Sunday, August 4, 2019

Retrospective #169: When I told her, “I’m diabetic…”

When I ordered 2 fried eggs and a side of bacon for breakfast in a hotel in New Orleans a few years ago, the waitress said the special came with grits and a muffin. When I declined, she countered that it would save me money. When I told her, “I’m diabetic,” she just looked back at me with a blank expression. After she left, my wife told me the waitress didn’t understand that “grits and a muffin are ‘sugar’.” People don’t know that ALL CARBOHYDRATES break down to simple sugars, mostly glucose. GLUCOSE IS “BLOOD SUGAR.”
Ignorance about Type 2 diabetes is endemic. People are abetted in this ignorance in part by self-denial. After all, who wants to “give-up” favorite foods! But it is also aided and abetted by institutional obstructions: Government in the pocket of Agribusiness and Big Pharma; the medical associations and societies (the AHA and the ADA), are also largely dependent on Agribusiness and Big Pharma for financial support; and the intransigence and intractability of the Dietary Guidelines to accept the “inconvenient truth:” that the one-size-fits-all, low-fat, high-carb recommendation it has been dispensing since 1980 has been a huge, failed experiment in nanny-state government.
Another aspect of this problem is, “If I’m going to avoid eating carbohydrates, what can I eat?” Implied in this question is that “everybody knows” that we shouldn’t eat saturated fat and cholesterol because “they’re artery clogging.” Well, that’s just not true. Countless studies, from the very beginning – Ancel Keys and George McGovern notwithstanding – attest that saturated fat is good for you. In fact, saturated fat is essential for healthy cells. And the liver makes most of our cholesterol (100% for vegans) to use for the production of cell membranes, bile acids and hormones, including vitamin D. Even Keys acknowledged later in life that dietary cholesterol is inconsequential.
Cholesterol is blamed for clogging arteries when it’s actually repairing (with plaque) inflamed artery walls whose erosions are filled with small dense LDL particles. It’s the INFLAMMATION and the SMALL DENSE LDL particles that are the problem – not the cholesterol that came to “PUT OUT THE FIRE.” The test for inflammation is the hsCRP.
The best way to fix the high “small/dense LDL problem is to increase the HDL particles in your blood (by eating saturated fat) so they (the good HDL particles) can carry the small/dense LDL particles back to your liver before they get stuck in your arteries. You can also increase the size/quality of your LDL particles from small/dense to large/fluffy by eating low-carb. Statins only lower your large/buoyant LDL cholesterol, leaving the small/dense ones to get stuck and be covered with plaque. Eating low carb will also lower your triglycerides and raise your HDL.
A day or two later, we were having breakfast at a motel in small Cajun Country town called Thibodaux. I’m told it is home to the 3rd best culinary school in the country. In the breakfast room the coffee “creamer” was “Coffee-Mate,” a sweetened chemical concoction designed to eliminate saturated fat (from milk and cream) and replace it with “sugar” (carbs). I had my usual eggs and bacon but noticed that for the breads they provided a whipped spread whose primary ingredient is “partially hydrogenated soybean oil.” Doesn’t everybody know that that’s trans fat!
Later I had occasion to speak to the motel’s managing partner about these things. He asked, reasonably, what he should he be offering his guests instead? I said “half and half and butter”! When he started to ask about saturated fat, I suggested he talk to the culinary school people. Let’s hope he does and that they support my suggestions. They should know better, but… it’s Thibodaux. Sorry, but let this last story illustrate why I’m concerned.
The day before we had been on a “Swamp Tour.” With time for lunch before starting out, I asked the ticket seller about a place to eat, mentioning that I was diabetic. Later, our tour guide, who had overheard me, mentioned that he was diabetic too. He told me that he takes orals meds AND BASAL AND MEALTIME INSULIN.
I asked him what he eats. He said his doctor told him he could eat one slice of bread with breakfast. I then asked him what he had just eaten for lunch. He said he had had spaghetti. When I told him what I eat for breakfast and lunch, he just looked back at me with a blank expression. The boat driver told me later his friend had blood sugars in the 300s. And he walked with a limp. This man does not have a good prognosis. I’m thinking: amputation.

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