Monday, March 25, 2019

Retrospective #37: Therapeutic vs. Prophylactic Dieting

A prophylactic diet is designed to lose weight and to prevent the health consequences of weight gain: the advent of disease. A therapeutic diet is designed to lose weight and to address the consequences of the onset of disease. This list of therapeutic diets illustrates how a diet can be designed both to lose weight and to improve your health.
The Therapeutic Ketogenic Diet, and “Keto” Diets
The Therapeutic Ketogenic Diet was developed at Johns Hopkins University in the early 1920’s to treat epilepsy in children. It is an effective medical therapy, but its popularity waned with the development of drugs. The diet is 90% fat by calories. Modern hacks of this diet, popular for weight loss, are called simply “Keto” diets. They are are 65 to 70% fat, both body and dietary fat, since your body fat is consumed for energy when you eat Very Low Carb.
The Atkins Induction Diet
Atkins Induction is considered to be low carb (which it is), and high protein (which it isn’t!), because nobody will call it high fat. It is high fat. Atkins Induction (Phase I: 20g Carbs/day) is a version of the ketogenic diet at 55 to 65% fat. It is a weight loss diet especially effective for people with medical conditions such as cholesterol issues (low HDL and high triglycerides), high blood pressure, and Type 2 diabetes. It is also an effective regimen for those with Metabolic Syndrome. See Retrospective #9 “Metabolic Syndrome,” to review the symptoms and evaluate yourself.
The Bernstein Diet
Richard K. Bernstein, MD, has been a Type 1 diabetic for about 70 years. He developed a very low carb, moderate protein, high fat diet, 30 grams of carbs a day, 6-12-12, for breakfast, lunch and dinner. This Way of Eating (WOE) emphasizes “eating to the meter” in order to control post-prandial (after meal) blood glucose levels.  The Bernstein program is a very effective way for Type 2s to lose weight, without hunger or lethargy. Your lab results (blood sugar, blood lipids and, as you lose weight, blood pressure, will improve as well, but it requires major dietary changes and strict compliance. It’s challenging, unless you realize your improved health, your lifespan really, depend on it. Many Type 2’s, and those who want to avoid becoming Type 2, eat just 30g of carbs a day. By “eating to the meter” you will maintain a stable blood glucose and completely avoid a progressive worsening of disease.
The Diet Doctor’s LCHF Diet
This diet is described in Retrospective #35 below. Eating Low-Carb, High-Fat (LCHF) is a great way to lose body fat. It provides satiety, or a sense of fullness, that permits you to eat two or three small meals a day with no snacks. It maximizes body fat burning and thus keeps a high metabolic rate. It is thus similar to the 3 diets described above.
These diets are all safe and effective therapeutic diets. They are mostly designed for Type 2 diabetics (like me), or Pre-diabetics, or people who are overweight with symptoms of Metabolic Syndrome (Scroll down to #9). They all require a lifestyle change and a lot of self control, but they are life changing in their benefits. You will achieve dramatic weight loss without hunger and without loss of energy. Most important, you will achieve dramatic improvements in health by all clinical measurements (blood lipids, i.e. cholesterol, blood glucose, blood pressure and inflammation). But because they require strict compliance, most people won’t even give them a brief trial.
Besides, unless your doctor tells you that you are sick, you may not think there is a reason to change your lifestyle. Just “Take this pill and you’ll be healthy,” (s)he says (and you hope), so you won’t think major changes are needed.
Consider taking responsibility for your own health. After all, most people still have not been diagnosed with a chronic disease, yet, but they often have unrecognized symptoms, especially high post-prandial blood glucose. And if they do have symptoms of Metabolic Syndrome, when a doctor recognizes them, he or she will write a script for a pill: a statin, or a blood pressure pill, or Metformin. Sure, for the “healthy” population out there (and most of you think that includes you, right?), the easy thing to do is kick the can down the road for a few more years. A few more pounds, a few more pills. A prophylactic diet today, a therapeutic diet tomorrow. It’s your choice, of course.

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