Saturday, May 18, 2013

The Nutrition Debate #109: “Prisoner for Life”

Sounds like a Merle Haggard song, doesn’t it? But this column is not about music; it’s about the life-long travails of a type 2 diabetic. But before you get all mewlish, or repulsed in shock and denial, let me try to explain why I think this is a good thing. Let me tell you about how, seriously, a little over ten years ago I thought I would be dead by now. Today, I am much healthier and am looking forward to a long and healthy life. Two things occurred this week to remind me of how lucky I am.

First, in a side bar conversation (PM) with an on-line friend, we were discussing one of the confounding problems of weight management: set point theory. One point in particular caught my attention:

Weight management is really a multi-faceted issue, and it's different for everyone. I'm really happy for you that you can lose weight with what you are doing, but even so, it seems to me that you are still walking a very fine line between successful weight loss and keeping the weight off. If you stray even a little bit from your protocols, you gain weight. To me, that seems like you are also dealing with a broken metabolism, and you will be a prisoner of lower calorie and diet (carbohydrate restriction) the rest of your life. It is not about calories in calories out. There is something happening with your metabolism that is not working right, but I don't know what it may be for you.” (Emphasis mine)

Well, of course, my friend was right! I know it, and I have known and accepted that reality for quite a long time. For reasons that are at this point too tiresome to repeat, I am seriously intolerant of carbohydrates, and that includes virtually all (50% to 60%) of the foods that I have been eating for my entire life. I am now required to limit carbohydrates to about 5% of my diet, or just 10% of what I previously ate. I needed to eliminate 90% of the carbs I formerly ate! That’s the reality of it.

That kind of undertaking calls for a big adjustment. And the medical establishment has decided you can’t do it. They have concluded that it is too difficult to make dietary changes of that magnitude, even if it means saving your life. And they’re right. Most people can’t do it. Or won’t do it. Wives complain their husbands won’t give up this or that food. Wives who try to do it look for “substitutes” that have the “mouth feel” of the favorite food they have had to give up. Both husbands and wives cheat. Some diet programs are so sure you can’t do it that they have cheat meals or even cheat days built into their program. In general, there is an attitude that to do this, you have to “give up” a lot. Well, you do! If you want to live.

This is further complicated by the prevailing wisdom in the medical establishment: that “heart healthy” means avoiding saturated fat and dietary cholesterol. You cannot, you will not get well if you follow this advice. Saturated fat and dietary cholesterol is not the problem with our diet. It is the refined carbohydrates and sugars, (including excessive amounts of fructose), grains, particularly wheat (even the “whole grain” forms), and vegetable oils that are making us sick. And type 2 diabetes will continue to be a “progressive disease,” with the onset of the “inevitable complications,” so long as we continue to follow the establishment’s prescription of “balanced diet and exercise,” and progressively more medications.

I came to these realizations by accident. I started on Atkins Induction, on my doctor’s advice, to lose weight! And to our mutual surprise, my diabetes went into remission almost immediately. I quickly was able (forced) to drop my diabetes meds. Next, my blood lipids improved, slowly but very dramatically (HDL doubled, Triglycerides came down by two-thirds). And as I lost lots of weight my blood pressure went from 130/90 to 110/70 on the same meds. After a few years I switched to the Bernstein diet and learned a lot by asking questions on a low-carb forum for people like me. Great support!

The second thing that occurred to me this week is that I was reminded by a CDE (Certified Diabetes Educator) that “attitude is all important.” Diet, exercise, medication, she says – they’re all important too; but without the right frame of mind, you won’t stick with it. And you have to like the foods you will be eating for the rest of your life. I do. I cook more now than I ever did before. There are so many good foods, whole foods, real foods, from which to choose. And great cook books, and fabulous web sites with daily recipes. The varieties of meats, fowl, fish, vegetables, salads, and healthy fats are endless.

So, as to being a “prisoner for life,” I think just the opposite is true. I have been freed from a progressive worsening of my disease as it was being managed by the “standard of practice.” While I will always have a “broken metabolism,” by radically changing my diet I have been liberated from the inevitable complications that would have inexorably overtaken me if I had continued my “balanced” diet and the medical course of treatment my doctor (and the mainstream medical establishment) had prescribed for me. I have been paroled from my life sentence. And as long as I am on good behavior, I expect to live a long and healthy life.
So, what’s the takeaway? As I said at the beginning of this piece, if you had told me a little more than 10 years ago that I would be healthier today than then – way healthier, I wouldn’t have believed you. I expected to be long dead by now. So that’s the takeaway: (You) Take care of yourself, and you will be “freed” of this disease and live a long and healthy life.

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