Monday, June 29, 2020

Retrospective #499: Lose the Fat, Save Your Life

This column, #499, will be my next-to-last post on Blogger. I started to write on Blogger about type 2 diabetes and nutrition in 2010 because a friend, who was following “doctor’s orders,” died of heart disease, a Macrovascular complication of type 2 diabetes. He was a pharmacist, and as his condition worsened through medical mismanagement of his disease, he became an insulin-dependent type 2 diabetic.

Why did this educated man follow “doctor’s orders”? Why would he not? Don’t we all, generally? Aren’t doctors trained to treat disease? Like high blood sugars, a type 2 symptom? The answer to these questions is, of course, “Yes.” So, you might suppose that a pharmacist would too. Pharmacists are trained in pharmacy and pharmaceuticals, and that is how doctors treat type 2 diabetes. With drugs. They treat type 2’s primary indication: a high blood sugar.

So, Dick continued to eat the one-size-fits-all, “balanced,” very high carbohydrate diet to which he, and the rest of us, sadly, have transitioned during our lifetimes, and especially since 1980: The Standard American Diet (SAD). This diet, if you didn’t know, is +/-60% carbohydrates. Check out the Nutrition Facts panel on processed food. And it is not the healthy, whole-food carbs we used to eat. They are highly processed boxed and bagged food products and sugars.

Knowing what I learned on my own, and from online forums, I was motivated to help others treat the cause, not the symptom of type 2 diabetes, and reverse the course of the disease. But it didn’t start out like that. From the time I was diagnosed a type 2 in 1986, I followed my doctor’s advice too. To control my blood sugar, my doctor started me on one oral medication and over the course of 16 years I graduated to where eventually I was maxed out on 2 classes of oral meds and starting a 3rd. I was, to be sure, on a certain path to becoming an insulin-dependent type 2 too.

Then my doctor turned his attention to my weight. He had read, “What If It’s Been a Big Fat Lie,” the cover story of The New York Times Sunday Magazine on July 7, 2002. He tried the diet himself, to lose weight. When it worked for him, he asked me to try it too, just to lose weight. It occurred to him, though, as we walked down the hall to schedule my next appointment, he said, “It might even help your diabetes. The diet was Very Low Carb (20g of carbs a day). We know now how well that works, but doc didn’t learn it in medical school, and Dick didn’t learn it in pharmacy school.

In the next week, strictly eating just 20 grams of carbs a day, I had 3 hypos (hypoglycemic episodes). Each time I called the doctor and each time he cut my meds. The first day I stopped taking the 3rd class and by week’s end had cut the other two classes of meds in half twice. I later stopped one of those, a sulphonylurea, and today just take Metformin.

In the course of 9 months, strictly followed the Very Low Carb regimen, I lost 60 pounds. Four years later I slipped a little and regained 12, so I started Very Low Carb again and over a year and a half lost another +/-120 pounds.

Of course, copious health benefits (and cost savings) followed. Besides the diabetes drugs, my doctor too me off statins. Why? My Total Cholesterol and LDL remained about the same, but my HDL more than doubled from borderline (39mg/dl) to 84 average. And my triglycerides (TG) dropped from 135mg/dl to 49 average. On this Very Low Carb diet, my TG/HDL ratio, “the strongest predictor of a heart attack” was always less than 1.0 (“a very low probability”). And so was my chronic inflammation, and my blood pressure dropped to 110/70 on fewer meds.

When I started out to eat Very Low Carb, it was just to lose weight, as both my doctor and I wanted. I had followed his weight loss “prescription,” before, including when he employed a Registered Dietitian in his office. I did it then and in 2002 because, like most of us, I trusted my doctor. I was positively inclined to “follow doctor’s orders.”

But my doctor didn’t learn how to lose weight in medical school. He learned it from a newspaper story. He did it just to lose weight, and he did. And when he suggested that I try it, he thought – almost as an afterthought, channeling something he remembered maybe from a pre-med course in physiology – that it might help with my worsening type 2 diabetes – no matter how many drugs he prescribed for it. By accident you might say, my doctor saved my life. Today, 18 years later, I am in tip top health, still 150 pounds lighter that when I started, and I think I may live forever.

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