Saturday, February 28, 2015

The Nutrition Debate #292: Type 2 Diabetes: Doctors in Transition

First off, let me be clear. I am not angry at doctors, in general. Neither am I an apologist for them, although examples of both have occurred in my 291 previous posts. Let’s face it: clinicians who treat Type 2 diabetes are in a tough spot. They are like passengers on the Titanic, cruising along in the dark, comforted by the knowledge that what they were taught in medical school is still the current treatment protocol. They are also aware, however, that how they are required to treat “will trap patients in a lifelong regimen of drug management, obesity and escalating diabetes.”
The Nutrition Debate #12: "Turning the Titanic", written 4 years ago, was a flop (only 30 page views). I guess people aren’t interested in abstract metaphors and allusion. They want concrete solutions. Well, folks, please don’t wait for the medical establishment to substantially change the standard of care for Type 2 diabetes. There are too many forces in play now. I don’t need to go into them all in detail. (It would just be a rant!) Suffice it to say the entire field of “healthy eating” today is dominated by the powerful food processors and manufacturers (“Agribusiness”) and drug manufacturers (“Big Pharma”). They in turn influence public health policy and corrupt drug research. To close the loop, their ads enrich the media and "miseducate" the public.
There are, of course, notable exceptions. In the modern era, Robert Atkins, MD, raised awareness of the benefits of low carbohydrate nutrition. He was attacked by the medical establishment as “a dangerous fraud” (The Nutrition Debate #4). Then, in 2008 Gary Taubes, the 3-times Science in Society award winning journalist, wrote, “Good Calories – Bad Calories” (“The Diet Delusion” in Britain). That book had a huge impact, especially (although less than he’d hoped) on medical practitioners. One MD, Kurt Harris, publicly acknowledged the influence that GC-BC had on him.
Dr. Harris was the creator of the “Archevore” protocol and “PaNu,” but he has since taken down his websites. Interested readers, however, can find some of Harris’s writing at Psychology Today here and The Nutrition Debate #19. Another book I’d recommend is Volek and Phinney’s “The Art and Science of Low Carbohydrate Living.” A very good online site where I “went to school” is Dr. Bernstein’s Diabetes Forum. It’s full of friendly and very helpful people.
Attempts by doctors and others to escape from the current treatment protocol and reach a wider audience via individual practice are by definition very limited. Blogs and other media do reach more people but are not very remunerative. Some have done that anyway with considerable success. The “Diet Doctor,” Andreas Eenfeldt, MD, is one such. “Authority Nutrition,” created by Kris Gunnars, a medical student, is another. And of course long-time blogger Jimmy Moore has a very popular website and many podcasts under his belt. Recently, he’s added a couple of books with Eric Westman, MD, from Duke University.
There are many other emerging "practitioners" who have seen the light, of course, most of whom have now written books, some reviewed here. A recent favorite book, and an easier read than GC-BC, is Nina Teicholz’s “The Big Fat Surprise.” She’s obviously riffing off Taubes’s earth-shaking New York Times July 7, 2002, Magazine cover story, “What If It's All Been a Big Fat Lie.” My internist read Taubes’s piece and suggested I try Atkins Induction. That’s how it all started for me.
Then, last summer, the American Diabetes Association (ADA) officially issued a Position Statement. Their “New Nutritional Guidelines,” state clearly, “It is the position of the American Diabetes Association (ADA) that there is not a “one-size-fits-all” eating pattern for individuals with diabetes.” It concluded, ““This Position Statement was written at the request of the ADA Executive Committee, which has approved the final document.” My response was, “Cowabunga, the ADA makes the turn” (#155). This “patient centered manifesto” would change everything! One problem: the document was written by, for and from the perspective of the Medical Nutrition Therapist, not the ADA doctor members. Did they even read it?
So, what will it take for more doctors to make “the turn”? If the Titanic is going to “stay the course,” would there not be a business opportunity for enterprising doctors and entrepreneurs to chart another course on a different “ship”? A course that will NOT “trap patients in a lifelong regimen of drug management, obesity and escalating diabetes.” Is there not a business opportunity for a medical practice, led by a recognized leader and backed by solid science, to multiply and expand using existing, established medical groups as well as digital marketing?
Well, such a business plan does exist, in a nascent stage.  In #293 I will tell you more about the HEAL Clinics.

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