Saturday, March 30, 2013

The Nutrition Debate #95: My Doctor Died Last Week – An Appreciation

My doctor died last week. The cause, unfortunately, was bad medical advice. An internist and cardiologist educated and trained in the traditional school of medicine; he was taught how to treat symptoms: Write a script. High cholesterol? Prescribe a statin. It will lower LDL cholesterol and get the Total Cholesterol within the guidelines of the standard of practice. Unfortunately, it did not lower his risk for all cause mortality. My doctor died of…intransigence.

I remember my doctor as someone who cared about me. When I first came to see him in 1991 (on my 50th birthday!), I was morbidly obese and I had already been a Type 2 diabetic for five years.. My doctor first focused on improving my blood sugar control. He prescribed higher doses of the sulphonylurea (Micronase) I was on and then, when it became available in the U.S., added Metformin. When I was “maxed out” on both of those, he started me on Avandia. None of these drugs seemed to work  well though, or at least not well enough. My diabetes got progressively worse, but then it was supposed to, according t protocol. The medical establishment describes Type 2 diabetes as a “progressive disease.”

Of course, my doctor also really wanted me to lose weight. I remember when the Registered Dietician he had on staff counseled me to eat “a balanced diet,” cut down on calories, and exercise for half an hour at least three times a week. She even gave me suggested meal plans and ideas for snacks when I couldn’t get to the next meal without a little “energy boost.” None of this worked for me either. He tried, though, to get me to lose weight. I was just unable to do it, or lose it and keep it off. He probably wrote in my chart that I was “non-compliant.”

Then, luckily one day in August 2002, when I walked into his office, he was standing at the nurses’ station. When he saw me he said, “Have I got a diet for you!” Turns out the month before he had read the Gary Taubes’ cover story, “What If It’s All Been a Big Fat Lie,” in the New York Times Sunday Magazine and had tried the recommended diet himself. He lost 17 pounds! So, I tried it. It was Atkins Induction in which you eat less than 20 grams of carbohydrate a day to lose weight. I did it for nine months and lost 60 pounds. During this time my doctor saw me monthly to monitor my health.

The first thing that happened, though, was that I started getting “hypos,” or hypoglycemia, a low blood sugar condition. I called my doctor and he progressively took me off all the medications I was taking until I was just on a minimum dose of Micronase and Metformin. A few years later, when I switched to the Bernstein Diet (designed for diabetics), I lost another 110 pounds and titrated off the Micronase completely. I still take 500mg of Metformin with my evening meal.

My doctor saved my life, but couldn’t do it for himself. He reverted to a “balanced diet” and regained the weight he had lost and then some. When I continued to see him three times a year for many more years, and regained some weight and then lost more, he would always ask me, “How’d you do it?” I would answer, “I stopped eating carbs!” He would look at me and smile wryly, perhaps wistfully. I wondered if he was thinking, “How does he do it? I wanted to tell him, “It’s easy, doc, once you get keto-adapted.” But, I know he couldn’t do that. It would just go against the grain for a traditionally schooled cardiologist to eat a diet that is 70% fat, 25% protein and just 5% carbohydrate. It would be anathema to him to add salt to his food, and to eat all the saturated fat and cholesterol that his heart (literally) desired.

Of course, he ordered a lipid panel for me each time I saw him (and an EKG, which was always “normal”), and echo cardiograms and carotid tests once a year. He saw that on my Very Low Carb diet my HDL doubled and my triglycerides dropped by two-thirds. He saw that my A1cs and my C-Reactive Protein (hs-CRP) tests were stellar. But, despite the evidence of my good health – my greatly improved health on the diet he recommended to me more than 10 years before – he was unable to bring himself to try it again. What more evidence did he need? Maybe it was something else. Maybe he just couldn’t accept that his entire life in medical practice had been “a big fat lie.” I mean, how do you do that?
Virtually the entire Western world is now vested in the “lipid hypothesis.” For more than fifty years, starting with Ancel Keys (who made the cover of Time magazine in 1961), and then the American Heart Association, and the American Diabetes Association, and the list goes on, everyone has been piling on to a then unproven hypothesis which is now a disproven theory. George McGovern got the government involved in 1977, and from 1980 onwards we have been getting the “Dietary Guidelines for Americans.” The current version equates saturated fat with trans fats! And recommends steep reductions in sodium and cholesterol for all Americans. The science doesn’t support these nutrition goals. But the USDA and Big Agribusiness and Big Pharma are all, metaphorically speaking, “in bed with each other” along with the big manufacturers of processed foods. Can this ever be turned around? Will it ever be? It is so frustrating. Anyway, I am grateful to my doctor for saving my life, even if he couldn’t save his own.

Wednesday, March 27, 2013

The Nutrition Debate #94: “Eating Clean”

'Carey' is one of the leaders of the hugely popular Lifestyle > Eat-Drink-Man-Woman Forum on the Singapore-based web site. He came to my intention last year when he posted a link to one of my columns, and I had a lot of hits from Singapore. Carey’s first LCHF thread at has had 30,000 replies in 3 parts. Parts 1 and 2 closed when they had reached 10,000 replies. As Part 3 neared 10,000, he started a new thread.  

The new thread is called: “[Fan Club] LCHF Lifestyle.” Carey started it with about 75 LCHF resources, mostly links to low-carb, Paleo, and Primal sites in the US.  I am delighted that he mentioned two of my columns as a LCHF resource for FAQs: #51 “Dietary Cholesterol” (“Very good article on cholesterol”) and #25 “Understanding Your Lipid Profile” (“How to read our cholesterol test but honestly, the conventional test is not very useful”). He’s pretty hip, so I sometimes lurk myself. The problem, for me, is that many of the replies are in Singlish, the colloquial English-based Creole language spoken mostly by the ethnic Chinese population of Singapore, a very cosmopolitan city.

Anyway, this column is about the term “eating clean.” It is a term that is mentioned several times but not succinctly defined. It appears, however, to be the manifesto of all those Singaporeans who subscribe to a LCHF Lifestyle. I like it because it is a positive concept. There is no cultural stigma as there would be if they were to consider eating a diet that is high in saturated fat and cholesterol. Never mind that the diet that most of us eat is almost all highly processed foods that have been damaged in manufacturing or preparation. Never mind that it is our high carb, high sugar, high grain, high fructose, high Omega 6 vegetable oil diet that is making us sick!

The conception “eating clean” is, by definition, ridding ourselves of all those toxins and poisons that are part of the Standard American Diet (SAD). “Eating clean” occupies the high ground. “Eating clean” is about eating well – eating good, healthy whole foods without any snarly attributions to cave men. No divisive associations with social causes like saving the planet that have the effect of dividing the population according to their political or other world view.

“Eating clean” is simple in part because it is broad and a bit undefined. It is vague and amorphous and somehow uplifting. It is inclusive, and it has mainstream potential. We are all free to choose what and how we eat. It is thus also about personal liberty. It is liberating. That also means that it is open to interpretation, but that is okay with me so long as there is strong leadership and good guidance, and “carey” provides that. He is very patient, but is quick to respond to and correct his skeptics, often ending an edgy reply with “…hahah.” He has earned the affectionate sobriquet “uncle.”

Another aspect of the movement to “eating clean” that I like is that its precepts are by definition open ended. As the understanding of the science of healthy eating and nutrition evolves, the movement will to adjust to the new science. For example, as we learn more about the how livestock’s diets affect their nutritive value, preferred sources of protein may change. And as the mainstream continues to make its gigantic, slow turn to acceptance of “clean eating” as an alternative to the food pyramid-based SAD, the tide of public health will change. The shift has already begun.

I really miss the “voice” of Kurt Harris, MD, creator of the Archevore Diet, a now inactive web site that I still highly recommend. Some of the favorite things I like about his site are these quotes: “I have had a lifelong interest in science and medicine as culture, and believe all claims to scientific authority should be subject to thoughtful skepticism.” An Archevore is someone who eats based on essential principles, and also someone who hungers for essential principles. Take your pick.”“After hearing Gary Taubes on the radio, I had an epiphany and ever since I've been exploring the field of nutrition through the lenses of medicine and evolutionary biology. It is becoming clear now that many of the diseases afflicting humanity are not a natural part of the aging process, but may be side effects of technological and cultural changes in the way we eat and live that have occurred since the dawn of agriculture roughly 10,000 years ago, and especially in the past few hundred years.”“These changes seem to center largely on the sequential introduction of what I call Neolithic agents of disease - wheat, excess fructose and excess linoleic acid.”

Harris pretty well sums up the new paradigm for me. I have now appended Dr. Harris’s Neolithic Agents of Disease (NADs) to my own LCHF Lifestyle: a meme or manifesto for the West – the Yin to the Singaporean “LCHF Lifestyle” Yang.
Most of “carey’s” followers are ethnic Chinese, and most are young women. The young men seem to me to be as much interested in building muscle and meeting young women, as losing fat. The Eat-Drink-Man-Woman Forum is part of a social network, and the “[Fan Club] LCHF Lifestyle” is a popular venue. Whether the social connection is a sub-text or a pretext doesn’t matter. It is another positive aspect of the LCHF Lifestyle/“eating clean” nexus. I think it’s “brilliant,” as the Brits say. And it clearly is working. Perhaps some entrepreneur out there who reads this blog will see an opportunity to do the same thing “here” (in the West): LCHF on Facebook. Or perhaps someone already has, and I am too ossified to have noticed. Maybe a reader can tell me if we have a LCHF social network Yin to their Yang here in the Western World.

Saturday, March 23, 2013

The Nutrition Debate #93: Is the Washington Post Biased?

This is not a column about political bias. In my book that question has already been answered with a resounding “yes.” For any readers still reading, I commend you for having an open mind, or at least being curious about what a blog called “The Nutrition Debate” has to do with bias at the Washington Post. The answer is: Their food editor, Joe Yonan, has just “come out” with the announcement that he has become a vegetarian. Now, I ask you, how can he not be biased? Okay, that’s a rhetorical question. Of more interest to me – I being omnivorous – is this: How long can he survive?

Let me be clear. I don’t mean how long can Joe Yonan live (although that is a legitimate question); I mean how long can he keep his job. The National Public Radio aired a piece on this on Weekend Edition on March 9, 2013, and in the text version asked this same question in a more provocative way, “Career Suicide or Lifesaver.” Written by Lydia Zuraw, the story here is largely based on the Scott Simon interview with Yonan, the Washington Post’s food and travel editor.

Zuraw’s piece is also notable for pointing out that the New York Times food columnist Mark Bittman is about to publish a book, “VB6,” subtitle “Eat Vegan before 6:00 to Lose Weight and Restore Your Health…for Good.” Is this then just a case of “copycat journalism”? Or is it the #2 liberal rag trying to get the jump on the Old Grey Lady? To me, it just proves that both of these mainstream vehicles are just as irrelevant in matters of food and health as they are in almost every other aspect of our culture and politics. Sorry to rant off-topic, but news of these two developments has been upsetting to me.

Together, these “conversions” by influential writers in the mainstream print media will no doubt have an effect. I hope it “stirs the pot” and the “Alternative Hypothesis” (low-carb, high-fat) rises to the top. I have been encouraged recently by many developments, not least of which was my wife coming home recently to tell me excitedly about “The People’s Pharmacy” radio show on NPR, hosted by Joe and Terry Graedon. They quoted Walter Willett, MD, PhD, Chairman of the Department of Nutrition at Harvard University’s School of Public Health “, saying “It’s Not About the Fat.” Willett, lead researcher on the hugely important Nurses’ Health Study, said on Harvard’s World Health News, “We have found virtually no relationship between the percentage of calories from fat and any important health outcomes.” He has also said that dietary fat is not a major determinant of body fat and plays virtually no role in obesity. Is anybody listening to this man, arguably the world’s most respected epidemiological nutritionist?

That same week the Graedons announced they would interview Jonny Bowden, PhD, and Stephen Sinatra, M.D. about their 2012 book “The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease – And the Statin-Free Plan That Will.” Bowden also released in 2013 his new edition of “Living Low Carb.” Subtitle: “Controlled Carbohydrate Eating for Long-Term Weight Loss.” I’ve recently read both and recommend them, respectively, to people who aren’t yet convinced of the saturated fat—cholesterol scam and those who want to learn about low-carb nutrition and low-carb diet options. So, understandably I think, I was encouraged by these forays into the mainstream media by the Alternative Hypothesis to healthy eating that I and others of my ilk ascribe to and advocate.

I understand, I guess, “the hook” that vegetarianism and even veganism has for some people. Their doctors tell them they are starting to get “sick” (ironically on the Standard American Diet, prophetically abbreviated SAD). And they don’t get it yet that eating a low fat diet, that is very high in carbohydrates, including wheat, fructose and Omega 6 vegetable oils, is what is making them sick. This is the unhealthy diet that our government(s) and “quasi-public” public health establishments, and the entire “medical establishment” (associations that sound like they are independent but were long ago co-opted by Big Ag and Big Pharma, espouse. If you doubt that – if that sounds crazy to you – check out their funding sources and constituent advisory board members. They are rife with corruption and revolving door appointees.

“The hook” works when they realize that they are getting “sick.” They know that they need to do something but not something too radical. They can’t reject everything they have been told by their doctors (and their doctors can’t disavow everything they’ve been taught for 50 years and we all still get from the media). So, they are induced to try a change that has lots of “feel good” ancillary benefits: “Easy, sustainable weight loss that not only improves your health but can help the planet” with “wide-ranging benefits—to the environment, the economy, and global health—of reducing our consumption of meat and animal products….” This moral high ground is how his publisher hopes to sell Bittman’s book.
Personally, I would rather make a decision about what to eat based on my own personal health. Alright, call me a selfish individualist. But remember, Darwin: “Natural selection” and “Survival of the fittest.” Science rules in my book, and I’m going by what’s been shown to be best for my own health. Besides, it’s hard for me to accept that bovine flatulence is responsible for 51% of the greenhouse gasses on the planet, and that that is responsible for global warming (“climate change”), the rising oceans, Sandy, and 53 inches of snow in Boston this winter.  Is there any cataclysm on this planet for which Americans are not blamed? Hugo Chavez’s cancer? Well, maybe that, if Chavez ate the Standard American Diet.

Saturday, March 16, 2013

The Nutrition Debate # 92: Why We Eat

Why do we eat?  Of course, the simple answer is, “We eat because we’re hungry,” but this begs the follow-up question, “Why are we hungry?” It also requires a few footnotes for the obvious exceptions. For example, there are occasions when we eat when we are not hungry, and when we overeat when we are. So, I don’t purport to have all the answers or even to fully explain the ones that I do. I just want to lay out a basic outline of the issues as I understand them because I think it is useful to think about the question. We should examine the way we have come by habit, tradition and culture to live and eat the way we do. And then, to separate those from why we need to eat.

Eating, I noted from watching a Stephan Guyenet “Ancestral Nutrition and Health” video on his Whole Health Source website, can be divided into homeostatic and non-homeostatic categories. Homeostatic eating is for hunger only, Guyenet explains, whereas non-homeostatic is all other eating, including eating for pleasure, emotion/stress, social, and ‘mealtime’ eating. Whole books have been written about each of these examples of non-homeostatic eating, and I think most of us can readily relate to each, if not to all of them. This, then, is but a cursory review.

What characterizes each of these non-homeostatic categories is that none of them is driven by hunger. Eating for pleasure is an indulgence, a pure luxury. Eating to relieve stress is an outlet – a diversion, but it is not driven by hunger. Social eating, as in hor d’oeuvres at cocktails or before a dinner party, is a custom of hosting and accepting the hospitality of a host. This is also a way to allay anxiety much in the way that smoking was and drinking is in such situations. And eating three meals a day at prescribed times regardless of whether or not we are hungry is a vestigial tradition from a time when most of us lived a life of heavier exertions. Many cultures today still have their main meal (dinner) at mid-day, and a light supper at the end of the workday. These practices, including eating “regular” meals at fixed times, are all examples of non-homeostatic eating. It’s worth thinking about that last point, if you’re not hungry.

Eating more than is required to satisfy hunger is a little more complicated and is in a different category that needs to be addressed separately. I like the way Guyenet frames the issue: “What makes us eat more than is required for leanness?” he asks.” Leanness!  Hmmm…. A tantalizingly appealing question; it makes me want to know the answer. Guyenet’s answer is “…the system that regulates long-term energy balance and body-fat mass. Okay, this is where we get into “the weeds” – human physiology and biochemistry – neither of which is my strong suit. So, I’ll leave you on your own to explore all the experts who delve into this subject every day on the web. My personal favorite, perhaps because his views informed mine, is Gary Taubes of “Good Calories-Bad Calories.” He is at odds, though, with Stephan Guyenet.

So, I have framed the question. Now I want to return to what we can do to understand our current situation and our options. We must separate out all the occasions of non-homeostatic eating. We must think of all such occasions as voluntary excursions apart from homeostatic eating. They do not impel us to eat (unless we’re carb addicted sugar-burners  needing a “fix” every couple of hours). They are not “what make us eat more than is required for leanness.” It is a choice we make and as such it is entirely within our control. We (theoretically, at least) can do it or not, as we decide.

Then, with only homeostatic eating “on the plate,” as it were, can we understand what “regulates long-term energy balance and body-fat mass”? From my perspective the world is divided into two cohorts: those with normal fat metabolism and those who have developed a disregulated fat metabolism. It is well beyond the purview of this short article to discuss the susceptible genotypes of the latter group, but suffice it to say that almost everyone who is overweight or obese, and who otherwise has the symptoms of Metabolic Syndrome, falls into the “disregulated” group.

For this group, the regulator of long-term energy balance is insulin. Those who fall into the disregulated group have become insulin resistant. In other words, their cells are resistant to insulin, so insulin levels rise in the blood. This blocks access to fat stores so they crave “sugar” (carbs) for energy. The higher levels of circulating insulin prevent the body from accessing the fat stores that we have set aside to be used for energy.

Such is the situation. So, what is the solution? How can anyone who is overweight or obese, and especially those who have Metabolic Syndrome or are pre-diabetic or are diagnosed with Type 2 diabetes, get access to their own body fat stores for use as energy when the body is in need of it for “long-term energy balance”? The answer: Eat a Very Low Carb diet. Eat a diet very high in fat (mostly saturated and monounsaturated), moderate protein, and VERY low carb. When you eat Very Low Carb, your serum insulin drops and fat stores break down and enter the bloodstream to supply energy.
“Not eating more than is required for leanness” is a process. Being lean is a “product.” It may be merely a “pipe dream”, but the only way to find out is by the process. The VLC Way of Eating is easy, once you get used to it. The “product”???

Saturday, March 9, 2013

The Nutrition Debate #91: Low-Carb Breakfasts (and a No-Carb Lunch)

Chances are you will reject these meal suggestions out-of-hand. Especially lunch. That’s okay. All I can do is “put it out there” for you to consider. It’s your choice to accept it or not, right? But I gotta tell you: what I am doing, and what I am suggesting you try, really works. It works for me, and I think it would work for you too. But you have to try it to find out.

If you eat as described here, as/when you adjust to it, here’s what will “work” for you: 1) You will not be hungry, either before or between meals – breakfast, lunch or dinner, if you eat a small dinner that basically follows the same principles; 2) you will lose weight, typically 1 to 2 pounds a week, depending on how much you have to lose; 3) the weight you lose will include abdominal weight – the central obesity or omental adiposity that is so bad for your cardiovascular health; 4) you will “feel healthy,” have lots and lots of energy, and an elevated mood; 5) as you lose a lot of weight, any weight-related hypertension will improve; and 6) your lipid panel will definitely improve, perhaps not your Total Cholesterol and LDL lipoproteins but your HDL will increase (up to double) and your triglycerides will decrease (up to two-thirds).

Do all these things seem like worthwhile and beneficial outcomes? If you’re not sure, ask your doctor – not about how you intend to achieve them, but about the outcomes themselves. Your doctor, if he or she has been paying attention to the latest developments in CAD and CVD health, other morbidities, and all-cause mortality, will recognize how important all these outcomes, especially the lipid panel and central obesity, are. Weight, blood pressure, glucose metabolism and blood lipids are all interrelated. Collectively, when “out of whack,” they comprise what is known today as the Metabolic Syndrome (see #9, here, for the parameters). It is a direct outcome of the Westernized diet that we (most of us) have been eating for the last fifty years, also known as the Standard American Diet (SAD) that is still recommended by government and public health officials, and SADLY, still advocated by most health associations and practicing physicians.

The breakfast I am suggesting you try is designed to provide healthy protein and fat, with a minimum of carbohydrates. I will provide four or five examples. You can vary them, or eat the same one every day as I do, except on Sunday. (On Sunday I make a brunch of veal or lamb kidneys with mushrooms and onions, cooked in coconut oil, and then a little Marsala.) Each of these can be preceded or accompanied by coffee or tea, with half & half and a no-calorie sweetener.

·         Two eggs (any way – I eat them fried in bacon fat) with two strips of bacon. Nothing else, except the beverage.

·         Three eggs, scrambled, with a little full cream and some shredded mozzarella cooked in. Good and gooey.

·         Three eggs, scrambled, with some smoked salmon “tidbits” mixed in. Great protein and Omega 3s. Delicious!

·         Three eggs, scrambled, with pulled bacalao (shredded dried salt cod), onions and sliced black olives. Very tasty.

At present, we are eating the 2 egg breakfast, but occasionally we make one of the three egg breakfasts. They appeal to me for several reasons: 1) it omits the bacon, which many people will want to do to avoid the nitrate/nitrite issue; 2) the egg preparations are all delicious and full of flavors; 3) three egg yolks a day is the recommendation of the Jaminets in “Perfect Health Diet,” in part for the choline content; 4) salmon and cod are both cold-water fishes with good Omega 3s, and cream and cheese and olives are all good food. You can add fresh or dried herbs if you like.

Do not be tempted to add any bread of any kind, or any whole fruit or especially any fruit juice, or any “natural” sweetener (i.e., honey), or any cereal, hot or cold, or any milk (just full cream or a little half and half). You don’t need it, and this program won’t work if you don’t follow it. So, don’t be a baby about it. Suck it up and just do it. Try it for awhile.

Then, when you have tried it for awhile, and you realize how good you feel while eating this way, and how you are not hungry and you are starting to lose weight, you might want to try “my perfect lunch.” Not many people do, but then that is their loss. My “mentor” (aka my online editor) practically gags at the idea, but I think she believes, and she has me believing too, that this is part of the reason for the very dramatic improvements in blood lipids (↑HDL) that I have experienced since I started eating this way. Okay, hold you nose. Here it is:

·         1 can of King Oscar Brisling sardines in Extra Virgin Olive Oil, Double Layer (avoid any packed in soy bean oil).
I eat this straight out of the can 5 to 6 hours after I have breakfast, whether I am hungry or not. I am actually not hungry, but I want my body to stay in ketosis from the food I eat and the body fat it burns, not from the breakdown of any of my muscle fiber. Breakdown of body fat, yes; breakdown of muscle fiber, no; so, I eat protein (with fat) three times a day at regular 5 to 6 hour intervals, then fast for 12 to 14 hours to give my body a chance to just burn body fat. That way, it will remain in a “happy” state of low-level ketosis – the state of harmonic homeostasis that it is designed to be in. Your body will be “happy” if fed protein with fat in small, well-spaced meals and then, while you fast (and sleep), it is allowed to feed on your fat reserves. That’s what those calories you ate years ago and stored (both carbs and fat) are there for!

Saturday, March 2, 2013

The Nutrition Debate #90: The “Easy as 1-2-3 (and ½) Diet”

My wife says, “Most people aren’t like you.” What she means is, “She can’t do Very Low Carb like me ‘cause she can’t give up… (fill in the blank): a) bread, b) fruit, c) ice cream at bedtime – the list is endless. That’s okay. I understand that when people say “I can’t,” they mean “I won’t.” I understand this is a choice they are free to make.  If they refuse to take charge of their own health – when it becomes clear that their doctors are clueless about how to deal effectively with obesity and its co-morbidities – then they will progress to, and “get,” what lies ahead for them. Do I sound frustrated?  

If you are one of those who “can’t,” then this new diet – that I have just created (with my tongue plugged firmly in my cheek), is NOT for you. But if you have an adventurous spirit, it is a diet that you might want to consider for a day or two or even longer. I did the 1-2-3 part a while ago and it worked brilliantly. I lost 7 pounds in 2 days and 9 pounds in 3. I then stopped NOT because I was hungry but because I had achieved my goal, which was to turn around a trend of weight gain. I stopped the gain “cold” and dropped to my target weight for that week.

In other words, it worked for me in the way I had hoped. It might do the same for you if you are already ketoadapted, as I was. For the uninitiated, that means I had no glycogen stores in my liver to provide a steady supply of glucose to the bloodstream for a few days. I was already in a ketogenic state, and my body was adapted to burning ketones as my primary source of energy. If you’re not “there,” you will probably have a different experience. YOU might get hungry.

Anyway, the “Easy as 1-2-3” part of my diet is to eat a breakfast of 1 cup of coffee with 1 ounce of heavy cream and 1 packet of your choice of artificial sweetener (my choice is Splenda or Truvia); then you eat 2 strips of bacon and 3 fried eggs (for the choline). That’s breakfast: 38 fat grams, 26 protein grams, 3 carbohydrate grams, and 465 kcals total.

Then you skip lunch and you skip dinner. The next morning, repeat: the 1-2-3 breakfast, then no lunch and no dinner.

As I said, I did my 1-2-3 breakfast for just 2 days, but I can imagine (here’s the adventure part) doing it longer – maybe even a week. I reached a point almost a year ago where my body is in balance, that is, where it is in homeostasis while I am eating a VERY carb restricted diet: Under 900kcal/day when I eat two meals a day and 1200kcal when I eat three. My body is telling me that it is getting everything it needs from my body’s energy stores and from the food I eat and the supplements I take. It is the first time I have been at this point, and I am not sure how I got here. I read a lot, experiment a lot, listen to my body, and it seems to be telling me now that everything is copasetic. It is satisfied. I AM NOT HUNGRY.

I do not mean to imply that I am in a static condition. I am actively losing weight – about 2 pounds a week, exactly according to plan. I managed to do that through the holidays last year, and later while on vacation for a week, eating out and drinking every night. So, there have been challenges, but they have been easy to meet. I HAVE NOT BEEN HUNGRY.

What’s with the “and ½” part of the diet? That’s where I unplug my tongue from one side of my cheek and plug it into the other side. I just read the new edition of “Perfect Health Diet” by Paul and Shou-Ching Jaminet. The PHD is a very good read for people in the Paleo and Primal movement and for people with imperfect health who want to regain their health through diet. I agree with their overarching philosophy and approach to health through diet…but, they are really clueless with respect to Type 2 diabetes. Safe starches don’t work for Type 2s. Frankly, I am embarrassed for them in this respect but otherwise wholeheartedly endorse their ideas for everyone except Type 2s.  T2’s need to eat to their meter.

As for the “and ½” part, on page 365 of the 2012 edition, in the section on “How to Raise HDL Levels,” the Jaminets say “a half bottle of wine per day raises HDL levels by 17 percent.” That’s a good thing. Check out their footnote (18) on-line. Of course, if you elect to follow the “1/2” part of my new diet, I think you should opt for the two-meal-a-day version and eat a small dinner of a fatty meat or fish and a non-starchy vegetable smothered in butter or roasted in olive oil.

 I have been doing Very Low Carb on and off for more than 10 years and I have come to a place where I am very comfortable and happy with the way I feel and with my health. My mood (and my prospects!) are much better today than 10 years ago (at 71, I’m no “spring chicken”).  I’m interested in living a lot longer and keeping “all my marbles.” So I have taken a keen interest in my own healthcare. I still need to lose weight (my BMI is still about 34). So, given that I feel so healthy, and I DO NOT GET HUNGRY AT ALL, EVER, ANYMORE, I have two easy choices: 1) Eat according to the “Easy as 1-2-3 Diet” for a day or two, or longer, or on alternate days, or some such random mix, or 2) eat according to the two-meal-a-day plan (“plus ½”), as we did on our recent 1-week vacation. I didn’t lose much weight, but I had more fun.

It’s nice to have choices, especially when they are easy. And they are easy if you don’t feel there are forces beyond your control driving you to seek out and eat food. Being hungry is a powerful hormonal drive to seek out food and then to eat it.  I also know now that I don’t have to convince my wife that “most people aren’t like (me).” It’s okay with her.