Saturday, January 11, 2014

The Nutrition Debate #175: “Your blog is primarily for type 2 diabetics, right?”

“Your blog is primarily for type 2 diabetics, right?” I was chatting with a family member before a holiday dinner recently, and I fumbled a bit with my answer. I said, “Yes, but…” and mentioned pre-diabetics and people who are overweight and likely to have all the medical markers for Metabolic Syndrome such as low HDL cholesterol, high triglycerides, and LDL cholesterol particles that are small-dense rather than large-buoyant.

I saw our dinner guest’s eyes glaze over, so I quickly added: “Some people have a genetic predisposition to a disregulation of fat metabolism called Insulin Resistance (IR).” I said, “Losing weight for some people was not just about eating less (of a balanced diet) and exercising more.” At this point, our guest, who is quite thin, replied that that was how he lost weight. I had now lost him on both points. He was clearly looking to change the subject, and I don’t blame him.

But this conversation stuck in my head for a few days, and I realized it was time, after 174 posts, to define my blog more definitively. The Nutrition Debate is about, well, the nutrition debate. It’s true that I have been a type 2 diabetic since 1986 and that for the first 16 years I allowed my doctor to “treat” me with medications. Over the years, the dosages increased until eventually I was maxed out on two and started a 3rd. This was considered “normal” because “type 2 diabetes is a progressive disease,” according to the conventional wisdom. To be fair, my doctor also consistently urged me to lose weight, and he provided the conventional “prescription” for that too: eat a “calorie-restricted, balanced diet and exercise more.” It didn’t work.

Over the years I got fatter and sicker, until in July 2002 my doctor read Gary Taubes’s seminal New York Times Sunday Magazine cover story, “What If It's All Been A Big Fat Lie?,” He tried the very-low carb diet recommended (Atkins Induction), and then suggested that I try it too, to lose weight. What happened, instead, was that from the very beginning I started getting hypos (dangerously low-blood sugars). So I called my doctor, and he told me to stop taking one of the meds. The next day I was still getting hypos, so I called again, and he told me to reduce the other two meds by half. Then, a few days later, he told me to reduce them by half again. Later, I eliminated one, and today I take just 500mg Metformin once a day.

The immediate effect of eating a very low carb diet was that my blood sugar returned to normal. After a while my fasting BSs were in the 80’s and 90s on a minimum dose of 1 med after 16 years of 150s on 3 meds. I also lost a lot of weight (170 pounds eventually), and my blood pressure was much better controlled (from 130/90 to 110/70) on the same meds.

But the effect of this very low carb diet on my blood lipids was even more spectacular. My average HDL cholesterol more than doubled from 39 to 81, and my average triglycerides (blood fats) were reduced by almost two-thirds (from 137 to 49). In addition, while my total cholesterol and LDL remained about the same, the LDL particle size and pattern changed from Pattern B (small-dense) to Pattern A (large-buoyant), and my high-sensitivity C-reactive protein labs (a marker for systemic inflammation) decreased from 6.4 in early 2003 to a low of 0.1 in late 2012.

So, is this blog just about or for type 2 diabetics? I think not. This blog is about healthy eating, for everyone. The Nutrition Debate for me is also not just about carbs. It is much, much broader. Equally important, again for everyone, is the debate over dietary fat: Saturated fats versus inflammatory polyunsaturated fats such as corn oil and soy bean oil. And it is about protein, and sugars (both simple and added) and processed-foods, including liquid foods (milk, fruit juices, and smoothies).

But this sounds like a diet that is against everything, as someone once said. Not true. It is for eating whole, real foods, not processed and manufactured foods. Some people have called this “eating clean.” Others, like Dr. Kurt Harris who developed the Archevore Diet, describe it as avoiding “the Neolithic agents of disease – wheat, excess fructose, and excess linoleic acid” (in vegetable oils). Harris says, “It is becoming clear now that many of the diseases afflicting humanity are not a natural part of the aging process, but are side effects of the technology and other powerful cultural changes in the way we eat and live that have occurred since the dawn of agriculture roughly 10,000 years ago.” A sort-of Paleo manifesto.

“I believe we can make sense of many of the diseases prevalent now and relate them to some simple but profound changes that have occurred with the introduction of agriculture and the more recent industrialization of our foodways,” he says. “These changes are related to how the food environment, including its availability, interacts with the metabolic environment of our bodies,” and “…the diseases of civilization are largely related to the abandonment of the metabolic conditions we evolved under.” Both Gary Taubes and Dr. Kurt Harris are in my pantheon of heroes.
So, are most of my regular readers type 2 diabetics, or pre-diabetic (Metabolic Syndromers), or just IR (Insulin resistant and thus carbohydrate intolerant) and overweight or obese? Maybe, at present, but I hope that more of you will come, as I do, to see that “eating clean” is the best way for everyone to avoid the Diseases of Western Civilization.

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