Saturday, May 25, 2013

The Nutrition Debate #111: “…the usual complaints” of aging


This column, unlike most, will be an entirely subjective and personal (n = 1) account of my condition. It will not, except as noted in paragraph #2, include any laboratory reports or other metrics or links to research. I have been grappling about how to address this matter for some time. It is hard, perhaps because it is so intangible. It has been reported in the literature, of course, but even then it is hard to quantify. My topic is qualitative. I am talking about the quality of life I have experienced and am experiencing since I began to eat a Very Low Carb (VLC), medium protein and high-fat diet, almost 11 years ago, to treat my Type 2 diabetes. I was diagnosed a Type 2 in 1986.

I am now a 72 year old male who is still overweight…in fact, obese (BMI = 33). In 2002 I weighed 375 pounds (BMI = 52). I now weigh 238 pounds. At one time, about 5 years ago, I was down to 205. I also had high blood pressure with prescriptions for a “cocktail” of 3 meds. My blood pressure is now “normal” (120/80) on the same meds. I also had low HDL and high triglycerides. My HDL has now doubled and my triglycerides have been cut by 2/3rds. My total cholesterol and calculated LDL have been constant, LDL up slightly actually; but more than offset by the other lipids so, in the opinion of my doctor, all is ‘copasetic.’ And my fasting glucose’s (mid-80s) and HbA1c (5.6mg/dl) look “non-diabetic” so long as I stick strictly to a VLC diet, Bottom line: Today, I am a lot healthier than I was 10 years ago.

I was at a cocktail party last fall in which a few old men were standing around talking about “the usual complaints” of aging. When it was my turn to share, I said to an 89-year old retired ophthalmic surgeon that I had no complaints whatsoever. In fact, I announced to the group, I felt better much better than I did 10 years ago. They all looked at me in disbelief, like I was being disingenuous or just in denial. I quickly explained I had lost 140 pounds in those 10 years, and one of them commented that that explained everything. The subject quickly changed, perhaps not to embarrass me by any further probing. Or perhaps it made perfect sense to them (all doctors, btw) in a gross sense.

Anyway, I have been thinking about their reaction to my honest response for awhile and want to explore if not explain it. For one thing, I am happier. I no longer have the fear that I will die an early death as I did when I was morbidly obese. Besides all the physiological risk factors (and there are indeed many that could be cited), this fear was well founded and was probably a stress generator, which produces inflammation. So, if for no other reason than I am not as fat as I once was, and therefore likely to live longer from an epidemiological perspective, my mood has been elevated. Of course, I could also have an elevated mood because of the foods I am eating, but that is a whole other area of scientific investigation. Suffice it to say, for whatever reason, I am happier now.

Of course, the most common question people asked, especially when I was at my lowest weight (205), was “Don’t you feel ‘better’?” My response then was always, “Not really…although I did feel, once when I was walking across a parking lot (when my weight was about 250), that my step was ‘lighter’.” But that was all I recognized or felt, at the time. Today that different ‘feeling’ has been lost by so much time and sameness.  But looking back, I would say now that I am much happier, and that really is a big difference. Had I realized it then, I would have mentioned it.

Additionally, I and my doctor are very pleased that my health markers (BP, cholesterol, and glucose metabolism) have all improved so dramatically. Because of the weight loss, my dramatic blood pressure improvement signals an improved prognosis for both health and longevity. The improvement in inflammation markers, triglycerides, HDL, HbA1c and fasting blood glucose, I attribute entirely to the foods I eat on a VLC diet. Taken together, they constitute a much improved health outlook and sense of well being. That’s something hard to measure… but priceless.

Perhaps the most remarkable (and inexplicable?) change in my health is that in my 63rd year, about a year after starting on Atkins (I eventually changed to the Bernstein diet for diabetics), I began to have arthritis in two fingers of my left hand. Anyone familiar with the symptoms will recognize it: persistent pain and swelling in the 2nd joint. It came and went for a few weeks and then mysteriously disappeared…forever. I had it, I’m sure. And it’s gone, completely for 10 years now. It just disappeared without a trace. This is, of course, simply an association. I do not suggest causation, but who knows. I’m just glad not to have to endure it, as so many others do, as one of “the usual complaints” of aging.

So, it’s good to be happier and healthier, to paraphrase Mel Brooks. Happier and healthier are mutually supportive aspects and integral parts of “the entire harmonic ensemble of the human body,” to borrow a phrase Gary Taubes’s 10 “certain conclusions”* in his seminal 2007 work, “Good Calories-Bad Calories” (titled “The Diet Delusion” in the UK). They are inextricably intertwined into our fabric. Together, they are the essence of health and well-being. I feel and believe that I have it now, and I just wanted to share that. I hope that I have successfully conveyed it to you, my readers.
*All 10 conclusions are listed in The Nutrition Debate #5 on this blog. There is also an index of all columns on the blog.

3 comments:

  1. Hi! Just found your blog, and read back through much of it, particularly all the posts relating to lipid panels, cholesterol, etc. I'm about ready to 'fire' my regular doctor for the same reasons you apparently 'went off' on your vacation spot doctor. She keeps trying to push statins on me. I've lost 41 lbs. in 2013 on a 'primal' diet. She doesn't apparently realize that people in the middle of a large weight loss see their lipid panels turn 'bad' for a while, as the fat cells release/are more highly in the blood stream from the weight loss. When I explained that to her nurse, and the fact statins are not proven in women, all I got was a call the day later to try this NEW statin instead of Crestor. WHAT the hell? I'm going to try a Functional Medicine doctor in a couple of months, and if I like her, drop kick my old doctor. I don't need to be training my own doctor on the latest research on the subject. :)

    ReplyDelete
    Replies
    1. Hi Gwen,
      I'm very pleased you found me. Welcome. I like the fact that you're taken charge. I've been saying this over and over across a broad range of topics, but none in more important than with respect to statins. Obviously, I agree completely with your postition and commend you on your stand.

      At the very least you want to find a doctor who is willing to work with you on your lipid panel. My old one (who died) was, and my new one seems to be willing as well. We'll see. My Florida endo was not, as you saw and commented. I had no patience with him, but I did get the HOMA test result, was had some comforting aspects to it, even if he never got a chance to interpret them for me.

      I assume you've read #25, "Understanding Your Lipid Panel," but (if you haven't already) read #27, "...the strongest predictor of a heart attack" as well. The TG/HDL ratio is not normall calculated on a lipid panel (the TC/HDL is), and it has been shown to be very predictive. Mine is virtually always <1.0 since my TGs are always low and HDL always high (on this WOE, NOT before). My old doctor also liked hs (hign sensitivity) C-reactive protein as a general marker for inflammation.

      You are 'right on' on your message about the benefits of statin in women in general, and on men and women who have never had CVD or a heart attack. Unfortunately, doctors all follow the NCEP guidelines since that is the Standard of Practice and the key to being paid for treatment, etc.

      I am frightened by the movement to ban bloggers from giving nutritional advice (like the one in North Carolina who was charging a fee and who was stopped by a court after he was reported by RDs in that state. I understand that that movement is gaining momentum. We do not need government Dictocrats telling us what to eat and what advice to follow under penalty of law.

      Anyway, thanks for commenting and reading my blow. Spread the word!!!

      Delete
  2. I appreciate it very much, at least I know from it someone is reading the contents I have here.
    Metout XL

    ReplyDelete