Wednesday, October 9, 2013

The Nutrition Debate #150 – Another Milestone, Amid Ramblings and Ruminations

A year and a half ago, as this blog reached the 3,000 page-view mark, my hometown weekly newspaper advised me that they “had done enuf on carbs and fat.” So, we both moved on. Since then I have published over 100 more columns online, and just passed the 30,000 page-view threshold, with a pace of 4,500 per month and accelerating. I also increased my publication rate to two columns per week. The newspaper is still published, but is delivered only sporadically and never forwarded to our winter home in Florida.

In a parallel universe, I think the world of the Alternative Hypothesis of Nutrition, of eating Low-Carb High-Fat (LCHF), is also growing steadily. It’s not exploding exactly, but it is “mushrooming,” that is, popping up here and there and everywhere in unexpected places and in similar, easily recognizable forms. This is very gratifying. I am, of course, encouraged and buoyed by these mostly piecemeal advances. I see them everywhere, on the radio, on TV, in print, and in the proliferation of web-based resources. I also see them in my own rapidly growing readership. I am especially gladdened to see so many “foreign” readers, thanks in part to Google Translate: China, the Ukraine, Canada, Germany, the UK, Russia, France, Singapore, Australia, Sweden and the Philippines

One of the basic premises of The Nutrition Debate is that we as individuals are in charge of our own health because diet is a large part of health. The conditions that we have always associated with aging are increasingly being seen as instead being associated with diet. This old idea is back - “Let food be thy medicine” Hippocrates.  No surprise then, that we are interested in getting the best dietary advice. Unfortunately, the medical professions – and I think they would be quick to agree – are not trained in nutrition. They are trained in diagnosing and treating disease rather than prevention.

Equally unfortunate, the dietetics profession and the diabetes educators, while trained in nutrition, are misinformed, to be kind. They (in general) are the last persons whose advice we should seek and follow, and I do not see this changing soon. They follow the conventional wisdom of the AHA and the ADA. And large organizations can be very slow to change. It is such a shame… and so illogical that these two professions, medicine and dietetics, who should be interested in science and who should be open minded about unproven, even disproven hypotheses like the diet/heart hypothesis, are ignoring the increasing body of undeniable, irrefutable evidence that eating a low-fat, high-carbohydrate diet is what is making us sick. So you must seek your own dietary advice.

If you think this is a daunting prospect, just remind yourself that your doctor monitors your health and is very results oriented. He is interested in health outcomes: a good weigh-in and good lab tests – in other words, things that you are in charge of. You make these things happen. Will he care about how you do it?  If he is surprised at your improved or even stellar results, he may ask you how you did it. And don’t you be surprised if he is openly skeptical, or offers another explanation when you tell him. And be pleased if he just quietly accepts your explanation, even with a wry grin, and maybe an upturned corner of the mouth and a glint in his eye. Mine was. He was always glad to see me because he knew it was going to be a “happy” consultation, because with my treatment plan, my diabetes is not a progressive disease.

If your doctor is pleased with your health outcome, but not well disposed towards your methods, consider that you don’t have to tell him how you did it. The fact that he is stuck in his ways is not your problem. Your health is your problem; and hopefully a long term one. He’s gotta do what he’s gotta do. He needs to follow the standards of practice of his specialty to protect his practice from a liability lawsuit and to get paid for his service from whatever insurance you have. There are other factors at play besides the “best interests” of the patient. Such is the current state of the health care business.

Big Pharma, Agribusiness and the Public Health Establishment are all engaged in this giant corrupt bargain. The media just trumpets their latest marketing message.  The “Alternative Hypothesis” movement, to borrow a phrase from the iconic Gary Taubes, is made up of serious health care researchers and practitioners who think “otherwise” so we should all be grateful for the small but important changes we see. The trend and the rate are accelerating, just as the readership of this blog is. The only dragon we have yet to slay is the saturated fat/dietary cholesterol demon, and that one cannot be long for this earth. We just need to keep hammering out the mantra: “Dietary Cholesterol has nothing to do with Serum Cholesterol.” And we need to get more doctors to test for “big fluffy” (Pattern ‘A’) vs. “small dense” (Pattern ’B’) LDL, and to care more about how to get lower triglycerides and higher HDL by diet alone – low carb dieting – than about lowering high Total Cholesterol and LDL with statins and other drugs.

Remember: The TG/HDL ratio is an important metric. TG:HDL <1.0 for optimum health and minimum cardiovascular risk. So is A1c. Heart attack risk falls as the A1c drops to 5.5 and below. You can set these targets as your goals and reach them with a low carb approach. “Eating Clean,” is the way to achieve a healthy heart disease risk (lipid) profile. And lose weight. And improve blood pressure. And reduce inflammation…

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