Thursday, October 31, 2019

Retrospective #257: Non-surgical bariatric medicine

Does this sound like an oxymoron to you? It did to me, until I looked up the definition of “bariatric.” According to Merriam-Webster online, bariatric means “relating to or specializing in the treatment of obesity.” Well, non-surgical bariatric medicine is what Yoni Freedhoff, MD, an Ottawa, Canada, family doc practices.  He also founded Ottawa’s Bariatric Medical Institute, “a multidisciplinary, ethical, evidence-based nutrition and weight management centre.” He quips in “About Me” that, “Nowadays I’m more likely to stop drugs than start them.” He sounds like my kinda doc.
What brought Dr. Freedhoff (I’m gonna call him Yoni) to my attention was an email from my editor. “Sugar” has been one of her long-time “faves,” so when Yoni heralded Canada’s Heart and Stroke Foundation’s (HSF) 2014 issuance of “Sugar, Heart Disease and Stroke” – what Yoni calls a “world leading sugar statement” -- she gave me a heads up.
Yoni described the HSF position statement “as hard hitting as any I’ve read,” providing “a slew of recommendations” for consumers, the Federal and Provincial Governments, and other regulatory bodies such as school boards. Some of the recommendations, such as taxing sugar sweetened beverages and “Bloomberg style” drinking cup size bans, I do not favor. Likewise, they would have little chance of enactment in the more individualistic, civil-libertarian political environment of the U.S., but that’s not Yoni’s thrust. It was what enabled the HSF to make their recommendations possible in the first place: HSF’s decision to “divorce themselves from their throngs of food industry partners.”
Yoni’s exhilaration is palpable. He begins, “Huge kudos for Canada’s Heart and Stroke Foundation,” and then he adds,
“Whether or not you agree with the HSF’s recommendations, one thing’s incredibly clear, the HSF is no longer the food industry’s partner – and that news is tremendous for Canadians as it’s amazing how forceful and broad-sweeping public health organizations’ recommendations can be when there’s no worry about upsetting industry partners.
Yoni continues, “While reading this position piece and in it the HSF’s clear unadulterated-by-industry voice, I couldn’t help but wonder what sort of forces Dietitians of Canada and the American Academy of Nutrition and Dietetics could be were they to divorce themselves from the throngs of food industry partners, for as it stands now, they’re both rather toothless and certainly not describable as drivers of change or true champions of health.
Muckraking is a messy business, though. Many a good researcher and clinician has in the past had their career ruined by going against the flow, unable to get research funds or be published in a peer-reviewed journal, by advancing an alternative hypothesis or clinical approach to practicing medicine. Two names that advocated such views that come to mind while I have been writing are Kurt Harris, MD, (The Archevore Diet) and Kris Gunnars, (Authority Nutrition).
I wrote about Dr. Harris several times, beginning in 2011 with “Retrospective #19.” Dr. Harris is today a radiologist in Sturgeon Bay, WI, but he figured it all out way ahead of everyone. If I ate today (or then), from “the beginning,” the way he advocated and I related in #19, I could not have improved on it. I daresay, the same goes for all of us.
Kris Gunnars usually blogged about healthy eating, but occasionally he went off on a tangent into the politics of nutrition. One of my favorites was, “Big Food is Much Worse than Big Tobacco” in which he takes off on the same American Academy of Nutrition and Dietetics, the “professional” organization that is “the ‘biggest organization of nutrition professionals in the world’ – the ones in charge of licensing Registered Dietitians in the U.S.”
Another withering Authority Nutrition post was “15 Million Reasons for Low Fat Diets.” That’s the amount of food industry funding the American Diabetes Association (ADA) receives, while still recommending that “people eat a low-fat, high-carb diet. According to the ADA, diabetics should eat 45-65 grams of carbohydrates PER MEAL.
Then there’s this Gunnar’s post: “Six Reasons I Do Not Trust Mainstream Health Authorities”. You can’t find any of these stories at the hyperlinks I provided in the original #257 but you can still read them by title search. Do you still trust your government, your medical associations (who guide doctors and Medicare) and your food ‘manufacturers’?

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