Sunday, August 20, 2017

Type 2 Diabetes, a Dietary Disease #394: “Alternative Preventive Medicine”?

A friend, whose father perhaps not incidentally was a medical doctor, recently wrote me, “I tend to believe many of the ideas you have uncovered [?] have valid outcomes.” He described these ideas as “alternative preventive medicine,” and lamented that “modern medicine doesn’t have a great deal of concern for them.” He opined, “They love leaning on prescription solutions.” These comments gave me a lot to ponder.
First, with respect to my friend, he has been reading my columns almost since I began writing them in 2010 and he knows that I don’t just talk-the-talk; I walk-the-walk. Even if he acknowledges that my “ideas” have “valid outcomes;” I have failed to persuade him to follow a Very Low Carb or Low-Carb, High-Fat Way of Eating. Like most people under the care of a specialist physician, I suspect he eats the way (s)he tells him. And today he is still “9-months pregnant” with a large projecting belly (and other health issues).
Second, from my friend’s viewpoint, it sounds to me like “my” ideas are still a voice in the wilderness. It’s true, of course, from an establishment perspective, that low-carb, moderate-protein, high, healthy-fat eating is the opposite of the way we have been told to eat by the establishment for our entire lives. In that sense, this Way of Eating is surely “alternative.” Even Taubes, in his ground-breaking book, “Good Calories – Bad Calories,” describes his “Carbohydrate Hypothesis” (as opposed to the Diet-Heart hypothesis) as “alternative.”
And surely the low-carb, moderate-protein, high-fat Way of Eating is “preventive.” And I don’t mean for just the overweight, obese, pre-diabetic and type 2 diabetics amongst us. I mean for the world’s entire population!
Since 1977, when the Dietary Goals for the United States was published, we have been told to eat a diet of 55%-60% carbohydrates, 30% fats and 10% protein. To this day the Nutrition Facts label on all processed food packaging basically still advises us to eat that way. Some years ago they removed the percentage of protein, and the 2015 the Guidelines eliminated the “eat no more than 30% fat, but the 300 grams of carbs on a 2,000kcal diet for women and 375 grams on a 2,500 kcal diet for men remains. Do the math. For women, 300g x 4kcal/g = 1,200 calories = 60% of 2,000 calories. For men, 375g x 4kcal/g = 1,500kcal = 60% of 2,500 calories.
That percentage of carbohydrates (60%) is way too high. It is the reason we are all (i.e. most of us) fat! That’s how they fatten beef on the feed lot. We eat too many processed carbs and baked goods, and refined sugars and beverages sweetened with high fructose corn syrup or cane sugar. I don’t have to tell you. You know.
So, if we are going to go with Hippocrates’ dictum of “let food be thy medicine and medicine be thy food,” what is a sensible “alternative, preventive medicine”? You don’t have to go to “extreme” measures (unless your medical indications warrant it or you want to – it is safe to give up carbs entirely), here is my suggestion:
     For women, reduce your carb intake to 20% (vs.60%) of 2,000 calories. That’s 100 grams a day and a 2/3rds reduction. You will feel better, lose weight easily, and have better blood lipids, especially HDL-C (the good cholesterol) and TGLs. Look for lower inflammation and, as you lose weight, improved BP.
     For men, reduce your carb intake to 20% of 2,500 calories. That’s 125 grams a day and also a 2/3rds reduction. You will have all the same benefits and feel pumped all day long. No need to snack. Your metabolism will run at full-speed because your blood sugar won’t crash. Honestly. You’ll feel great!
Of course, as you eat fewer carbs, you can increase your protein from 10% to 15% or even 20% and your fats from 30% to as much as 60%. That’s not as much as it seems since fat is more than twice as energy dense as both protein and carbs (9kcal/g for fat vs. 4kcal/g for protein and carbs). Eat more butter, cream and olive oil!
As my friend wrote, this is a “real preventive route to reaching better health.” I just wish he’d take to the road.

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