Friday, August 30, 2019

Retrospective #195: “I did it myself, with no help from my doctor”

The other day I had an email exchange with someone who reads The Nutrition Debate. It began like this:
“I was diagnosed with Type 2 Diabetes 9 months ago. Dr. gave me 3 months to see what a diet might do before putting me on meds. Just stopped eating bread, potatoes, pasta, and ice cream. Been 9 months, lost 20 pounds, A1C totally normal (5.7) and fasting glucose at 100-105 over 3 blood works.”
I replied: “Good story. And your ‘diet’ doesn't sound too restrictive. That's good. One thing I'd like to know is WHO told you to try ‘low carb.’ Was it someone specific (e.g. your doctor), or was it just what you've been hearing and reading increasingly in the media these days? Your answer is important to me.”
He replied: “I did it myself with no help from my doctor. Just made sense since I was a big white carb eater and knew that was a big sugar source.” A thinking man: eating refined carbs and sugars made his blood sugar rise!
There, you see. I’m not that crazy fanatic that you all think I am. And you don’t have to be one either. Here’s this guy, presumably with a regular work and family life, who saw what had happened to him (diagnosed a Type 2), he recognized he was a “big white carb eater”, and he envisioned the result (disease, meds, eventually complications).
So, he decided to DO something about it. He “just stopped eating bread, potatoes, pasta and ice cream” for 9 months and lost 20 pounds! His A1c’s returned to “normal” (clinically on the cusp of “non-diabetic” on the ADA scale), and his fasting blood glucose stabilized at the lower end of the pre-diabetic scale “over 3 (successive) blood works.” That, as I said, is a “good story.” And it could be yours, too, if you took the same steps as my correspondent.
Notice, though, that his doctor didn’t tell him to eat low carb. He just gave him 3 months to get his act together “before putting me on meds.” That’s the ADA protocol: “lifestyle changes” (“diet and exercise”) first, then start you on meds. The problem is that the ADA’s medical protocol doesn’t advocate the right dietary changes. Surprised? No? Doctors aren’t trained in nutrition. But a more cynical view is that your doctor is in business to treat illness, with medicine. Besides, exercise is not a good weight loss strategy. Personally, it just makes me sweaty and hungry.
In my opinion, though, It’s immaterial. What your doctor wants to see are results, i.e., good labs: A1c’s and fasting blood glucose, and other markers, like weight, waistline and BMI. And blood pressure. She is probably also testing your cholesterol, and if she is paying attention to more than Total Cholesterol and LDL, she will note improvements in HDL and triglycerides, as well as inflammation markers like hsCRP. They will all improve on a low carb diet.
So, how complicated is this? To quote my correspondent: “(It) just made sense since I was a big white carb eater and knew that was a big sugar source.” What did he have to do to turn his health around? He “just stopped eating bread, potatoes, pasta, and ice cream.” In nine months, he lost 20 pounds, just doing this. And, he said proudly, “I did it myself with no help from my doctor.” I would argue, though, that the doctor did help. He made an explicit threat: “Dr. gave me 3 months to see what a diet might do before putting me on meds.” That’s motivational!
That kind of threat (coercion?) works for many people: the kind of people who want to have control over their own lives, who don’t see themselves as victims, and who don’t want to be dependent on other people or things. I remember thinking when I was in my 40s that I would never be someone who had to take medications or supplements every day for the rest of my life. LOL. Such is life. We are invincible, until we are no longer invincible. But as long as I can, I want to be able to say, as my email friend and new reader said, “I did it myself…” I say, props to him!

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