Wednesday, February 26, 2020

Retrospective #375: A New Year’s Eve Conversation, Part 2 of 2

This column and the previous one, from 2017, like every column in the Retrospective series, were originally published weekly. In the Retrospective series they have been edited for size, format and content and are being published daily.
Part 1 of this 2-part series (Retrospective #374) relates how “Bruce” lost weight easily by “going off carbohydrates almost entirely” for two weeks. I met Bruce casually at a New Year’s Eve party and gave him one of my cards. He decided to check out my website, and then to try Very Low Carb (VLC) eating. In our earlier conversation that evening, Bruce told me that he had lost 10 pounds. Our conversation continues here:
Dateline: January 14th (still later the previous evening)
You’re welcome, Bruce. Weight loss was my original motivation (in 2002) for eating VLC because, like yours, my doctor thought that being overweight was a cause of T2DMThey were both wrong, as Gary Taubes and many other experts in physiology and medicine have now exhaustively and conclusively proved. See my Retrospective #5 or Gary Taubes's "Alternative Hypothesis" in "Good Calories-Bad Calories" (2008), a heavy but solid, evidence-based read.
An easier read would be, "What If It's All Been a Big Fat Lie," the New York Times Sunday magazine cover story of July 7, 2002. Google it. My doctor read it, tried the diet himself, and recommended it to me. That's when I got interested in low carb for weight loss. And, incidentally, it started the modern revolution in dietary science that so much of the orthodox profession still continues to dismiss. That's why Taubes, who won the National Science Writers’ Association award 3 times, wrote GC-BC. Sadly, he was to be disappointed by the medical community’s response to his book. 
INSULIN RESISTANCE IS THE CAUSE OF T2DM. IT IS ALSO THE CAUSE OF OBESITY, NOT THE OTHER WAY AROUND.  Insulin is the transporter of glucose in the bloodstream, and so long as there is enough glucose (from carbs) circulating in the blood, insulin levels remains elevated and blocks the alternative fuel, body fat, from breaking down to fatty acids to maintain energy balance. The body saves this fat, a more dense source of energy (9kcal/g vs.4 kcal/g for carbs and protein), for long fasts, including famine and winters (from a Paleolithic/historical perspective).
My current focus in this column is on "Pre-Diabetics," newly diagnosed Type 2s, and those who, like you, have been told they "might be Pre-Diabetic." The medical societies have been very slow to revise standards for diagnosis, but they have been doing it. They just haven't gone nearly far enough. There are many clinicians today who have, however, and many who just may classify you unambiguously as Pre-Diabetic, or even a frank, incipient Type 2 diabetic.
I hope you have a baseline A1c on a recent lab test, because it you stay on your VLC Way of Eating, you will see it drop, perhaps significantly, and perhaps even out of the range of Pre-Diabetic to below 5.7%. That should be your goal.
I also hope you have a baseline metabolic panel or at least a lipid (cholesterol) panel with which to compare your next lab tests. After doing this Way of Eating for awhile, my HDL more than doubled from 39mg/dl to 84mg/dl (comparing 15 average tests for both). And my triglycerides plummeted by two-thirds (from around 150mg/dl average to below 50 average. Both values have stayed there for many years now. My latest cholesterol test: TC 184; HDL 91; LDL 84; TG 46.
BTW, after one day of eating Very Low Carb, I had a hypo and called my doctor. He told me stop taking one diabetic oral med. Later that week he cut the other two in half TWICE, later eliminating one. Now I just take 500mg Metformin.
Dateline: February 29th (6 weeks later)
I emailed Bruce to invite him to another party, our annual Mid-Winter Wing-Ding. He replied:
Hi Dan,
Thanks much for the invitation, but I am in Jensen Beach for January only.
LOST 40 POUNDS [my emphasis] and am taking One-a-Day “Silver” daily.

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