in general. Just ask almost any traditionally-schooled “certified” dietician or Certified Diabetes Educator (CDE).
The current trend in nutrition blogs is “healthy eating,” a good thing, but insufficient for the rapidly growing percentage of the population who are becoming carbohydrate intolerant. This manifests itself in weight gain, of course, but also in associated lipoprotein and blood glucose disregulation, known collectively as Metabolic Syndrome. I wonder sometimes if the blogger/researcher/clinician does not him or herself suffer from metabolic disregulation. I do, and by changing what I eat I found a fix.  So I think this is worth blogging about at length.
The largest audience of “seekers” on diet-related matters, I’ve noticed, are those with a weight issue. They may be a little overweight, a lot overweight, obese or even morbidly obese, and they all want to lose weight effectively and permanently. I was and still am one of those. When I weighed 375 pounds I wanted to lose weight. When my doctor suggested Atkins, I had no idea I would eventually lose 170 pounds. Nor did I realize that I would dramatically improve my lipid health and my T2DM and my hypertension. Neither, however, did I imagine that I would later regain 70 of the pounds I had lost and ‘give back’ some of my health gains, except interestingly my lipid panel gains.
I know that weight loss is the primary area of readers’ interest because my blog, The Nutrition Debate, covers a wide subject area, but my most popular columns (which Blogger tracks for me) are about diets and weight-loss. The problem of losing weight and keeping it off is intractable. That is not to say that there is not also a very large audience of people out there generally who follow nutrition who have a keen interest in “healthy eating.” These include a large cohort who wishes to avoid the Diseases of Civilization and others like the Paleo/Ancestral Health movement, the slow food people, the CSA movement and the fitness community. All of these do not necessarily need, and are not looking for, a therapeutic diet, unlike those of us who already have damaged metabolisms.
 So, that is the distinction that I think has to be made. I enjoy reading about neurotransmitters and hormones and enzymes and the latest, “our old friends” the gut flora. However, for me personally, I am keenly interested in what it means “…to be just too late”. There is a failed mechanism in MY metabolism such that for me it is “just too late?” By whatever name -- insulin resistance, or impaired glucose tolerance, or carbohydrate intolerance, or leptin resistance, or some consequence of any and/or all of these conditions, I must be resigned to what one commenter said on another blog, that: “Some of us cannot tolerate more than small amounts of carbs, and probably will never be able to do so.”
If so, as this becomes clearer to me, or perhaps as I come to accept what is already pretty clear, that will mean that I need to adopt for the rest of my days the Way of Eating that I followed when I lost 170 pounds. That is what someone who has T1DM or is gluten and/or casein intolerant has to do. Except that these folks – and I know a few people who have one or both of these disorders – don’t have a choice. They will die (the Type 1s), or wish they would (figuratively speaking), if they do not follow a strictly prescribed way of eating all day every day for the rest of their lives. In that sense I’m lucky. I can cheat and think I got away with it…at least in the short term. But there’s the rub. It is an insidious disease. I have to “own up” to it: I have a disregulated metabolism.  It is “just too late” for me. There, I said it.
© Dan Brown 6/24/12

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