tag:blogger.com,1999:blog-74104455004760136192024-03-18T12:09:26.541-04:00Type 2 Nutritiondanbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.comBlogger997125tag:blogger.com,1999:blog-7410445500476013619.post-3574014789191780202020-06-30T10:26:00.003-04:002020-08-04T08:26:28.317-04:00Retrospective #500: Many, many thanks, especially to my intrepid editor. <div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">With this column (#500), I will cease publication on
Blogger of the Retrospective Series of “The Nutrition Debate,” renamed at some point,
“Type 2 Nutrition.” The daily Retrospective Series posts were edited versions
of my original posts begun in 2010. The Retrospectives were begun in
anticipation of a possible book.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">None of this endeavor would have been possible without
my intrepid editor, Laurie Weakley. From the very beginning, she has been there
for me and my faithful readers. Of the original 500 weekly posts, <i><u>she
never missed a timely, thorough and professional review of even one</u></i> –
and she did it entirely <i>pro bono</i>. Laurie recognized, without my ever mentioning
it, that 1) my writing skills left much room for improvement and 2) my
motivation was purely educational outreach (not a commercial enterprise). She
wanted to help with both.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">Laurie was formerly a university librarian. She is
smart and highly skilled in computers, very well read in the physical sciences
(and otherwise), and extremely well organized with a vast library of saved
hyperlinks. She also has the skill to improve a writer’s message without
changing it. She’s flexible to adapt to a writer’s style, a very good
communicator and has a soft touch when making corrections and suggestions. In case
I haven’t made myself clear, I highly recommend Laurie Weakley to anyone looking
for a highly qualified editor.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">I originally began writing this column at the
invitation of the editor/publisher of a local weekly newspaper. He published my
columns as “content” to fill space between ads. He published about 20 columns
and then lost interest in “all the low-carb stuff.” A few years later, he
ceased publication of the weekly newspaper too,<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">On the other hand, interest in “the low carb stuff,” has
increased exponentially. For me it began in 2002 with The New York Times Sunday
Magazine cover story, “What If It’s All Been a Big Fat Lie,” by the heralded
science writer Gary Taubes. Taubes based his story on research but
fundamentally vouchsafed for Robert Atkins, MD. I’m very glad to say, it got <i><u>my</u></i>
doctor’s attention. <b><i><u>He</u></i></b><i><u> just wanted to lose weight</u></i>,
and he wanted me to as well. So did I. <i><u>He</u></i> tried the diet recommended
and lost 17 pounds in 6 weeks. My doctor then suggested I try it too.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">And the rest, as they say, is history. By the time the
local newspaper publisher asked me to write a column for him, I had lost 170
pounds, first on Atkins Induction (20g of carbs a day), 60 pounds over 9 months,
and then another 110 on Dr. Richard K. Bernstein’s 6-12-12 program for
diabetics. I also learned a lot by lurking on Bernstein’s on-line “Diabetes
Forum.” And in the first week on Atkins Induction, I had 3 hypos, and he took
me off virtually all 3 of my oral anti-diabetes meds (all except 500
Metformin), putting my diabetes “in remission.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">My doctor knew he was going “off label” by prescribing
“very low carb” for weight loss, so he monitored me monthly for a year. In that
time, and in the 18 years since, I never had a hypo again. In addition, my HDL
more than doubled, my triglycerides dropped by more than 2/3rds and he took me
off the statin he had prescribed. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">My column’s focus these last 10 years has remained the
same: <b><i><u>Type 2 Diabetes is a dietary disease</u></i></b>. It is best
treated with a Very Low Carb diet. Since 2010 I have had about 425k page views
on Blogger, plus with the daily Retrospective Series, an unknown number on
Facebook and Twitter. But that pales in comparison to the giants, many of whom
arose after I began. Dietdoctor.com, I think, now gets about over 400k hits <i><u>a
day</u></i>!<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="line-height: 115%; mso-bidi-font-size: 12.0pt;">Andreas Eenfeldt, MD (dietdoctor.com), and Jason Fung,
MD (The Jason Fung Fan Club – Fasting Support) are today two of the brightest
stars in the nutrition firmament and among my favorite places to visit. They
deserve our profound gratitude <i><u>and thanks</u></i> for their pioneering
work and courage. But for me, personally, I am hugely indebted to my intrepid
editor, Laurie Weakley, who stayed with me for almost 10 years in my weekly foray
into the blogosphere.<o:p></o:p></span></div>
<span style="font-family: "calibri" , sans-serif; font-size: 12.0pt; line-height: 115%;">Thank
you, Laurie. I don’t know how I can ever repay you for your support and
encouragement…and help. </span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-90405289786411573132020-06-29T08:18:00.001-04:002020-06-29T08:19:51.936-04:00Retrospective #499: Lose the Fat, Save Your Life<div class="MsoNormal" style="line-height: 115%;">
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 <i><u>pharmacist</u></i>,
and as his condition worsened through medical <i><u>mismanagement</u></i> of
his disease, he became an <i><u>insulin-dependent</u></i> type 2 diabetic.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
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.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
So, Dick continued to eat the
one-size-fits-all, “balanced,” <i><u>very</u></i> 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.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
Knowing what I learned on my own,
and from online forums, I was motivated to help others treat <i><u>the</u></i><u>
<i>cause, not the symptom</i></u> 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 <i><u>my</u></i>
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 3<sup>rd</sup>. I was, to be sure, on a certain path to becoming
an insulin-dependent type 2 too.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
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 <i>The New York Times</i> Sunday Magazine on July 7, 2002. He tried the diet
himself, <i><u>to lose weight</u></i>. When it worked for him, he asked me to try
it too, <i><u>just to lose weight</u></i>. 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 <i><u>Very</u></i> Low Carb (20g of carbs <i><u>a
day</u></i>). We know <i><u>now</u></i> how well that works, but doc didn’t
learn it in medical school, and Dick didn’t learn it in pharmacy school.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
In the next week, <i><u>strictly</u></i>
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 3<sup>rd</sup> class and by week’s end had cut the other two
classes of meds in half <i><u>twice</u></i>. I later stopped one of those, a
sulphonylurea, and today just take Metformin.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
In the course of 9 months, <i><u>strictly</u></i>
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.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
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.<o:p></o:p><br />
<br /></div>
<div class="MsoNormal" style="line-height: 115%;">
When I started out to eat Very Low
Carb, it was <i><u>just to lose weight</u></i>, 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.”<o:p></o:p><br />
<br /></div>
<span style="font-family: "calibri" , sans-serif; font-size: 11.5pt;">But my doctor didn’t
learn how to lose weight in medical school. He learned it from a newspaper
story. He did it <i><u>just to lose weight</u></i>, 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 – <i><u>no matter how many drugs
he prescribed for it</u></i>. 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.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com1tag:blogger.com,1999:blog-7410445500476013619.post-29820166204468686362020-06-28T07:55:00.001-04:002020-06-28T07:55:28.415-04:00Retrospective #498: Save Money on Food and Meds Too<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">For almost
500 columns I have been harping on the health benefits of adopting a Low Carb
or Very Low Carb Way of Eating. I have been trying to cajole my readers into
acting in their own best interests. I’ve been telling you that you will lose a
lot of weight, easily and without hunger, you will normalize your blood sugar
regulation, and by strictly following a low-carb diet, you will put your Type 2
diabetes in remission…and with it reduce your risk of all the co-morbidities,
both Macrovascular and Microvascular. By now, I hope, you have been persuaded…<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">However,
just in case, if you need a little more push, there’s another very good reason
to eat a Very Low Carb diet:<o:p></o:p></span></div>
<div class="MsoNormal">
<b><span style="font-size: 11.5pt; line-height: 115%;">YOU WILL
SAVE A LOT OF MONEY ON FOOD AND MEDS TOO. AND I’M TALKING <i><u>SERIOUS</u></i>
MONEY HERE.<o:p></o:p></span></b></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Let’s start
with medications. If you are overweight (from chronic hyperinsulinemia), you
are probably on blood pressure medications. At one time I was on 3 classes of
BP meds. As you lose weight and your BMI returns to “normal,” your doctor will be
able, in all likelihood, to titrate you off one or two or even all three BP
meds.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">If you’re a
diagnosed Type 2 diabetic, you may be on as many as 3 classes of oral anti-diabetic
meds. I was, and within the first week of going “cold turkey” on a Very Low
Carb diet (20g of carb a day), my doctor had to take me off one and reduce the
other 2 meds in half <i><u>twice</u></i>. And a while later, he eliminated a 2<sup>nd</sup>
med altogether. I still take a very <i><u>inexpensive</u></i> Metformin, but
many very low-carbers have stopped taking that medication as well.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In addition,
the <i><u>new</u></i> classes of diabetes meds that are still on patent are <i><u>very</u></i>
expensive. The 20% Medicare co-pay for the SGLT-2 class, that makes your
kidneys excrete glucose, is $300 for a 60-day. That’s a $1,500 prescription!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">And it
you’ve been following “doctor’s orders” and eating a “balanced” diet of 55% to
60% carbohydrate, the Standard American Diet (SAD for short) of processed carbs
and simple sugars (as in fruit), you may already be injecting insulin in your
body…so I don’t have to tell you how expensive injected insulin (and other
injectables) have become recently.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Then, if
you’ve been eating the SAD, you probably have “high cholesterol,” a Total
Cholesterol (TC) of </span><span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-family: Calibri;">≥</span><span style="font-size: 11.5pt; line-height: 115%;">200mg/dl and an “elevated LDL-C,” so you’re taking a statin. But it’s low
HDL and high triglycerides that are the real risk to your cardiac health. My HDL
doubled and my triglycerides dropped by 2/3<sup>rds </sup>on VLC, and my doctor
took me off statins. Eating a Low-Carb or Very Low Carb diet will fix non-alcoholic
fatty liver disease (NAFLD) too. It will burn visceral (abdominal) fat around
and within the liver and pancreas too, returning them to “normal” function. All
of these medications (7 or 8 so far) cost a passel of money, and you can save virtually
all of it…while improving your health!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Saving money
on food is also a huge opportunity. People say protein and fat are more
expensive than carbs, but have you looked at the price of a box of cereal or a
bag of chips recently? And those “foods” are not nutrient dense. In fact, they
are empty but addictive calories. And they’re <i><u>totally non-essential</u></i>.
That right. <i><u>There are <b>no</b> essential carbs</u></i>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Proteins have
certain “essential” amino acids (that your body can’t make), and fats contain
certain essential fatty acids (Omega 3’s and 6’s). And without fat, there is no
way to take up the essential fat-soluble vitamins A, D, E and K.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">And fat is
satiating and protein digests more slowly, so you will eat <i><u>less</u></i> <b><i><u>real</u></i></b>
food when you eat just protein and fat because <i><u>you’ll be less hungry</u></i>.
In a restaurant, I frequently order just an appetizer. <i><u>That’s</u></i> a <b><i><u>big</u></i></b>
way to save money.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">And then
there’s fasting: the 16:8 type, where you skip one meal a day, and there’s the
OMAD way, where you skip two meals every day and eat just one-meal-a-day, again
because you’re not hungry. Now, <b><i><u>that</u></i></b> saves a lot of money.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Finally,
there’s extended fasting (EF), where you fast all day, taking just water, coffee
or tea. When your body is fat-adapted, it switches back and forth easily
between eating VLC and fasting, while <i><u>maintaining a high energy level
because it has access to your body fat for fuel</u></i>. When you are in this
state of <b><i><u>nutritional ketosis</u></i></b>, you can full-day fast on
alternate days, or even 2 or 3 consecutive days, all the while feeling pumped
no matter what your activity level. <o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">And
you feel great, because you are full of energy, but also because of <b><i><u>all
the money you saved on food and meds</u></i></b>.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-27414621791202188992020-06-27T09:39:00.003-04:002020-06-27T09:39:44.476-04:00Retrospective #497: How to Transition to a Low-Carb, Fat-Adapted Life<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">A few years ago, Andreas Eenfeldt, MD, founder of
dietdoctor.com, the world’s most widely viewed source of information on the
health benefits of a low-carb lifestyle, produced a New Year’s video with these
5 guidelines:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<b><span style="font-size: 11.5pt; line-height: 115%;">1) <i>FOLLOW STRICTLY A LOW CARB DIET, 2) EAT ONLY WHEN HUNGRY, 3) SLEEP 7-8
HOURS A NIGHT, 4) WEIGH YOURSELF DAILY, AND 5) PRACTICE INTERMITTENT FASTING
(IF)</i>. <o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">This prescription works. I lost altogether
180+ pounds, put my Type 2 diabetes in remission (in the first week!), and
dramatically reversed “high cholesterol” (stopped taking a statin) and lowered
my “chronic inflammation level.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">How you transition from “here”
(where YOU are NOW) to “there” (how you WANT to be) is what this post is about.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">To strictly follow a low carb diet,
you need to know what a carb is. No joke! Most people don’t know. There is not room
here to describe a carb in detail, so suffice it to say: </span><b><i><u><span style="font-size: 11.5pt; line-height: 115%;">IF IT IS NOT PROTEIN OR FAT, IT IS A CARB</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">. Think
about that. Then make the time to learn about carbs, because to be successful
in this Way of Eating, </span><b><i><u><span style="font-size: 11.5pt; line-height: 115%;">you need to know</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">Then, when you <i><u>strictly</u></i>
follow a low-carb diet, you will soon discover that you eat a lot less because <i><u>you
are never hungry</u></i>. That’s because when you eat low-carb, your blood
insulin level is low and your body can access stored fat whenever it needs it
for energy balance. Your <i><u>body is adapted</u></i> to burn its own fat for
energy, <i><u>so </u></i></span><b><i><u><span style="font-size: 11.5pt; line-height: 115%;">you don’t need to eat.</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">When I first thought about the Diet
Doctor guidelines, I wanted to reverse the order of guidelines 1 and 2 above.
Then, I realized it’s nonsensical to follow the “eat only when you’re hungry”
guideline <i><u>if you’re always hungry</u></i>! And </span><b><i><u><span style="font-size: 11.5pt; line-height: 115%;">if you eat a “balanced” diet (typically 55% to 60% carbs), you
WILL always be hungry</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">, or at least every 2 or 3 hours.
So, that’s why you have to “<i><u>strictly follow a low-carb diet</u></i>”
before you can, “<i><u>then, eat only when hungry</u></i>.” Got it?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%; mso-bidi-font-weight: bold;">Then came along Jason Fung, MD, the
Toronto nephrologist whose book, “The Obesity Code” was a blockbuster. Fung has
a way with words, and his writing style is very “accessible.” You will see that,
when you’re not hungry, fasting becomes much easier. So, Fung and Andreas Eenfeldt
are kindred spirits and now frequently collaborators in fasting.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">The two IF methods Eenfeldt described a few years ago were
5:2 and 16:8. I suggest you use them both to transition to a low-carb,
fat-adapted Way of Eating. Once you start strictly eating low-carb, <i><u>and</u></i>
you start skipping breakfast (except for coffee with heavy cream), <i><u>because
you’re not hungry at breakfast</u></i>, you’ll already be fasting 16:8.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">Then, you might also sometimes transition to skipping lunch,
or to eating a very light one (one or two hard boiled eggs). And voilà, you’ll be
in a mildly ketotic state – a mild form of <b><i><u>nutritional ketosis</u></i></b>
– for most of the day.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">The other form of IF that Eenfeldt describes is 5:2. I have
instead adopted, from time to time, as needed for weight loss, intermittent 42-hour
fasts 2 or sometimes 3 times a week. Instead of eating 5 days and fasting 2, I
eat 4 days (Tue-Thu-Sat-Sun) and fast the 3 alternate days, M-W-F, fasting from
supper one night to lunch the second day after. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">Guidelines 4, to get a good night’s sleep, they say is
important. Just make sure your bladder is empty before retiring, and if you
have trouble falling off, take a magnesium pill or even a glass of wine. Guideline
5, weighing yourself daily, is a good idea for motivational reasons. I keep a
written record and set a weekly weight loss goal.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%;">
<span style="font-size: 11.5pt; line-height: 115%;">The essential thing is, when you eat, eat Very Low Carb. In
2002, I started “cold turkey” on 20 grams of carbs a day. I saw immediate
results. Within the 1st week, my doctor took me off virtually all the oral
antidiabetic medication I was on to avoid hypos (hypoglycemia or low blood
sugar); I had three hypos the 1<sup>st</sup> week, but not one since (in 18 years).<o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">The other two
macronutrients (protein and fat), besides carbohydrates, are important to
understand, but are secondary in importance to weight loss. Protein is
important to eat, every day when you’re not fasting, but if you’re fat-adapted
(from strictly eating very low carb), and you want to lose body fat, you don’t
have to eat extra fat beyond that which comes with the protein. <i><u>Give your
body a chance to burn body fat, not food, to make up the energy deficit</u></i>,
whether you’re fasting, or eating less because you’re not hungry, even of
“feasting” days. Your body likes to burn fat.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com1tag:blogger.com,1999:blog-7410445500476013619.post-21782314486010737692020-06-26T10:27:00.000-04:002020-06-26T10:27:13.343-04:00Retrospective #496: Maintaining “Half the Man I Once Was”<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In The
Nutrition Debate: Type 2 Nutrition #400, I related how after years of eating
Very Low Carb, with ups and downs and many misadventures, and finally with an
excursion into Extended Fasting – both alternate day and consecutive day – I
achieved a weight loss result I could never even have imagined at the start: I
was just half the man I once was.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">It all began
with my doctor’s suggestion in 2002 that I begin a program of eating Very Low
Carb (20g of carbs <i><u>a day</u></i>), <b><i><u>to lose weight! </u></i></b> I weighed 375 pounds. After 15 years of
on-again, off-again compliance – even some periods of outright cheating – I finally
weighed in at 187 pounds. My BMI went from 54 to 27, and I was just half the
man I once was.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As everyone
who has lost a lot of weight knows, the challenge at that point was to maintain
that loss, or at least most of it. Alas, I failed. In the ensuing months, I
regained and then lost some of the weight. Along the way I thought a lot about
my attitude toward food, including the cultural influences and the emotional
drivers that influenced the eating habits and patterns that I had acquired over
a lifetime. That’s a lot to know, and my introspection was not perfect.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<i><u><span style="font-size: 11.5pt; line-height: 115%;">One thing
was certain though: Carbohydrates drove my weight gain and regain</span></u></i><span style="font-size: 11.5pt; line-height: 115%;">. I had been diagnosed a type 2
diabetic in 1986, at age 45. I had probably begun to develop Insulin Resistance
in my early teens (I remember when and how and why.) By the time I reached
middle age, I was Carbohydrate Intolerant, Insulin Resistant and a full-blown type
2.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Reading Gary
Taubes’s New York Times seminal piece, “What If It’s All Been a Big Fat Lie,”
gave my doctor and them me the confidence to try Very Low Carb. Reading Taubes’s
tome, “Good Calories, Bad Calories” (“The Diet Delusion” in the UK), gave me an
understanding of the science of insulin resistance, type 2 diabetes and obesity
(“Diabesity”). It also explained Metabolic Syndrome and Gerald Reaven’s
associated Unifying Theory of Disease. When I started to write about type 2
diabetes on Blogger in 2010, Gary Taubes was the subject of The Nutrition Debate
#5.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">An important
factor in my early adoption of eating Very Low Carb was the online community. I
became a regular at The Bernstein Forum, first as a lurker, then as an active participant
to learn more, and later as a sort of mentor to others. I had lots of questions,
and members of this community were very supportive of Very Low Carb eating. In
no time at all (it seems), I had lost 170 pounds. Seriously, support in a friendly
environment is very conducive to learning.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Another
influence, long before he (they) became the blockbuster enterprise they are
today, was Andreas Eenfeldt at DietDoctor.com. It was Andreas who, in a timely
January post some years ago, available as an inducement to becoming a monthly
subscriber (which I recommend), suggested a 5-point manifesto. Rule #1 was, “Eat
only when you are hungry.” This was so valuable on so many levels: a) think
before eating, b) question cultural norms and habits, and c) remind yourself of
the primary purpose of eating: nourishment to maintain energy balance (if
required by eating).<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">That last
point became clearer when I thoroughly understood the role of the hormone
insulin in energy management: <i><u>If your body has access to stored energy
(body fat), possible only when you have a low level of circulating blood
insulin, in turn made possible by a low level of glucose in the blood, your
body will be both nourished and in energy balance</u></i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, returning
to where I began this post, my goal now is to be forever in ONEDERLAND. Onederland
is the world in which, when you step on the scale, the first number you see is
a “1.” Does that sound like fantasy to you? It did to me, at one time. But when
eating Very Low Carb worked, for losing weight easily and without hunger, it
was just a matter of one-day-at-a-time, then one-week-at-a-time, and with every
passing month, the goal became closer to reality.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In my case, my
goal for the rest of my days on this planet is to maintain my weight between 195
and 199 pounds. I will do this with a combination of generally following the
principles of Very Low Carb (VLC) and One Meal a Day (OMAD). I will include <i><u>protein
every day</u></i>, including whatever saturated fat is inherent in it. In fact,
I will choose fatty cuts and always eat <i><u>full fat</u></i> dairy, including
heavy whipping cream in my morning cup of coffee. I will otherwise eat only a
moderate amount of fat, to allow my body to burn its own fat, and I will avoid
as much possible all unnatural PUFAs.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Finally,
I will use full-day fasting, as often as needed, to keep my weight within my Onederland
range. Wish me luck!</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com2tag:blogger.com,1999:blog-7410445500476013619.post-38897715012336578672020-06-25T09:59:00.003-04:002020-06-25T09:59:46.915-04:00Retrospective #495: “A Very Low Insulin Diet”<br />
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">I’ll bet you’ve never heard of this
diet! Am I right? Well, if you haven’t, it’s because there <i><u>isn’t</u></i>
a diet as such. It’s an outcome actually, of eating a certain way that achieves
<i><u>a low blood insulin level</u></i>. <span style="mso-spacerun: yes;"> </span>And <i><u>that</u></i> is a <i><u>very</u></i>
good outcome, as I’ll explain. It’s also the <i><u>natural</u></i> outcome, as
I will show, of eating the way our ancestor ate. The problem is there’s no way
yet of knowing, objectively, from a simple (inexpensive) blood test, that you’ve
achieved that desired outcome.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">As a consequence, once you have
achieved this outcome – until a cheap blood test is available – you will have
to rely on a surrogate marker to know if, how and when you have achieved <i><u>your
goal: a low blood insulin level</u></i>. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">To understand “how,” we’ll need to
delve into a little basic human physiology. Insulin is a hormone that has
multiple roles in metabolism and fat partitioning. It is secreted by the
pancreas, a small gland near the stomach, in response to eating carbohydrates.
And as carbs are digested into glucose, insulin accompanies them into the
bloodstream and acts to “open the door” of the cells where the glucose is taken
up for energy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">So, when you eat carbs, your blood insulin
level naturally rises. And the glucose from the carbs you ate are in excess of your
energy needs, they are stored or, when storage is full, by a process called <i>de
novo lipogenesis</i>, the liver converts them to fat and stores them in your
fat cells. Then, as the circulating glucose is absorbed and burned or stored or
converted to fat, your blood insulin level drops. And that is what a normally
functioning glucose metabolism does.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Then, in that normally functioning
glucose metabolism, when you blood insulin level goes low between meals, when
you body calls for energy <i>for whatever purpose</i> (basal metabolic or
activity), your low blood insulin level signals the liver to take energy from
those recently refilled or other fat cells. Your fat cells cycle the
triglycerides back into your blood stream (broken down as free fatty acids),
and you get all the energy you need from your stored fat. Again, that is what a
normally functioning glucose metabolism does. <i><u>A low blood insulin level allows
your body to continuously access stored body fat to maintain energy balance</u></i>,
including any level of energy required by your activities. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">But what happens if for years and
years, to avoid “saturated fat and cholesterol,” you have eaten – as you’ve
been told – a diet <i><u>very</u></i> high in carbohydrates? And what happens
if that diet, for your “convenience,” is mostly processed carbs from prepared
foods or products sold in boxes and bags? And what if, to make the food more
“palatable,” sugar (a simple, easily digestible carb) is added to virtually all
processed foods, e.g., store-bought bread or peanut butter?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">What happens is that for many people the
body resists the unnaturally high level of glucose in the bloodstream. The
transport hormone – the insulin accompanying glucose in your blood, it unable
to open the cell that needs the energy. Those cells have developed <b><u>Insulin
Resistance</u></b>. Well, the glucose <i><u>and the insulin</u></i>, continue
to circulate, the cells don’t get the glucose energy they need, and <i><u>because
your blood insulin level is still high</u></i>, your liver can’t access your
stored body fat for the needed energy. So, your metabolism slows, and you feel
tired… and sluggish…and hungry.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">If you are one of those who has
developed…over many years…a degree of Insulin Resistance, your doctor has no
direct measurement to find out. He doesn’t have an affordable or insurance
reimbursable test that he can use to measure <i><u>your blood insulin level</u></i>.
But she, <i><u>and you</u></i>, have a few good surrogates: 1) you body fat
level. The cause of obesity, or “overweight,” is not sloth or lack of activity.
It is Insulin Resistance. If you have a “touch” of <b><u>Insulin Resistance</u></b>,
your <i><u>elevated blood insulin</u></i> is being transported back to your
liver where it converts it to fat, and your <i><u>elevated blood insulin</u></i>
is blocking body fat from being used for energy when your body needs it, so you’re
hungry and you eat for energy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Another surrogate is an elevated
blood glucose level. Your doctor can easily test for this, either with a
hemoglobin A1c test which measure the glucose on your red blood cells over 3
months. This is a good surrogate because, as we say, if you have an elevated
blood glucose, it is <i><u>because</u></i> you have an <i><u>elevated blood
insulin</u></i> because of <b><u>Insulin Resistance</u></b>.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">If you have <b><u>Insulin Resistance</u></b>,
the precursor condition for Type 2 Diabetes, you can treat it yourself by not
eating the foods that make your body produce and transport insulin to help your
body take up glucose: <b><u>CARBOHYDRATES</u></b>.<o:p></o:p></span></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-86547160193304046882020-06-24T08:43:00.004-04:002020-06-25T10:11:50.098-04:00Retrospective #494: My Simple Food Rule<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">My “food
rules” haven’t changed much since I started eating <b style="mso-bidi-font-weight: normal;">Very Low Carb</b> in September 2002. At the </span><w:sdtpr></w:sdtpr><w:sdt id="-1253741111" sdttag="goog_rdk_1"><span style="font-size: 11.5pt; line-height: 115%;">my doctor’s </span></w:sdt><span style="font-size: 11.5pt; line-height: 115%;">suggestion, to lose weight, I began with Atkins Induction:
20 grams of carbs a day. It worked in the way my doctor intended. I lost 60
pounds in 9 months. It also worked in another way that was unintended, or at
least not anticipated. In the <i style="mso-bidi-font-style: normal;"><u>1st
week</u></i> I had to come off nearly all <w:sdt id="-1099334197" sdttag="goog_rdk_3">3 oral</w:sdt><w:sdt id="595295641" sdttag="goog_rdk_4">
diabetes</w:sdt> medications that I was on.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As best I can
remember, the Atkins<w:sdtpr></w:sdtpr><w:sdt id="337660889" sdttag="goog_rdk_10"> protocol only </w:sdt>addressed carbohydrates<w:sdt id="512876077" sdttag="goog_rdk_11"> at the time </w:sdt>. That’s worth
noting. It’s only – okay, well <i style="mso-bidi-font-style: normal;"><u>largely</u></i>
– <b style="mso-bidi-font-weight: normal;"><u>only carbs that matter.</u></b> To
lose weight (lots of it – I eventually lost 180+ pounds), you only need to
restrict – <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>severely</u></i></b>, I’ll admit – <b>CARBOHYDRATES</b>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, if all
you need to know, to lose lots of weight and greatly improve your health, is
to <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>severely</u></i></b>
limit the carbs you eat, the first thing you need to learn is: what foods
contain carbs. Today, there are many ways to go about doing this: 1) You can
“count carbs.” That’s what I did. From the start, I estimated portion sizes,
used on-line sources for carb counts and recorded everything I ate in an Excel
chart I created; or 2) You can use an on-line service to do the work for you,
but be careful; many of these sources are much too lax in their allowed foods.
They think you “can’t” or want to eat in a way that <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>severely</u></i></b> limits
your carb intake. They’re too friendly to the weak-willed or insufficiently
motivated, or 3) Once you know what foods are carbs, you can just totally (or
mostly) avoid them, in most meals or by fasting. Whichever way you choose,
once you learn about carbs, remember: you just have to stick with <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>Very</u></i>
Low Carb</b>.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I learned
what I needed to know, and then I ate (mostly) in compliance with this new
knowledge. The foods I ate, were primarily protein and fat – saturated fat
that is an inherent component of animal protein. If you aren’t prepared to do
that, you will have a tough row to hoe. Artificially manufactured vegetable
oil (polyunsaturated) fats are inherently <i style="mso-bidi-font-style: normal;"><u>unhealthy</u></i>,
and you <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>mus</u></i></b><w:sdtpr></w:sdtpr><w:sdt id="685647404" sdttag="goog_rdk_14"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>t</u></i></b></w:sdt><w:sdt id="-1156845124" sdttag="goog_rdk_15"><b style="mso-bidi-font-weight: normal;"><u> </u></b></w:sdt>eat fat with protein.
Protein has primarily cellular and hormonal functions. And you need <i style="mso-bidi-font-style: normal;"><u>healthy</u></i> saturated fats, and some
monounsaturated fats like olive oil, to absorb the fat-soluble vitamins: A, D,
E and K.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As I lost
weight by eating mostly protein and good fats,, I discovered I needed less
food to feel full. <span style="mso-spacerun: yes;"> </span>I wasn’t hungry most
of the time. My body was in mild ketosis, just ketotic enough to burn body fat
as an energy source. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>Fat and carbs are the only two sources
of energy</u></i></b>. <span style="mso-spacerun: yes;"> </span>I didn’t need to
eat carbs for energy. My body fat provided all the energy needed.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">That’s when
I started to ask myself: If I’m not hungry, why am I eating 3 meals a day? My
body runs well on its own fat (and some ketones), so, if I’m not hungry, why
eat just because it’s a certain time of day. I started <w:sdtpr></w:sdtpr><w:sdt id="-282883204" sdttag="goog_rdk_19">having </w:sdt><w:sdt id="2101756734" sdttag="goog_rdk_20">just</w:sdt> coffee with heavy cream for
“breakfast,” and skipping lunch or just being sure <i><u>lunch was only
protein with some fat</u></i> so I could stay mildly ketotic and not be
hungry. At supper, just eating a small meal of animal protein (with saturated
fat) and a portion of low-carb vegetables tossed in butter or roasted in olive
oil, was always enough for me.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">But I
sometimes snacked. My snacking was always just before supper (happy hour).
When I was on anti-diabetes meds (sulfonylureas) that was always the time of
day when my blood sugar was lowest. My snacking may be cultural as well. I
have always enjoyed a glass of wine, or two. (I only drink spirits in a
restaurant or when we have guests for dinner.) And with wine I might have
radishes with salt and butter or celery with anchovy paste, or stuffed olives.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_heading=h.gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">My cheats are 1) once in a while I’ll steal some of
my wife’s ice cream from the freezer, or 2) in a restaurant, eat a roll with
butter or olive oil. Rarely, I’ll share a dessert. These are indulgences.
Simple pleasures, from a previous life almost forgotten. The best part of
eating <b style="mso-bidi-font-weight: normal;">Very Low Carb</b> almost all the
time, besides the stellar labs, is how well I feel. I am often “pumped,”
almost euphoric. The mood difference is palpable. It’s <i style="mso-bidi-font-style: normal;"><u>not</u></i> just knowing <i style="mso-bidi-font-style: normal;"><u>I
am no longer fat!</u></i><o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Oh, and did
I mention<w:sdtpr></w:sdtpr><w:sdt id="1274665289" sdttag="goog_rdk_24">...</w:sdt><w:sdt id="531922687" sdttag="goog_rdk_25">I have </w:sdt>saved a lot of money on
drugs and food. And my blood pressure is lower. And my HDL doubled and my
triglycerides dropped by 2/3rds. And I don’t have to take a statin. And my
chronic systemic inflammation blood marker (hsCRP) is <i style="mso-bidi-font-style: normal;"><u>way</u></i> lower. <i style="mso-bidi-font-style: normal;"><u>And</u></i>
I did it without exercise (and saved lots of time and gym costs). <o:p></o:p></span></div>
<w:sdt id="794486338" sdttag="goog_rdk_8">
</w:sdt><w:sdt id="-1054546381" sdttag="goog_rdk_12">
</w:sdt><w:sdt id="-1785255941" sdttag="goog_rdk_13">
</w:sdt><w:sdt id="831262324" sdttag="goog_rdk_16">
</w:sdt><w:sdt id="-945849367" sdttag="goog_rdk_18">
</w:sdt><w:sdt id="67467241" sdttag="goog_rdk_21">
</w:sdt><w:sdt id="1963611721" sdttag="goog_rdk_22">
</w:sdt><w:sdt id="2116937966" sdttag="goog_rdk_23">
</w:sdt><w:sdt id="1427613430" sdttag="goog_rdk_26">
<span style="font-family: "calibri" , sans-serif; font-size: 11.5pt; line-height: 115%;">And all it requires is that I eat <b>Very Low Carb</b> most of the time. That’s
<b><i><u>VERY</u></i>
Low Carb</b>. It’s all you have to do.</span></w:sdt>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com1tag:blogger.com,1999:blog-7410445500476013619.post-38670749257714300482020-06-23T07:05:00.001-04:002020-06-23T07:05:12.601-04:00Retrospective #493: Why fasting is soooo easy!<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">I know. It doesn’t ring true. It sounds, literally,
incredible. <b><i><u>But </u></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>it IS true</u></i></b>, as I’ll explain.
I wouldn’t lie to you. My credibility with my regular readers is <i style="mso-bidi-font-style: normal;">too important</i> for me to squander it.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">But first, let’s address the thinking that questions this
assertion. On hearing this, a person thinks and maybe asks, “Don’t you get <i style="mso-bidi-font-style: normal;">hungry</i>? How’s your <i style="mso-bidi-font-style: normal;">energy</i> level? Do you <i style="mso-bidi-font-style: normal;">feel</i>
okay?<w:sdtpr></w:sdtpr><w:sdt id="272525673" sdttag="goog_rdk_2">”</w:sdt> My
answers are: “No, I <i style="mso-bidi-font-style: normal;"><u>don’t</u></i> get
hungry,” and “my energy level is very <i style="mso-bidi-font-style: normal;"><u>high</u></i>.”
In fact, I feel pumped, sometimes euphoric, almost manic. “I actually feel <i style="mso-bidi-font-style: normal;"><u>better</u></i> than okay. I feel <i style="mso-bidi-font-style: normal;"><u>great</u></i>!” And no, I’m not “Tony
the Tiger.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Why then do people ask those questions? Because it’s common
sense, and we’ve all experienced it. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>If</u></i></b><i style="mso-bidi-font-style: normal;"><u> you eat less on a <b style="mso-bidi-font-weight: normal;">“balanced”
(carbohydrate-based) diet</b></u></i>, <i style="mso-bidi-font-style: normal;">you
are going t0 be hungry when you don’t eat</i>! And if you don’t “feed your
body” (by mouth), your body will slow down! And as your metabolism slows, you
will have less energy and you <i style="mso-bidi-font-style: normal;">will</i>
feel weak. You may even feel unwell. That’s all very logical and true. Yes, <i style="mso-bidi-font-style: normal;"><u>but notice the big “<b style="mso-bidi-font-weight: normal;">if</b>.”</u></i><o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">This “if” clause contains the phrase “<b style="mso-bidi-font-weight: normal;">balanced carb-based diet</b>.” Eating less with <i style="mso-bidi-font-style: normal;"><u>that</u></i> diet <i style="mso-bidi-font-style: normal;"><u>will</u></i>
produce the effects described above because <u>you <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">are</i></b> starving your body
of needed energy</u>. It is being starved because it is unable to <i style="mso-bidi-font-style: normal;"><u>access</u></i> your body’s fat stores. However,
<w:sdtpr></w:sdtpr><w:sdt id="-1995332964" sdttag="goog_rdk_10">your </w:sdt>body
is designed 1) to be fed by mouth when food is available and 2) to be <i><u>fed
from fat stores</u></i> when food is <i style="mso-bidi-font-style: normal;"><u>not</u></i>
available, for example, when fasting. There’s only one problem. <i style="mso-bidi-font-style: normal;"><u>For </u></i><w:sdt id="-280875989" sdttag="goog_rdk_12"><i style="mso-bidi-font-style: normal;"><u>your</u></i></w:sdt><w:sdt id="-1163313713" sdttag="goog_rdk_13" showingplchdr="t"><span style="mso-spacerun: yes;"> </span></w:sdt><i style="mso-bidi-font-style: normal;"><u>body to work like that naturally, <b style="mso-bidi-font-weight: normal;">a switch</b> is needed to turn on the body’s fat fuel source</u></i>.
Here’s how the switch works.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">When you eat carbohydrates, your blood <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>insulin</u></i></b> level
rises. Your body secretes insulin to carry energy (glucose) from the
digested/absorbed carbs in your blood to your cells. Insulin then opens the
“door” for the energy to be taken up. Then, when the level of <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>glucose</u></i></b>
in your blood drops, <i style="mso-bidi-font-style: normal;">your <b style="mso-bidi-font-weight: normal;"><u>insulin</u></b> level also drops</i>. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>Insulin
is thus the switch</u></i></b>. <b><i style="mso-bidi-font-style: normal;"><u>Low
</u></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>insulin</u></i></b><i style="mso-bidi-font-style: normal;"> signals
the liver to switch from burning carbs for energy to burning your body fat
stores. </i><o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">So, in a <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>normal</u></i> </b>metabolism, when your
energy from the carbs you ate and have stored is expended, and your blood
glucose level drops, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>your blood insulin level also drops</u></i></b>
and your body switches <w:sdtpr></w:sdtpr><w:sdt id="-553621847" sdttag="goog_rdk_17">to</w:sdt> burning body fat for energy. It does this <i style="mso-bidi-font-style: normal;"><u>without</u></i> your feeling hungry, <i style="mso-bidi-font-style: normal;"><u>without</u></i> slowing down your
metabolism, and <i style="mso-bidi-font-style: normal;"><u>withou</u></i><w:sdt id="-1464808731" sdttag="goog_rdk_18"><i style="mso-bidi-font-style: normal;">t</i></w:sdt>
making you feel unwell. The reason that all this is true should now be
obvious: <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>Your body IS still being fed…FED BY OWN YOUR BODY FAT</u></i></b>.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<a href="https://www.blogger.com/null" name="_heading=h.gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">You will be fed at the level your
body needs <i style="mso-bidi-font-style: normal;"><u>for your activity level</u></i>.
You could run a marathon! This energy balance – called homeostasis – will be
met by the liver breaking up triglycerides (body fat) <i style="mso-bidi-font-style: normal;"><u>as needed</u></i>. You will be in energy balance so long as you
have fat to burn <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>and you don’t eat too many carbs</u></i></b>.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Another way to lower both blood glucose and blood insulin is
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>fasting</u></i></b>.
It is especially effective for people with a <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>disregulated</u></i></b>
glucose metabolism, e.g. those with <b style="mso-bidi-font-weight: normal;">Insulin
Resistance</b> (Type 2 diabetics and Pre-diabetics). When <w:sdtpr></w:sdtpr><w:sdt id="-408162215" sdttag="goog_rdk_21">we </w:sdt>don’t eat, <w:sdt id="2107147551" sdttag="goog_rdk_23">blood</w:sdt> glucose and blood insulin
go down and good things happen: 1) we burn body fat for energy without slowing
down our metabolic rate, 2) we lose weight <i style="mso-bidi-font-style: normal;"><u>without
hunger</u></i> because our body is being fed at the cellular level by body
fat, 3) ketone bodies, a byproduct of fat (triglyceride) breakdown, feed the
brain, and 4) while fasting, out bodies <w:sdt id="1598293283" sdttag="goog_rdk_24">gather up and use </w:sdt>cellular debris (<u>autophagy</u>)
and 5) oxidize (burn up) old cells (<u>apoptosis</u>). These <w:sdt id="802126271" sdttag="goog_rdk_27">renewal</w:sdt> processes <w:sdt id="-140502964" sdttag="goog_rdk_28">provide great benefit. </w:sdt>It is
also hypothesized that burning omental (visceral) fat, including fatty liver
and pancreatic <i style="mso-bidi-font-style: normal;"><u>fat</u></i> cells, <w:sdt id="-287044978" sdttag="goog_rdk_32">beta</w:sdt> cells (erroneously<w:sdt id="-1021542177" sdttag="goog_rdk_35"> considered to be</w:sdt><w:sdt id="1304117672" sdttag="goog_rdk_36"> ”burned</w:sdt> out”) begin to function
normally again.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">I’ve been a Type 2 for diabetic 34 years. So, what happens
when I eat Very Low Carb with Intermittent Fasting? I lose weight, my glucose
metabolism stabilizes, and I’m <i style="mso-bidi-font-style: normal;"><u>never</u></i>
hungry because I’m a fat burner. I have loads of energy, I save money on food
(and medicines), and I feel “pumped.” What’s not to like about those outcomes?<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
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</w:sdt><w:sdt id="2144066329" sdttag="goog_rdk_39" w:endinsauthor="Author" w:endinsdate="2019-07-04T17:42:00Z" w:insauthor="Author" w:insdate="2019-07-04T17:42:00Z">
</w:sdt><br />
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Your doctor will love it too. A year ago, my A1c was 5.0%.
My cholesterol panel is “to die for.” No statins. “Blood pressure of a
teenager,” the nurse said.” <i><u>When you’re not hungry all the time</u></i>,
fasting really is soooo easy.</span><o:p></o:p><span style="font-size: 11.5pt; line-height: 115%;"><span class="msoIns"><ins cite="mailto:Author" datetime="2019-07-04T17:42"><w:sdtpr></w:sdtpr></ins></span></span></div>
danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-86752325691435862832020-06-22T07:44:00.003-04:002020-06-22T07:44:27.330-04:00Retrospective #492: Weight Maintenance on VLC<br />
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As I <i style="mso-bidi-font-style: normal;"><u>re-</u></i>approach (LOL) a 180-pound
weight loss and my goal weight of 195 pounds, I’m <i>again</i> giving serious
thought to how I am going to <i style="mso-bidi-font-style: normal;">maintain</i>
that weight. Truth be told, most people who lose a lot <i style="mso-bidi-font-style: normal;"><u>don’t</u></i> maintain it. So, how am I going to do it <i style="mso-bidi-font-style: normal;">this</i> time? Ironically, this is a problem
I never thought I’d have. Who among the morbidly obese ever achieves their goal
weight? Well, after 17 years, and many “misadventures,” I’m nearly there.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Over the
years I’ve read lots of bad advice on the subject of “low carb.” Then one day I
read something that made sense to me. The advice was in Volek and Phinney’s, <a href="https://www.artandscienceoflowcarb.com/"><span style="color: blue;">The Art
and Science of Low Carb Living</span></a>. A few years later, when I met
Stephen Phinney – at Banff in 2016 at the 5<sup>th</sup> Global Symposium on
Ketogenic Diet Therapies – I told him, “Yours was the <i style="mso-bidi-font-style: normal;">first</i> time I had read <b><i><u>a prescription for weight
maintenance</u></i></b> that made sense to me.” He replied, “That’s because we
told the truth.” He then added, “Our publisher told us, “If you say that in
your book, it won’t sell.” We replied, “We don’t care. It’s the truth.” That’s
another reason <i style="mso-bidi-font-style: normal;"><u>why</u></i> it is one
of my favorite books.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Excerpt from
Chapter 16, “The Importance of Dietary Fat on Long-Term Maintenance,” page 206:
“(T)he purpose of this chapter [is] to address the need for added dietary fat
while keeping carbohydrates within an acceptable level of tolerance in the
long-term maintenance phase of carbohydrate restriction.”<span style="mso-spacerun: yes;"> </span>Then, another excerpt from page 210: “There’s
no metabolic reason why increasing [protein] would be beneficial,” and “too
much protein…has a modest insulin stimulating effect that reduces ketone
production.”<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">From Chapter
18, “10 Clinical Pearls,” page 238, relating to the Induction Phase of Very Low
Carb dieting: “the weight loss occurs because you are eating much less energy
that your body is burning.” “Typically, early on up to half of your daily
energy needs are coming out of your love handles. However, one’s protein needs
(expressed as grams per day) are about the same across all phases of
carbohydrate restriction, whether it’s your first week in Induction on your
second year in weight maintenance.” Then, the <i style="mso-bidi-font-style: normal;">coup de grace</i>, this excerpt is from page 239:<o:p></o:p></span></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u><span style="font-size: 11.5pt; line-height: 115%;">“Simply put, there
is no option for weight maintenance that is simultaneously low in carbohydrates
and low in fat. Your energy has to come from somewhere, and for people with
carbohydrate intolerance, their best (and long-term) energy source is dietary
fat. Practically speaking, that means purposefully seeking out enjoyable
sources of fat and routinely including them in your diet.” “You must get
comfortable eating fat as your primary source of dietary energy if you want to
succeed in low carb maintenance.”</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%;"> Let that sink in. It’s carbs or fat. It’s pretty
clear.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Now that
day, for me, is near. I will soon be at my maintenance weight, <i style="mso-bidi-font-style: normal;">again</i>. I will then continue to eat the
same Very Low Carb way I have striven for over the years. I will still have one
cup of coffee at “breakfast” with a dollop of heavy cream and a pinch of <i>pure</i>
stevia extract. For lunch, if I eat lunch, I will still eat a small tin of kippered
herring snacks in brine, or one or two hard boiled eggs, or a can of Brisling
sardines in water or EVOO, or occasionally a Haas avocado with vinaigrette
dressing in the cavity. To drink: cold-brew iced tea with liquid stevia.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">For supper,
I will eat the same small meal of a moderate protein portion and a low-carb
vegetable tossed in butter or roasted in olive oil. On occasion, before supper,
I will snack on radishes with butter and salt, or celery with anchovy paste, or
olives. I will also have two 5-oz. glasses of red wine, usually as a spritzer
(topped off with seltzer).<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I will
continue to weigh myself every day. When I rise to the top of my target range
(195-199), I will “fast” for a day. My “fast” will consist of my morning coffee
(with cream and stevia) and just <i style="mso-bidi-font-style: normal;"><u>one</u></i>
red wine spritzer for supper.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I find that
my weight varies more due to water retention, from carb cheats, than from too
many calories. Weight lost during a one-day “fast,” due to the diuretic effect,
usually returns me to the bottom of my range.<o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">I <i><u>like</u></i> what I eat on my VLC diet, <i style="mso-bidi-font-style: normal;">and I feel <u>great</u></i>. I mean <i style="mso-bidi-font-style: normal;"><u>pumped</u>!</i> The older and leaner I
get, <i style="mso-bidi-font-style: normal;">the <u>better</u> I feel!</i> And
people tell me I look good in my new wardrobe. It’s actually fun being <i>almost</i>
“half the man I once was.”</span><o:p></o:p></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com6tag:blogger.com,1999:blog-7410445500476013619.post-48641884001384891222020-06-21T09:50:00.001-04:002020-06-21T09:50:15.173-04:00Retrospective #491: Ketogenic Intermittent Fasting<br />
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">My wife
tells me I should tell “newbies” how I started out on my VERY Low Carb journey,
<i style="mso-bidi-font-style: normal;"><u>not</u></i> how I manage to maintain a
180-pound weight loss. I tell her I did that in Type 2 Nutrition #419, <a href="http://www.thenutritiondebate.com/2018/02/type-2-nutrition-419-secret-cure-for.html"><span style="color: blue;">Reversing Type 2 Diabetes: My Secrets</span></a>,” I
describe the many ways that my Way of Eating has evolved since I began to eat <i style="mso-bidi-font-style: normal;"><u>Very</u></i> Low Carb in 2002</span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In this
post, however, I’m writing about my current paradigm, the “Ketogenic
Intermittent Fast,” as described by <b style="mso-bidi-font-weight: normal;">Dominic
D’Agostino</b>. D’Agostino, a PhD, is probably the leading researcher in ketogenic
metabolism in the USA today. He initiated the 2016 Nutritional Ketosis and
Metabolic Therapeutics Conference in Tampa, FL, that I attended. By the 3<sup>rd</sup>
year, 2019, it had morphed into The Metabolic Health Summit in Long Beach, CA,
which I also attended. It sold out, and they announced the next year’s
Metabolic Health Summit, would also be held in Long Beach in January. And it was, without me.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">D’Agostino
appears to be a healthy, very fit, <i><u>non-diabetic</u></i> scientist. He
says he follows a Ketogenic Intermittent Fasting diet 95% of the time. <b style="mso-bidi-font-weight: normal;">Jeff Volek</b>, a PhD physiologist, now at
Ohio State, is also a world-renowned expert in low carbohydrate research who
presented both in Tampa and Long Beach. Together with <b style="mso-bidi-font-weight: normal;">Stephen Phinney</b>, MD, Volek authored, “The Art and Science of Low
Carbohydrate Living,” one of my favorite nutrition books. Phinney is co-founder
of<span style="mso-spacerun: yes;"> </span><a href="https://www.virtahealth.com/"><span style="color: blue;">Virta Health</span></a>, “a clinically proven treatment plan
to reverse Type 2 diabetes without medications or surgery.”<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">At the Tampa
meeting Volek spoke to an overflow crowd in a break-out session attended mostly
by endurance athletes and bodybuilders. I did not attend. LOL. In Long Beach
Volek had a plenary session, which I <i style="mso-bidi-font-style: normal;"><u>did</u>
</i>attend. But I gleaned from some Tampa attendees that many of the ultra-lean
and ultra-muscular attendees take a therapeutic dose of Metformin, off label, <i style="mso-bidi-font-style: normal;"><u>to help get and stay lean</u></i>.
Metformin works by 1) suppressing unwanted gluconeogenesis especially in those
with any degree of Insulin Resistance, and 2) by increasing insulin
sensitivity. In this way users keep their blood <i style="mso-bidi-font-style: normal;"><u>glucose</u></i> levels low and <i style="mso-bidi-font-style: normal;"><u>thereby</u></i>
their blood <i style="mso-bidi-font-style: normal;"><u>insulin</u></i> levels
low…<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>and
thus, being in ketosis, burn body fat (instead of the “unwanted” glucose) for
energy TO GET AND STAY LEAN</u></i></b>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">This would
explain the pied piper interest in Volek and Nutritional Ketosis from athletes
and bodybuilders. It stands to reason. To burn body fat, <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>they want to be in nutritional
ketosis most of the time</u></i></b>. To do that they eat low carb,
moderate/high protein, and high fat. They keep blood glucose and blood insulin
low, eat protein and exercise to build muscle, and burn body and dietary fat
for energy. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>To get and stay lean, that is their modus operendi</u></i></b>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, for
“healthy” people who want to stay lean, that is the “ketogenic” part. What does
that have to do with fasting? <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>When you fast, your blood glucose lowers,
you blood insulin lowers, and you burn body fat for energy</u></i></b>. If you
were a Low Carber before – low enough to be in “Nutritional Ketosis” – your
body easily shifts from “fed” to “fasting,” <i><u>without hunger</u></i>, and you
use body fat for energy and without slowing down your metabolism</span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In addition,
according to D’Agostino, fasting has 1) anti-inflammatory effects and 2)
epigenetic effects, by the mechanisms of <a href="https://en.wikipedia.org/wiki/Apoptosis"><span style="color: blue;">apoptosis</span></a>
and <a href="https://en.wikipedia.org/wiki/Autophagy"><span style="color: blue;">autophagy</span></a>.
Check out the hyperlinks. These effects are why ketogenic nutrition and fasting
are such hot research topics today. Researchers are exploring the use of
ketogenic nutrition and fasting for the whole panoply of metabolic disorders.
All that, however, is OT (off topic) for today’s post. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">My focus these days is how to maintain my 180-pound weight
loss, keep my Type 2 diabetes in remission (with A1c’s in the low 5s), and stay
in tip-top physical and mental health. In other words, how I’m going to
continue to thrive. I’ve concluded that Ketogenic Intermittent Fasting is the
best way for me to do that. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As the
National Institutes of Health <b style="mso-bidi-font-weight: normal;">Richard L.
Veech </b><span style="mso-bidi-font-weight: bold;">(d. 1/30/20)</span> told Gary
Taubes, “Doctors are scared of ketosis. They’re always worried about diabetic
ketoacidosis. But ketosis is a normal physiologic state. I would argue that is
the normal state of man.” And, as Dr. D’Agostino says, “It keeps the brain
happy,” and “I feel better.” D’Agostino also says he “likes the food,” and he’s
“lost his sweet tooth.” I like it too.</span><o:p></o:p></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-37679869119801114102020-06-20T09:07:00.004-04:002020-06-25T10:12:30.485-04:00Retrospective #490: Why, just…why?<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I’ve been
struggling with this question for a long time. Why what? Well, that’s the
problem. It’s hard to figure out what the question is. And then there’s the
answer. That’s even more of a conundrum.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As readers
know, I’m not afraid to be honest, even brutally honest. I also don’t mind if
I offend someone’s sensibilities…if it’s in a good cause. And I believe
passionately that the health and well-being of our nation, even the world,
both physically and mentally, is a good cause. It’s worth broadcasting the
truth, even if at a cost.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I have put
the question in various forms: Why don’t people want to change? Why is it so
hard for people to change? Can a person change what one eats, or the way, or
when, one eats, at any age? Why don’t people <i>believe</i> that changing what
they eat will improve their health? Or if they do, whom do they believe when
it comes to what is a “healthy diet”? Why should a person give up their
favorite “comfort” foods? What if it’s all been a big fat lie?<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As I
approach column #500, I’m frustrated. I’m no closer to the answer as to why
others can’t/don’t/won’t change than I was when I started. I can only re-tell <i style="mso-bidi-font-style: normal;"><u>how<b style="mso-bidi-font-weight: normal;">
I</b> did it</u></i> and hope that is persuasive and connects with you.<i style="mso-bidi-font-style: normal;"><u><o:p></o:p></u></i><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In 2002, as
I approached the end of my work life, I weighed 375 pounds and faced a short
retirement; Why? I looked around and didn’t see many morbidly obese old
people, and those I did see didn’t look to be in good health. I had been a
diagnosed Type 2 diabetic for 16 years, was maxed out on 2 oral meds and
starting a 3<sup>rd</sup>. My prospects were that I would soon be injecting
insulin. And sooner rather than later I would die of “diabetic complications.”<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">The common <b>Microvascular</b>
ones: 1) end-stage kidney disease with dialysis (nephropathy), 2) being wheelchair
bound because of amputation(s) (neuropathy) and 3) blindness (retinopathy). But
today, the <b>Macrovascular</b> complications are being recognized as even more
common: heart disease, stroke, Alzheimer’s disease (“type 3” diabetes) and
several cancers. I was scared. I didn’t want a “short retirement.” I was
motivated to change.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">My doctor
thought the best way to treat my Type 2 diabetes and high blood pressure, was
for me to lose weight. He had urged me to do that for many years. All <i><u>his</u></i>
cajoling – and <i style="mso-bidi-font-style: normal;"><u>my</u></i> attempts –
had failed. When I lost weight, following his advice to “eat less and move
more,” on a “<b><i style="mso-bidi-font-style: normal;"><u>balanced</u></i></b><i style="mso-bidi-font-style: normal;">”</i> diet – I failed. Then, one day, when
I walked into his office (at 375 pounds, remember), he said, “Have I got a
diet for you!” His timing was perfect.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">A few months
earlier, in July 2002, my doctor had read, “<a href="https://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html"><span style="color: blue;">What If It's All Been a Big Fat Lie</span></a>,” the cover
story of <i style="mso-bidi-font-style: normal;">The New York Times</i> Sunday
magazine. The author, Gary Taubes, proposed an “Alternate Hypothesis” to the
“low-fat,” “balanced” diet that mainstream medicine had pushed for sixty years
and <i style="mso-bidi-font-style: normal;"><u>has made us</u></i><u> <i style="mso-bidi-font-style: normal;">fatter and sicker</i></u>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Taubes,
thrice an award-winning science journalist, wrapped up GC-BC with 10 “certain
conclusions [that] seem[ed] inescapable” to him. The first 3 follow; the
others are in The Nutrition Debate #5, posted <a href="http://www.thenutritiondebate.com/2011/01/nutrition-debate-5-gary-taubes-and.html"><span style="color: blue;">here</span></a>.<o:p></o:p><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal" style="border: none; line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-border-shadow: yes; mso-list: l0 level1 lfo1; mso-padding-alt: 31.0pt 31.0pt 31.0pt 31.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: black; font-size: 11.5pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-size: 11.5pt;">Dietary
fat, whether saturated or not, is not the cause of obesity, heart disease, or
any other chronic disease of civilization.</span><span style="font-size: 11.5pt;"><span style="color: black;"><o:p></o:p></span><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="border: none; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-border-shadow: yes; mso-list: l0 level1 lfo1; mso-padding-alt: 31.0pt 31.0pt 31.0pt 31.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: black; font-size: 11.5pt; line-height: 115%;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-size: 11.5pt; line-height: 115%;">The problem is the carbohydrates in the diet, their effect on
insulin secretion, and thus the hormonal regulation of homeostasis – the
entire harmonic ensemble of the human body. The more easily digestible and
refined the carbohydrates, the greater the effect on our health, weight, and
well-being.</span><span style="font-size: 11.5pt; line-height: 115%;"><span style="color: black;"><o:p></o:p></span><w:sdtpr></w:sdtpr></span></div>
<div class="MsoNormal" style="border: none; margin-left: .25in; mso-border-shadow: yes; mso-list: l0 level1 lfo1; mso-padding-alt: 31.0pt 31.0pt 31.0pt 31.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: black; font-size: 11.5pt; line-height: 115%;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-size: 11.5pt; line-height: 115%;">Sugars – sucrose and high-fructose corn syrup particularly – are especially
harmful, because the combination of fructose overburdens the liver which has
to dispose of it while glucose simultaneously elevates insulin levels. </span><span style="font-size: 11.5pt; line-height: 115%;"><span style="color: black;"><o:p></o:p></span><w:sdtpr></w:sdtpr></span></div>
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</w:sdt><a href="https://www.blogger.com/null" name="_heading=h.gjdgxs"></a><span style="font-family: "calibri" , sans-serif; font-size: 11.5pt; line-height: 115%;">My
wife says, “Your diet is too extreme. You don’t have to cut out <i>all</i> carbs. You just have to cut down.”
Okay, I say, if that works for you, DO IT. I have friends who’ve cut back on
their carbs a little and a lot, and they’ve <i><u>all</u></i>
<i><u>lost weight</u></i>. I found it easier
to eat <i><u>so few carbs</u></i> that my
body burned <i><u>my body fat</u></i> for
energy. I’ve lost 180 pounds. The trick: <i><u>Eat
few enough</u></i> to lower <i>your blood <u>insulin</u></i>
levels <i><u>to signal the body <b>to access</b> your body fat</u></i>. If you
<i><u>don’t access</u></i> your body fat for
fuel, you <i><u>will</u></i> be hungry, and
you’ll just wind up back where you started.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com2tag:blogger.com,1999:blog-7410445500476013619.post-4140631914654945312020-06-19T07:37:00.005-04:002020-06-19T07:37:56.690-04:00Retrospective #489: When I was morbidly obese…<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">It’s been a
long time since I weighed 375 pounds, or even 250. It’s also been awhile since
I weighed 188 (“not half the man I once was,” my wife quipped), so I think it’s
worth retelling <i><u>what I ate when I
started</u></i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As I’ve told
here many times, I started on Atkins Induction at my doctor’s suggestion after
he tried it himself. Atkins induction is basically <b><i>Very</i></b> Low Carb, just 20
grams of carbohydrates <i><u>a day</u></i>.
That’s a very strict regimen, but it only restricts carbohydrates. Atkins
didn’t address protein or fats at that time, as I recall, but <i><u>he didn’t have to <b>because strictly eating VERY Low Carb (VLC) is all you have to do to
start losing weight FAST</b></u></i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I lost 60
pounds in 39 weeks (1½ pounds a week), following a regular 2-meal-a-day
regimen, and then I retired. During those 9 months I ate a breakfast that I
ordered from a kiosk on the street and took to my desk: eggs (2 fried or
scrambled) and bacon (2 strips), plus coffee with half and half and 1 Splenda.
Nothing else. Nothing. Period.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I didn’t eat
lunch. I worked through lunch and wasn’t hungry because the protein-and-fat
breakfast I ate, every day, was satiating. When I got home, our usual supper
was roast chicken thighs (2 for me) and a large serving of a low-carb vegetable
tossed in butter or roasted in the toaster oven with olive oil. Today, since
I’m a little more than half the man I once was, I am satisfied with 1 chicken
breast and a smaller serving of vegetables.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Why am I
retelling the story of how I began to lose weight when I was morbidly obese?
Because <i><u>it was (is) not complicated</u></i>.
The guiding principle is <b><i><u>VERY</u></i></b><i><u> low carb</u></i>. <b><i><u>THAT’S ALL</u></i></b>. That’s the
secret. That’s all you need to know. There’s no need to count anything. Not
calories, or carbs, or grams of protein or grams of fat. There’s no need to
obsess about <i><u>anything</u></i>. You
just need to be honest with yourself. <i><u>Don’t
rationalize, <b>AND DON’T CHEAT</b></u></i>. If you just follow this simple
principle, <b><i><u>you will lose a lot of weight</u></i></b>…and be much healthier for
it.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Of course,
my own story did get complicated, but that’s because of my personality. I’m
obsessive-compulsive about many thing, like recording things. I like numbers
and tables and writing and learning, and they all helped me on my journey. <i><u>But they aren’t necessary</u></i>. Don’t
let them be obstacles to <i><u>your</u></i> taking the plunge. All you have to
remember is: Just eat <b><i><u>VERY</u></i></b><i><u> LOW CARB</u></i>. Always. No rationalizing and no cheating. And if
you screw up (as we all do), don’t beat yourself up too much (a little is
okay). If you fall off, just get back on the horse and go forward</span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Getting
started with breakfast worked well for me. My job required that I put in a full
day, so taking time off for lunch didn’t work. But if you’re not hungry in the
morning (I never am now), you could just have coffee or tea with cream and a
sweetener (not sugar). I always have. I now use pure powered stevia with my coffee
or liquid stevia with iced tea. And then have a lunch of protein and fat. <i><u>Not a salad</u></i>. Salad greens are <i><u>carbs</u></i>. Eat an avocado, or olives,
or cheese for lunch, or roast beef, turkey or ham slices. When I ate lunch
after I retired, it was usually a can of Brisling sardines.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Supper got
smaller when I got smaller. Conversely, when I was still morbidly obese (and
started counting calories and protein and fat as well as carbs), I was always
surprised at how many calories I ate and still lost weight. The reason was that
I was used to eating large, “BALANCED” meals, but now they were <b><i><u>VERY</u></i></b><i><u> LOW CARB</u></i>, moderate protein and
high fat. <i><u>But they didn’t even <b>have</b> to be high fat because if I didn’t
<b>EAT</b> the fat, my body would break
down <b>body fat</b> to use as fuel to
maintain energy balance, <b>so long as I ate VERY low carb</b></u></i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Be conscious
of your eating patterns. Do something else if you get the “willies” and have a
craving. Nervous and mindless eating are things that you will have to control.
When that happens, just remember: stick to the program: Eat just two meals a
day, no snacks, and you <i><u>will</u></i>
lose lots of weight, <b><i><u>so long as you
eat VERY low carb</u></i></b>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<u><span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">Bottom line</span></u><span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">: It’s not complicated: <i><u>SO LONG
AS YOU EAT <b>VERY</b> LOW CARB</u></i>,
you will have access to your body fat for fuel. And if you aren’t feeling
hungry, <b><i><u>don’t eat</u></i></b>. Generally, don’t eat more than two
meals a day and don’t snack. You won’t be hungry because your body will be in
energy balance, <i><u>so long as you eat <b>VERY</b> low carb</u></i>.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-40834570578553020092020-06-18T10:06:00.001-04:002020-06-18T10:07:00.806-04:00Retrospective #488: NPR on Coconut Oil<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">A while back
I caught the last few sentences of <a href="https://www.npr.org/templates/transcript/transcript.php?storyId=676198472"><span style="color: blue;">this</span></a> “Eating and Health” piece on NPR’s Morning
Edition. In it, somebody (it was Alice Lichtenstein – more on her in a minute)
said, “Why things like coconut oil somehow slipped under the radar is a little
bit unclear. But it’s not consistent with any of the recommendations that have
occurred [passive voice] over the past 30, 40, 50 years.” I made a note to
listen to the full segment later. <o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">My first
naïve thought was that the “30, 40, 50 years” remark was a hedge. My hope was
that the speaker was saying that the quality of evidence <i><u>against</u></i> saturated fat was poor, as more and better research
has recently revealed. That the speaker was trying to scapegoat the long-held
Federal Government’s recommendation to <i>avoid</i>
saturated fat, including plant-based coconut oil, as unhealthy. Alas, my hopes
were dashed.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">It turns out
that the clip I heard was not scripted by an NPR segment producer; it was
actually made by Alice Lichtenstein, D.Sc., chief architect of the 2015 Dietary
Guidelines for Americans. And she was now “doubling down” and using
confirmation bias to assert the strength and “truth” of the Dietary Guideline’s
perennial dictum</span><br />
<span style="font-size: 11.5pt; line-height: 115%;">. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Since 1980
the Guidelines have recommended that we strive to avoid eating naturally
occurring <i>saturated</i> fat, <i>i.e.,</i> <i>animal</i> fat, in favor of “vegetable” (seed and grain) oils, all
man-made, unnatural and highly processed polyunsaturated fats. The reason
coconut oil “somehow slipped under the radar” is that it, like palm kernel oil,
are unusual in that they are <i><u>plant-based</u></i>
<i>saturated fats</i>. The Guidelines, if
you hadn’t noticed, are generally biased towards “plant-based.” And that is why
Lichtenstein would say, disingenuously, that “it is a little bit unclear.”<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">NPR’s April Fulton
begins the piece, “Is coconut oil a healthy food? It certainly is promoted as
one. Survey a broad group of Americans and 72 percent say, yes, coconut oil is
healthy.” Fulton adds, “<i><u>Fat is not the
enemy. Fat helps us feel fuller longer and stay satiated. Eating some fat can
actually help us snack less and potentially lose weight</u></i>.” <i>And <b><u>I</u></b>
would add</i>, although neither Alice Lichtenstein nor Alice Fulton mentioned
it, the Dietary Guidelines <i><u>dropped the
recommended limit on dietary fat, of 30% of total calories, in the 2015 Dietary
Guidelines!</u></i><o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><i><u><br /></u></i></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">However, six
months earlier, in <a href="https://www.usatoday.com/story/news/nation-now/2018/08/22/harvard-professor-coconut-oil-pure-poison/1060269002/"><span style="color: blue;">this </span></a><a href="https://www.usatoday.com/story/news/nation-now/2018/08/22/harvard-professor-coconut-oil-pure-poison/1060269002/"><i><span style="color: blue;">USA Today</span></i></a><a href="https://www.usatoday.com/story/news/nation-now/2018/08/22/harvard-professor-coconut-oil-pure-poison/1060269002/"><span style="color: blue;"> story</span></a>, Dr. Karin Michaels, PhD, professor at
Harvard’s T. H. Chan School of Public Health, said Coconut oil was “pure
poison.” “I can only warn you urgently,” she said, “this is one of the worst
foods you can eat.” Such advice from a Harvard epidemiologist only does Harvard and all dietary epidemiologists harm.
The First Law of Holes is, “When you find yourself in a hole, stop digging.”
But continue to dig <i><u>they</u></i> do.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Lichtenstein
was more fully identified in the<i> USA
Today</i> “pure poison” story as “Tufts professor of nutrition science and
policy” <i>and</i> “vice chair of the 2015
federal government’s dietary guidelines advisory committee.” She recently told <i>The New York Times</i> ‘there’s virtually no
data to support the [coconut oil] hype.’” None? Really?<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">Andreas Eenfeldt, MD, at theDietDoctor.com, <a href="https://www.dietdoctor.com/harvard-professor-coconut-oil-is-pure-poison"><span style="color: blue;">responded</span></a>, “<a href="https://www.dietdoctor.com/low-carb/science#heartdisease"><span style="background: white; color: #1f497d;">Study after study</span></a><span style="background: white; color: #1f497d;"> </span><span style="background: white;">has shown that
saturated fat isn’t bad for you. Unfortunately, outdated advice based on old
and disproven theories is still being believed, even by some professors at
Harvard. I recommend checking out the </span><a href="https://www.dietdoctor.com/low-carb/science#heartdisease"><span style="color: #1f497d;">updated science</span></a><span style="color: #6188ce;"> </span>on the topic…or just watch <a href="https://www.dietdoctor.com/harvard-professor-coconut-oil-is-pure-poison"><span style="color: blue;">this short video</span></a><span style="color: blue;">, </span>where some very clever medical doctors answer the question,
is saturated fat bad?”<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">NPR’s Fulton
concludes, So, it’s okay to use coconut oil; just don’t use it all the time.
What you want to do is shift the ratio more towards unsaturated fat and away
from saturated fat. And that means more olive, flax and canola oil and less
coconut oil and bacon. It’s all about the balance.” <b><i>NPR IS</i></b><b><i> SO,
SO WRONG! IT’S THE EXACT OPPOSITE!!!</i></b> <o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><b><i><br /></i></b></span></div>
<span style="font-family: "calibri" , sans-serif; font-size: 11.5pt; line-height: 115%;">The NPR piece then gets even worse. It advocates
“unsaturated fats like corn oil, sunflower oil or olive oil” and “olive, flax
and canola oil.” Curiously, there was no mention of <b><i>SOYBEAN OIL</i></b>. <b><i>Soybean</i></b>
<b><i>accounts
for a <u>whopping 87% of U. S. edible oil production</u></i></b>. [<a href="https://www.foodnavigator.com/Article/2004/06/29/Soybean-to-dominate-US-vegetable-oil-production"><span style="color: blue;">2008</span></a>]. Why do you suppose NPR didn’t even <i>mention</i> soybean oil? Aren’t Archer
Daniels Midland and Cargill both NPR underwriters? It appears that there’s more
work here for a good, <i>objective</i>
investigative reporter.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-15180853675601704172020-06-17T08:02:00.001-04:002020-06-17T08:02:03.236-04:00Retrospective #487: Fat Cat, Skinny Cat<br />
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">We have two house cats; one is fat and one is skinny. They
were both born to feral moms about 5 years ago, one behind a pizza parlor and
the other in a backyard. A non-profit trapped the moms as part of their TNR
(Trap/Neuter/Return) program. The moms were spayed, treated and released. The
offspring were also trapped or rounded up. We fostered the last one from each
litter and eventually adopted both.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The backyard cat is a big, lanky, lean male. His pizza-parlor
“sister” is smaller boned and <i style="mso-bidi-font-style: normal;">very </i><span style="mso-bidi-font-style: italic;">fat</span>. They both eat the same food:
supermarket “Fancy Feast” in 3oz (70kcal) cans, twice a day, plus Purina “Complete
Cat Chow”, <i style="mso-bidi-font-style: normal;">ad libitum</i>.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Both house cats seem to like both foods equally. They clean
their dishes and put a big dent in the chow bowl daily. They also snack at an
outdoor station where we feed our own small feral colony. That’s how we
originally got involved with the local TNR non-profit. A litter of 4 adolescent
ferals walked into <i style="mso-bidi-font-style: normal;">our</i> backyard about
15 years ago. They were adolescents – way too old to socialize – so we fed and
eventually trapped and TNR’d them all.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The food we give the ferals is the same Cat Chow (32% pro;
13% fat; 42% carbs), plus 2-13.5oz cans of Purina’s “Friskies.” The analysis of
these 366kcal cans is again 11% protein, but 2.5% fat, and 27% carbs (dry
matter basis). The ferals (and our house cats) also like these offerings
equally, scarfing both down twice a day. Both the house cats and the ferals
“know” each other and frequently eat side by side at the outdoor feeding station.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">(As an aside, one of the ferals occasionally comes into the
house, through a door left open in warm weather, and crosses to the kitchen to
eat at the house cats’ station. But never, in the 15 years that we have
faithfully fed them all, have <i style="mso-bidi-font-style: normal;"><u>any</u></i>
of the ferals <i style="mso-bidi-font-style: normal;"><u>ever</u></i> allowed <i style="mso-bidi-font-style: normal;">either</i> of us to touch <i style="mso-bidi-font-style: normal;"><u>any</u></i> of them, <i style="mso-bidi-font-style: normal;"><u>or</u></i><u> <i style="mso-bidi-font-style: normal;">even get close</i></u>.)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">All the ferals are lean. So why, given the way they are fed,
is one of our house cats, and all the ferals, lean and the other house cat fat?
They both have access to all 3 types of food. Both have good appetites, and
both have equal opportunities for exercise. Both run around the house and yard,
frequently chasing each other or birds or butterflies. The big, lean male, is
less active – more of a couch potato, but the fat female is completely
undeterred by her girth.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">If this were simply a comparison between two carnivores – our
house cats – eating a high carbohydrate diet, one could hypothesize that the
“pizza baby’s” genetic makeup was epigenetically “expressed” when she was
exposed to the high-carb Fancy Feast and Friskies diet. Or, <i style="mso-bidi-font-style: normal;"><u>that the “pizza baby’s” <b>mother,</b></u></i><u>
<i style="mso-bidi-font-style: normal;">or <b>her</b> mother, developed those
“expressed” genes (remember: she survived by living behind the pizza parlor)
and</i> <i style="mso-bidi-font-style: normal;">passed them on to her offspring.</i>
<i style="mso-bidi-font-style: normal;">Her offspring (our “fat” cat and her
siblings) were thus born predisposed and are therefore likely to get fat on a
high-carb diet</i></u>. And our lean house cat – the “backyard baby” – was
perhaps the product of a feral mom who hunted mice and voles (as our feral
colony did before we starting feeding them twice daily) and had a different set
of genes or similar genes that had <i style="mso-bidi-font-style: normal;"><u>not</u></i>
been epigenetically<i style="mso-bidi-font-style: normal;"> expressed by what she
and they ate. </i>She therefore produced a large, well-shaped, lean male
kitten. For further reading, see Dr. Cate Shanahan’s book, “Deep Nutrition.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Restating the question: Why didn’t the young ferals who
wandered into our backyard 15 years ago get fat on our nutritionally poor diet?
Is it because they were offspring of a carnivorous mom who ate animal protein
and fat and had <i style="mso-bidi-font-style: normal;">not</i> had <i style="mso-bidi-font-style: normal;"><u>her</u></i> genes “expressed”? Is that
why her offspring aren’t fat cats like our “pizza baby”? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">We’ll never know. Our house cant and
our ferals will never reproduce. But how about <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>you</u></i></b> and your
offspring? We’re said to be <i style="mso-bidi-font-style: normal;"><u>omni</u></i>vores,
but I would say that humans, while not obligate carnivores, are perhaps
facultative carnivores, a species that “<span style="background: white; color: #202124; mso-highlight: white;">does best on a carnivorous diet, but can
survive-but-not-thrive on a non-carnivorous one.” <o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="background: white; color: #202124; font-size: 11.5pt; line-height: 115%; mso-highlight: white;">This has
been amply demonstrated, I think, by the effects that the <i style="mso-bidi-font-style: normal;">high carbohydrate diet</i> that we’ve been eating since the dawn of the
Neolithic Age, made much worse recently by the highly processed industrial
foods and processed oils that we now eat.</span><span style="font-size: 11.5pt; line-height: 115%;"><o:p></o:p></span></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-368209742414753422020-06-16T10:00:00.004-04:002020-06-16T10:00:49.276-04:00Retrospective #486: Too depressing not to write about.<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I have been
haunted for the last few days by the memory of a luncheon my wife and I
recently attended at the home of friends. There were six of us, and we were
told not to bring any food; the hostess would prepare everything. I knew her
husband had been a long-term, non-obese type 2 diabetic, but I wasn’t
comfortable leaving the menu entirely up to her, so I decided at the last
minute to make a new keto recipe I had seen the day before.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">My sausage
and cheese meatball <a href="https://1drv.ms/w/s!AlGwll_DU2fOglJNAVLozNXypFPN"><span style="color: blue;">appetizer</span></a> is made with ground-up pork rinds
instead of the usual bread filler. I used <i>hot</i>
Italian (ground pork) sausage, grated Pecorino Romano cheese, and Epic BBQ pork
rinds. I made and tasted them the night before and thought they were a bit dry,
so I made a garlic aioli to serve with them. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">The hostess
reheated and graciously served my meatballs <i><u>before</u></i> lunch (with
other zero-carb offerings), and it’s a good thing I ate more than my share.
Lunch was what appeared to be instant rice and a chicken casserole covered in
breadcrumbs. The side was fruit jello. Rolls and butter completed the
offerings. Dessert was a (very good) store-bought cheesecake (brought by the
other couple)! I had a little of the chicken casserole and…dessert.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In table
conversation the other male guest asked to know the time. It seems his doctor
had called him the day before and said she wanted to see him as soon as
possible. He had a 2:30 pm appointment. He said he didn’t know what the rush
was all about. I asked him if he was diabetic. He nodded yes. “That makes 3 of
us,” I said.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">This nice
man is in his early eighties and looks 9 months pregnant. He carries his “baby”
high. He’s a poster boy for <a href="http://www.thenutritiondebate.com/2019/05/type-2-nutrition-473-its-visceral-fat.html"><span style="color: blue;">visceral adiposity</span></a>. Both of these guys carry
their fat <i>inside</i>. The difference is
our host husband looks only 6 months pregnant, not 9 months…and he doesn’t have
a “command” appointment to see his doctor that day!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Here’s the
depressing part. <i><u>The poster boy’s wife
is a retired Registered Nurse</u></i>. And our hostess spent her work-life as
an administrator in a retirement “village.” These women, and their diabetic hubbies,
<i>should know better</i> than to eat the
very foods that essentially <i><u>caused
their type 2 diabetes</u></i> and which now make their diabetes <i><u>worse</u></i>: <b>carbohydrates</b>!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">But these
conscientious couples are apparently <i><u>unconscious</u></i> of <b><i><u>the dietary
cause of type 2 diabetes</u></i></b> and the <i><u>dietary strategy to prevent progression</u></i>. If you pay
attention to what you eat, type 2 diabetes <i><u>does
not have to be </u>“<u>progressive</u></i>.” Instead, they (as most patients)
pay attention to what <i><u>their doctors</u></i>
tell them. <b><i><u>THAT’S A BIG MISTAKE</u></i></b>.<o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">Doctors treat the <i><u>symptoms</u></i>
of disease, including type 2 diabetes. When they diagnose a symptom, they
prescribe a medicine to treat it. Anti-diabetic meds help control high blood
sugar by lowering it. Some medicines force the pancreas to make <i><u>more</u></i>
insulin to deal with Insulin Resistance. Then, when the pancreas eventually
fails from overuse, they prescribe injected insulin, <i><u>making the Insulin
Resistance worse</u></i>. These therapies only treat a <b><i><u>SYMPTOM</u></i></b> of type 2 diabetes. <i><u>That is the current Standard of Medical Care</u></i>. The doctor is
just doing what he has been <i><u>taught and
paid to do</u></i>. The doctor would probably be censured by her medical
association and Medicare if she did not treat the <i>symptoms</i> of Type 2 diabetes as she does. Note: She is not paid to
treat, <b><i>or understand</i></b>, <i>the <b><u>cause</u></b></i>
of Type 2 diabetes.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Most people rely
on their doctor’s guidance. Both the
former nurse and her husband told us at lunch how wonderful his doctor is and
how well she treats him. But she is only treating the <i>symptom</i> of this disease, and
type 2 diabetes is just one of <i>a galaxy
of diseases with the same symptoms</i>: visceral adiposity, high blood
pressure, dyslipidemia (characterized by high triglycerides and low HDL-C),
type 2 diabetes, and a host of others.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In addition,
people who have these disorders – symptoms, really, of Metabolic Syndrome – have
double the susceptibility to heart disease (CVD <i>and</i> CAD), stroke, fatty liver disease, many types of cancer, and
even macular degeneration. These are all the “diseases of modern civilization,”
of simple sugars and other processed carbs, and manufactured vegetable oils—in
the words of Weston A. Price<u>,</u> all the “displacing foods of modern
commerce.”<o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">It’s so depressing. That is why I <i>had</i> to write about our recent luncheon
experience. I had to get it off my chest.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-18544588953147136322020-06-15T07:50:00.003-04:002020-06-15T15:16:57.388-04:00Retrospective #485: Grocery store bread is processed food.<br />
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">“Grocery
store bread is processed food” was scribbled on a “Post It” next to my laptop,
so since I fancy myself as a lay type 2 nutrition educator, it must have been
my intention to write about it. So here goes.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Most people
grow up eating a lot of bread at home. I did not. I was lucky. My father grew
up during the Great Depression. Later he had a good job and regarded our family
as too bourgeois to use bread fillers like “Hamburger Helper.”<span style="mso-spacerun: yes;"> </span>My mother didn’t put bread on the supper table
either. Like most kids, though, we ate sandwiches. They were a lunch-box
staple, together with fruit and cookies, to carry to school every day. <o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Store-bought
bread, at least the kind sold in a plastic wrapper, has to have a long shelf
life. <a href="https://www.google.com/search?q=silvercup+bread&safe=off&tbm=isch&source=iu&ictx=1&fir=mXqPsRDvaI1vqM%253A%252C_eqJ7edreyHpTM%252C_&usg=AI4_-kQLJ9rDNo6jcNJ5NZd-ScEIcZxlFQ&sa=X&ved=2ahUKEwi547au5fTeAhXP1lkKHckQDY8Q9QEwAnoECAQQBg%23imgrc=mXqPsRDvaI1vqM:"><span style="color: blue;">Silvercup</span></a> is the brand I remember. It was white
and spongy. I didn’t learn until recently that what made it spongy was sugar.
Here’s a challenge: Look at the label on any loaf of bread sold with a wrapper
in the supermarket. I defy you to find even one brand or variety where sugar,
HFCS, or some other form of sugar, is <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>not</u>, </i></b>after flour and water,
the third ingredient.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Did you know
that white bread scores 100 on the glycemic index! The glycemic index is a
scale from 1 to 100 which measures the rate at which a food will raise blood
sugar. No other food will make a Type 2, or Pre-diabetic or Insulin Resistant
person’s blood sugar rise faster and farther than white bread. Two slices of <a href="https://ndb.nal.usda.gov/ndb/foods/show/45208747?fgcd=&manu=&format=&count=&max=25&offset=&sort=default&order=asc&qlookup=WHITE+BREAD%2C+UPC%3A+077890313220&ds=&qt=&qp=&qa=&qn=&q=&ing="><span style="color: blue;">Walmart's white bread</span></a> contain 23g of carbohydrate
(including the added sugar) and 5g protein from gluten in the flour. Yeah,
gluten is a protein!<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Why is bread
the very <i><u>definition</u></i> of a high-glycemic food? Because <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">it is
a <u>PROCESSED</u> food, </i></b>made from <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>highly REFINED</u> white flour</i></b>
(and 3g of <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>ADDED</u> sugar</i></b>). Flour starts to break down into glucose
when <a href="http://www.thenutritiondebate.com/2012/05/nutrition-debate-53-on-digestion-and.html"><span style="color: blue;">enzymes in saliva</span></a> contact it! And sugar is a
simple carb that only needs to divide once (again, from the saliva in your
mouth!) to become glucose.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">Why is a processed food like white bread so much worse for
you and your blood sugar control than say an apple? To be clear, I’m <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>not</u></i></b>
advocating that you eat, as we learned as kids, “an apple a day.” I just want
to explain the difference. The carbs in white <b><i><u>flour</u></i></b> are
100% <b style="mso-bidi-font-weight: normal;"><i><u>glucose</u></i></b>
molecules. <b style="mso-bidi-font-weight: normal;"><i><u>Glucose</u></i></b>
makes your blood sugar rise.</span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">The
principal nutrients of an apple are simple sugars: <b style="mso-bidi-font-weight: normal;">SUCROSE</b>, a <b><i><u>di</u></i></b>saccharide of glucose and
fructose. Glucose and fructose are <b><i><u>mono</u></i></b>saccharides. The <b style="mso-bidi-font-weight: normal;">glucose</b> molecule goes into your blood
to be circulated and taken up for energy. The <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">fructose</i></b> molecule does <b><i><u>not</u></i></b>.
It goes, via the portal vein, directly to your liver, <i style="mso-bidi-font-style: normal;">for <b><u>detoxification</u></b></i>. If you need more glucose for
energy, your liver converts the fructose to glucose. If you don’t need more, your
liver stores it as glycogen. But if the liver is already full of glycogen, it
uses a process called “de novo lipogenesis” to <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">convert the excess fructose to
fat</i></b>. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>That’s right! The liver makes fat from the excess sugars, glucose
and fructose</u></i></b>.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">An apple also
has <a href="http://www.thenutritiondebate.com/2013/04/the-nutrition-debate-97-fructose-in.html"><span style="color: blue;">high fructose content</span></a>. After water (86%) and
fiber (3%) the remaining 11% of an apple by weight are simple sugars: 20% the <i><u>di</u></i>saccharide
sucrose (half glucose/half fructose), 23% “free” glucose and 57% “free”
fructose. The “free” molecules are <i><u>mono</u></i>saccharides. So, when the
sucrose breaks down to monosaccharides, an apple is 33% glucose and 67%
fructose. Only the 33% glucose in an apple raises your blood sugar immediately
versus 100% in a slice of white bread. You already know what the fructose does
to your liver. Ugh!<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Many years
ago, I met a nurse in a swimming pool (in Mexico) who told me her husband had a
fatty liver. This was at least a decade <i style="mso-bidi-font-style: normal;">before</i>
Non-Alcoholic Fatty Liver Disease (NAFLD) was among the conditions associated
with <a href="http://www.thenutritiondebate.com/2011/02/nutrition-debate-9-metabolic-syndrome.html"><span style="color: blue;">Metabolic Syndrome</span></a>. We now know that you don’t
have to be obese to have NAFLD. It’s the <a href="http://www.thenutritiondebate.com/2019/05/type-2-nutrition-473-its-visceral-fat.html"><span style="color: blue;">visceral fat</span></a> within and around your internal
organs, your liver specifically, that causes NAFLD. I wish I’d known that in
the swimming pool in Mexico. The nurse became and is still a Facebook friend.
Maybe she’ll read this, if she doesn’t know it already.<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Today, white
bread is the standard bearer for the “bad boy” foods we’ve eaten ever since we
carried a sandwich to school eons ago. And government still tells us to eat it.
Look at <a href="https://www.google.com/imgres?imgurl=https://www.choosemyplate.gov/sites/default/files/printablematerials/myplate_green_fruits.jpg&imgrefurl=https://www.choosemyplate.gov/myplate-graphic-resources&h=1000&w=1100&tbnid=trUzzqadeYVbYM:&q=choosemyplate.gov&tbnh=182&tbnw=200&usg=AFrqEzfMVpNuaN7AgwlTatmZLdIW-AvNXg&vet=12ahUKEwjakYSZ77rdAhVPpFkKHbeBBL4Q_B0wD3oECAUQCQ..i&docid=97ZfiqtX3qDcyM&itg=1&sa=X&ved=2ahUKEwjakYSZ77rdAhVPpFkKHbeBBL4Q_B0wD3oECAUQCQ"><span style="color: blue;">Choose My Plate</span></a> from the HHS/USDA and <a href="http://hmassoc.org/wp-content/uploads/Create-Your-Plate-2.pdf"><span style="color: blue;">Create Your Plate</span></a> from the American Diabetes
Association, respectively. <o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">But don’t
expect government to change. Agribusiness and Big Pharma have too much at stake
to let that happen.</span><o:p></o:p></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-61695561698254300812020-06-14T08:27:00.001-04:002020-06-14T08:27:16.611-04:00Retrospective #484: “He needs insulin to control his high blood sugar.”<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">“He needs
insulin to control his high blood sugar,” the wife in the TV commercial says.
That’s true. We <i><u>all</u></i> need
insulin to regulate our blood sugar, so why was I so upset to hear her say
that? Because of the wife’s <i><u>misleading</u></i> message. She was pitching
for a drug company that was selling <b><i><u>man-made</u></i></b> insulin that her
“husband” had to <b><i><u>inject</u></i></b>, after checking his blood sugar with a finger
prick (or a continuous glucose monitor).<o:p></o:p></span></div>
<div class="MsoNormal">
<i><u><span style="font-size: 11.5pt; line-height: 115%;">Everyone</span></u></i><span style="font-size: 11.5pt; line-height: 115%;"> needs insulin to control high blood
sugar. And <u>e<i>veryone’s</i></u> blood
sugar rises after eating, even the healthiest peoples’ blood sugar (glucose).
Carbohydrates, when digested, become glucose.
So do some proteins, to a certain extent, in a bit more time. And the
pancreas secretes insulin, which circulates in the blood with glucose, to
enable the uptake of glucose as energy. In healthy people, the insulin works.
The cells open. The circulating blood “sugar” lowers. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Without
insulin, either made by the body or injected, a person will die. Until
artificial insulin was discovered in 1921, Type 1 diabetics, who had suddenly
lost the ability to make their own insulin, did die. Until then, patients
(mostly children) were kept alive longer by eating a diet that was very low in
carbs and about 90% fat. <i><u>Fat is also a
very good, alternate energy source to carbs that doesn’t require insulin for
transport and uptake</u></i>. But with the invention of artificial insulin, the
high-fat diet treatment for Type1 diabetics stopped, because it was no longer
needed. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, what’s
my beef with a company just trying to sell its product? Answer: The patient in
the ad was <b><i><u>NOT</u></i><u> a Type 1 diabetic</u></b> <i>who <u>needed insulin to live because his body had stopped making it</u></i>.
He was a <b><i><u>Type 2 diabetic</u></i></b> <b><i>whose body had become <u>resistant</u> to
taking up glucose <u>because it had TOO MUCH circulating insulin!</u></i></b>
Type 2 is a <i><u>totally</u></i> different disease from Type 1. Unfortunately,
government, medicine and Big Pharma don’t see it that way.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">They want to
treat Type 1 and Type 2 diabetes as essentially the same. They want to <i><u>treat
the symptom</u></i>, a high blood sugar, as if it were <b><i>caused</i></b> by the same thing.
But Type 1 diabetes is <b><i><u>an autoimmune disease</u></i></b> where
the pancreas suddenly stops making insulin, and Type 2 diabetes is <b><i><u>a
dietary disease</u></i></b> where the cells have, over time, become resistant
to taking up glucose because they have long been exposed to <b><i><u>too
much</u> insulin</i></b>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Here’s the
irony. <i><u>Every time a <b>Type 2</b> injects insulin, it makes their <b>Insulin Resistance</b> worse! How stupid is
that?<o:p></o:p></u></i></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">It’s
frustrating. I don’t have an expensive drug to sell – a drug that misleads you
into thinking you’re treating <i><u>the cause</u></i> of Type 2 diabetes.
Instead, this treatment is just <b><i><u>masking</u></i></b> the symptom by
lowering your high blood sugar. <i><u>Insulin
Resistance</u></i> is <i><u>the cause</u></i> of Type 2 diabetes. Injecting
insulin is just making the Type 2 <i><u>dependent</u></i>
on injected insulin. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, in this
TV commercial the wife should be saying, “He needs to control his high blood
sugar by changing what he eats.” But I can’t afford that TV commercial. I’m not
selling insulin. If I had a 30 second TV spot, I would say, “If he eats <b><i>fewer</i></b>
simple sugars and other processed carbohydrates, his pancreas will need to
produce <b><i><u>less</u></i></b> insulin, thus reducing his insulin resistance and preserving
his pancreas. By having a <b><i><u>lower</u></i></b> <i>blood</i> insulin, his cells will become <b><i><u>more insulin</u></i></b><u> <b><i>sensitive</i></b></u>.”
That means they will be <b><i><u>less Insulin Resistant</u></i></b> and <b><i><u>take
up more glucose; i.e., function more normally.</u></i></b><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">With a
60-second spot, I’d add one of my favorite pitches used by some diabetes drugs:
“<b><i><u>It
might even help you lose weight</u></i></b>.” Many Type 2 diabetes drugs use that
as a “hook.” But that can’t be said with <b><i><u>injected insulin</u></i></b>. <b><i><u>High
levels of insulin in your blood</u></i></b> – <i>whether injected,<b> </b>or
secreted</i> – <b><i><u>CAUSE YOU TO GAIN WEIGHT</u></i></b>. <o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><b><span style="font-size: 11.5pt; line-height: 115%;">Insulin is the <i>weight <u>storage</u></i> hormone.</span></b><span style="font-size: 11.5pt; line-height: 115%;"> <b><i>Long-acting (24-hour) insulin, by design, <u>keeps
your blood insulin high ALL THE TIME</u>. In Insulin <u>Resistant</u> Type 2s,
high blood glucose remains high <u>because</u> of Insulin Resistance. In
Insulin <u>Dependent</u> Type 2s, blood insulin is high all the time, so you
can’t burn body fat for fuel and YOU MUST <u>EAT</u> WHEN YOU ARE HUNGRY <u>instead
of letting your body access its fat stores for energy</u>. Think about it!
Eating “lower carb” 1) improves your Insulin Sensitivity naturally, 2) lowers
your blood sugar naturally, 3) lowers blood insulin naturally, and thus enables
weight loss by letting the body access to its fat stores, naturally. <o:p></o:p></i></b></span></div>
<b><i><span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">Given that, why would any Type 2 diabetic inject
insulin to control their blood sugar? </span></i></b>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com3tag:blogger.com,1999:blog-7410445500476013619.post-42569146314365137852020-06-13T08:31:00.001-04:002020-06-13T08:31:24.134-04:00Retrospective #483: “…when used with diet and exercise.”<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Have you
ever noticed how <i><u>all</u></i> the type 2 diabetes medications advertised
on TV conclude with “…when used with diet and exercise”? That common refrain
riles me a bit, but I’ve never asked myself why. I think it’s time I do.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">First off,
by self-examination I admit to being something of a curmudgeon. However, I tend
to grouse only about the abysmal state of our collective health, including how
we (including I) got into this mess. In other respects, I think I have a positive
outlook on life, but you’d have to ask the people who know me best if that’s
true. Regardless, my <b><i>readers</i></b> could fairly describe me as
a crusty, grumpy old man. This column, however, is not about me. <i><u>This
column is about why the diabetes ads conclude with the caveat, “…when used with
diet and exercise.”</u></i><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">It’s
obviously a government (FDA) requirement. The Food and Drug Administration
(FDA) has to approve all claims made by drug manufacturers. The FDA also
dictates for what and when a drug may be prescribed. That includes as a <i><u>first
course</u></i> of treatment, as well as any <i><u>adjunctive therapy</u></i> if
the first medication fails to achieve the <i><u>primary target</u></i>. In the
case of a drug to treat type 2 diabetes, that “primary target” would be <i><u>lowering
the patient’s serum blood glucose</u></i>, a <b><i><u>SYMPTOM</u></i></b> of
type 2 diabetes, as measured today by a blood marker, hemoglobin A1c (hgA1c),
or simply, A1c.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Metformin is
the first drug prescribed today to “treat” type 2, and sometimes pre-diabetes.
But type 2 diabetes is <b><i><u>CAUSED</u></i></b> by Insulin Resistance (IR), <a href="http://www.thenutritiondebate.com/2018/08/type-2-nutrition-444-symptoms-are-too.html"><span style="color: blue;">as measured (too late)</span></a> by an Impaired Fasting Glucose (IFG).
Metformin is generic, cheap and widely accepted as the standard-of-care, almost
universally prescribed first <b><i><u>after diet and exercise have failed</u></i></b>.
After Metformin, which is now generic, the clinician has a wide choice of
drugs, depending on other risk factors and co-morbidities. That’s when the
phrase, “…when used with diet and exercise,” usually appears. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">And that’s
what gets me riled. Every doc is supposed to tell their overweight and Pre-diabetic
patients to “lose weight and exercise” <b><i><u>before ANY meds</u></i></b><i> are prescribed</i>. “Eat less and move more,” “eat a plant-based”
or “Mediterranean” diet and get <b><i><u>lots of exercise</u></i></b> (<i>to lose weight!</i>). And everyone <b><i><u>FAILS</u></i></b>.
By following the FDA’s and their doctor’s advice, hey fail to permanently lose
weight or stop or reverse the slow but inexorable slide to drug dependence,
eventually “<a href="http://www.thenutritiondebate.com/2013/11/the-nutrition-debate-160-letterman-to.html"><span style="color: blue;">graduating</span></a>” to type 2 diabetes. So why do the
diabetes ads still advise people to continue this failed strategy?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Answer: The FDA
mandates it. But, what does Big Pharma care? It’s a throwaway line because so <b><i><u>long
as PATIENTS continue to eat what government and their doctor have “prescribed”
as a “healthy diet,” type 2 diabetes WILL BE a “progressive disease,” and the
PATIENT WILL continue to worsen</u></i></b>.” And <b><i><u>BIG PHARMA IS THE BIG WINNER</u></i></b>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">There is no
downside for Big Pharma. <i><u>They’re</u></i>
not telling you how and what and when to eat, and certainly <i><u>no one</u></i> would tell you that
exercise is <i><u>not</u></i> good for you. Besides,
exercise and Metformin are well-documented ways for type 2s to slightly <i>improve their insulin sensitivity</i>, which
is good. But for weight loss, exercise is not an effective method.<o:p></o:p></span></div>
<div class="MsoNormal">
<b><i><u><span style="font-size: 11.5pt; line-height: 115%;">THE ONLY DOWNSIDE IS
FOR THE PATIENT</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%;">. By following the advice to eat what the government “prescribes” as a
“healthy diet,” <i>patients are being <b><u>herded like lemmings into the hands of
Big Pharma</u></b></i>. Whether this is a corrupt cabal, I’ll leave it for you
to decide. But more to the point, <b><i><u>in your own self-interest</u></i></b>,
you might want to <b><i><u>ask, why has the advice, “…when used with diet and exercise,”
failed?</u></i></b> And why does it continue to fail even as you take more and
more medications. It is because exercise and eating a balanced diet are <i><u>not</u> good ways to lose weight</i>? <o:p></o:p></span></div>
<div class="MsoNormal">
<b><i><u><span style="font-size: 11.5pt; line-height: 115%;">It is because the “healthy”
diet the government prescribes is NOT REALLY A HEALTHY DIET?</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%;"> If eating lots of carbs (like corn)
is a good way to fatten beef cattle in a “feed lot,” is it not also a good way
to fatten people? Yet, the government’s <a href="https://www.google.com/imgres?imgurl=https://upload.wikimedia.org/wikipedia/commons/thumb/7/75/US_Nutritional_Fact_Label_2.svg/1200px-US_Nutritional_Fact_Label_2.svg.png&imgrefurl=https://en.wikipedia.org/wiki/Nutrition_facts_label&h=1180&w=1200&tbnid=7Qr8aW916pyViM:&q=nutrition+facts+label&tbnh=160&tbnw=162&usg=AI4_-kQ14FduficyPSDv5xcH0Qa-C5g_YA&vet=12ahUKEwiJn9LqkdTeAhUmneAKHTDtBHwQ9QEwAHoECAUQBg..i&docid=fGtjuoQr6zVxzM&sa=X&ved=2ahUKEwiJn9LqkdTeAhUmneAKHTDtBHwQ9QEwAHoECAUQBg"><span style="color: blue;">Nutrition Facts label</span></a> on all “processed” foods
prescribes that the <b><i><u>PERCENT DAILY VALUE (%DV) FOR CARBS RECOMMENDED
FOR WOMEN (ON A 2,000KCAL DIET) IS 300G, OR 1,200KCAL, OR 60%. AND FOR MEN (ON
A 2,500KCAL DIET), IS 375G, OR 1,500KCAL, ALSO 60%. DID YOU KNOW THAT? DO YOU
THINK THAT IS TOO MANY</u></i></b><i>?</i><o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">If you want to avoid the inevitable “<a href="http://www.thenutritiondebate.com/2013/11/the-nutrition-debate-160-letterman-to.html"><span style="color: blue;">graduation</span></a>” to a cocktail of anti-diabetic
medications, including the ones advertised on TV, you might want to consider dropping
your intake of carbs, to 40, 20, 10 or even 5%, like me. </span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-6551449603048327712020-06-12T08:21:00.001-04:002020-06-12T08:21:08.863-04:00Retrospective #482: “What are you teaching these kids?”<br />
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">In the Schwab TV commercial, Carl, a salesman for a rival
stock broker, is addressing an elementary school class. When one of the
students asks what his firm has to offer, Carl says, “Good question!” But when
the kid replies to the broker’s answer with what Schwab has to offer, Carl
asks, “What are you teaching these kids?”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Now THAT’S a good question! Both kids and adults in the U. S.
have been subject to the government’s ideas about nutrition for over half a
century. It all started in the 50s with saturated fat and cholesterol and got
much worse in 1977 with the McGovern Committee’s Dietary Goals and then in 1980
with the very first Dietary Guidelines for Americans.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The result is plain to see. We for the most part have <a href="https://ninateicholz.com/new-us-food-availability-data/"><span style="color: blue;">followed the government's advice</span></a>. Many have no
choice. The military eats what the government cooks for them, and <a href="https://www.militarytimes.com/off-duty/military-culture/2018/10/03/a-staggering-number-of-troops-are-fat-and-tired-report-says/"><span style="color: blue;">they are getting fatter and fatter</span></a>. You can’t
blame that on a lack of exercise, can you? Our schools and hospitals are
subject to these HHS/USDA dietary guidelines too. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">So, what have they been teaching us and our kids? To lose
weight and be healthy: eat less and move more! Don’t eat red meat or processed
meat. Don’t eat meat! Or cholesterol or salt! Don’t eat saturated (solid) fat,
found in animal products. Instead, eat a plant-based diet including processed
“vegetable” oils (soybean, corn, Canola, etc.), all of them <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>UNHEALTHY
polyunsaturated fats manufactured and sold by Agribusiness and subsidized by
the USDA!</u></i></b><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Doctors too are having an increasingly difficult time under
the influence of government Dictocrats. To survive, many are now part of large
groups and hospital practices where corporate number crunchers are monitoring <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>your</u></i></b>
personal medical records to see that the clinician is recording that he advised
you to eat a mostly plant-based diet and you get the recommended amount of
exercise. If your doctor hasn’t advised you to do this, you’re lucky; he or she
is still in private practice <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>but</u></i></b> is at risk of HHS
sanctions and <i style="mso-bidi-font-style: normal;"><u>increasing “negative
payment adjustments”</u></i> from Medicare if this is not in <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>your</u></i></b>
patient notes. Their Medicare reimbursements will <a href="http://www.thenutritiondebate.com/2017/01/type-2-diabetes-dietary-disease-365.html"><span style="color: blue;">decrease by 9% by 2022</span></a>. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">So, what’s to be done about it? Obviously, the macro solution
is to get legislators out of the business of telling people what to eat, but
that is not going to happen. There will <i style="mso-bidi-font-style: normal;"><u>always</u></i>
be politicians, who take contributions from Agribusiness, who think they know
what’s best for you. They will <i style="mso-bidi-font-style: normal;"><u>always</u></i>
want to impose their will on us, by legislation. They will argue that it is the
proper role of government to look after the “general welfare” of the citizenry,
to justify with legislation anything that is not expressly “enumerated” as
powers granted to them by the Constitution. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">In this they have been abetted by a Supreme Court which has extended
the power of Congress to legislate away your freedoms, all in the name of the
“general welfare.” Some, who espouse a civil libertarian point of view,
objected, but others relented to pressure for the “general good.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Today, however, the tide is changing. In 2002, on the advice
of my doctor <b style="mso-bidi-font-weight: normal;">who <i style="mso-bidi-font-style: normal;"><u>just wanted me to lose weight</u></i></b>, I started to eat <b style="mso-bidi-font-weight: normal;"><i><u>Very Low Carb</u></i></b>. He had
been cajoling me for years, telling me to “eat less and exercise more,” but eat
a “balanced” diet. I even worked with his dietician, all to no avail. Then in July
2002 he read a <i style="mso-bidi-font-style: normal;">NYT Sunday magazine</i>
cover story, “<a href="https://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html"><span style="color: blue;">What If It's All Been a Big Fat Lie</span></a>.” He followed
the diet himself, by mid-August had lost 17 pounds, and suggested I try it too.
In the first week, I abruptly stopped almost all my diabetes med and eventually
lost 170 pounds.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">More and more people (and many doctors) are discovering this
Way of Eating. There are now thousands of practitioners worldwide who publicly
practice this way, and 10s of thousands more who would tacitly support <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>your</u></i></b>
decision to change the way you eat. After all, doctors and related health
professionals are interested in <i style="mso-bidi-font-style: normal;"><u>results</u></i>
and are persuaded by <i style="mso-bidi-font-style: normal;"><u>evidence</u></i>.
Not only will you lose weight <i style="mso-bidi-font-style: normal;"><u>easily</u></i>
this way, and do it <i style="mso-bidi-font-style: normal;"><u>without hunger</u></i>,
(body fat is food), your blood tests of metabolic markers, blood pressure and
inflammation, will improve dramatically. <i style="mso-bidi-font-style: normal;"><u>That’s
real evidence<span style="mso-bidi-font-style: italic;">!</span></u></i><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">The tide is also changing on the
Supreme Court. The balance of power is now 5 to 4 for a more conservative
interpretation of the “general welfare” clause. And soon it could be 6 to 3. Personally,
I will be much happier if and when Congress and the Courts decide that
government should have less to say about what we eat.</span><o:p></o:p></div>
<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-76974463156357541222020-06-11T07:57:00.001-04:002020-06-11T07:57:20.405-04:00Retrospective #481: “I’ve lost 30 pounds,” said Tim Cook, Apple CEO<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">If you Google,
“Tim Cook, ‘I’ve lost 30 pounds,’” you’ll find several pages touting Cook’s
boast about how he used his iWatch to lose weight. Of course, he was mainly
promoting the utility of a <i><u>prospective</u></i>
Apple iWatch app <i>in conjunction with</i>
emerging medical technology to help manage health conditions and make our lives
better.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">The quote
appears at about the 8:15 mark in </span><a href="https://www.cnbc.com/2017/05/03/exclusive-apple-just-promised-to-give-us-manufacturing-a-1-billion-boost.html"><span style="color: blue; font-size: 11.5pt; line-height: 115%;">this</span></a><span style="font-size: 11.5pt; line-height: 115%;"> May 2017 video interview with CNBC’s
Jim Cramer. Cramer was trying to get Cook to reveal the next “new” product from
Apple. Cook smiled and at first resisted, saying, “I can’t tell you” [about new
products]; and then, here’s what follows in this scripted interview:<o:p></o:p></span></div>
<div class="MsoNormal">
<u><span style="font-size: 11.5pt; line-height: 115%;">Cramer,</span></u><span style="font-size: 11.5pt; line-height: 115%;"> egging him on with a cue, “Health?” <o:p></o:p></span></div>
<div class="MsoNormal">
<u><span style="font-size: 11.5pt; line-height: 115%;">Cook</span></u><span style="font-size: 11.5pt; line-height: 115%;"> replies, “You know, this, <i><u>the watch</u></i>, has been an incredible
move into health, in the wellness and fitness piece.” <o:p></o:p></span></div>
<div class="MsoNormal">
<u><span style="font-size: 11.5pt; line-height: 115%;">Cramer</span></u><span style="font-size: 11.5pt; line-height: 115%;">: “You too?” [more script]<o:p></o:p></span></div>
<div class="MsoNormal">
<u><span style="font-size: 11.5pt; line-height: 115%;">Cook</span></u><span style="font-size: 11.5pt; line-height: 115%;">: “Yes, I’ve lost 30 pounds, partly
[due] to <i><u>my watch</u></i>.” <o:p></o:p></span></div>
<div class="MsoNormal">
<u><span style="font-size: 11.5pt; line-height: 115%;">Cramer</span></u><span style="font-size: 11.5pt; line-height: 115%;">: [prompting Cook again] “…because it
<i><u>prompts</u></i> us.” <o:p></o:p></span></div>
<div class="MsoNormal">
<b><u><span style="font-size: 11.5pt; line-height: 115%;">COOK</span></u></b><b><span style="font-size: 11.5pt; line-height: 115%;">: [finally getting to his pitch] “BECAUSE IT MOTIVATES YOU. IT CONSTANTLY
GIVES YOU FEEDBACK. IT CONSTANTLY GIVES YOU REWARDS, AND THIS MAKES A
DIFFERENCE…OVER TIME.”<o:p></o:p></span></b></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">What Cook
and Cramer were talking about is an Apple iWatch app <i><u>in development</u></i> that tracks blood sugar continuously from a
sensor attached to the upper arm just below the surface of the skin. The sensor
captures the rise and fall of blood “sugar” in response to several factors, but
<i><u>primarily to food that is eaten</u></i><i>.</i> <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">If you eat
something that causes a large increase, you <i>know</i>
that that it will shut down any fat burning your body is doing to supply energy
while the “sugar” (glucose from <i><u>any
type of carb</u></i>) is burned off first. You learn that <i><u>if you want your body to</u></i><u> <i>stay in fat burning mode</i></u>, <i>instead
of sugar-burning mode, you should avoid those foods</i>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Cook’s pitch
and Cramer’s interest are all about business, specifically the conjunction of
health science and technology. It’s a crowded field. Scores of innovators are
operating under the radar, clamoring to get on the bandwagon for a piece of the
mass-market. The early birds certainly have an advantage, but…over time, as
technology advances, the products will become commodified, and competition will
bring costs down.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In the 2017
interview, Cook was certainly aware that a “high cost” solution was on the
market. By March 2018 the FDA had approved the Dexcom 6 Continuous Glucose
Monitor (CGM). It costs about $5,000 a year and includes an integrated mobile
app which automatically downloads results to a Bluetooth-enabled device.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Then in
August 2018 the FDA approved the new Freestyle Libre CGM (about $1,620 a year).
It does <i><u>not</u></i> have an integrated mobile app yet, but a startup,
Ambrosia, has a workaround called BluCon to download results.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Metronic is
in the race too but lags at this writing. Stay tuned, though. By the time you
read this, who knows?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Unfortunately
for most type 2 diabetics, Medical insurance, including Medicare and
“Supplemental,” will only pay for this durable medical equipment and supplies <b><i><u>if
you are an</u></i></b><b><i><u> insulin-dependent diabetic who injects
MEALTIME insulin</u></i></b>. The government’s policy is designed to help
patients avoid life-threatening hypos (hypoglycemia), which, for some
diabetics, is an all-too-common and sometimes life-threatening occurrence,
often requiring hospitalization.<o:p></o:p></span></div>
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">But Tim Cook’s market
is “the wellness and fitness piece” – i.e., <b><i><u>the entire rest of the world</u></i></b>
– who will benefit from an inexpensive app and an affordable sensor that can be
integrated with the latest Apple iWatch… <b>BECAUSE
IT MOTIVATES YOU. IT CONSTANTLY GIVES YOU FEEDBACK. IT CONSTANTLY GIVES YOU
REWARDS, AND THIS MAKES A DIFFERENCE. And almost <i><u>everyone</u></i> could stand to lose 30 pounds. Lots of us, even
more!</b></span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com1tag:blogger.com,1999:blog-7410445500476013619.post-29776461227098134042020-06-10T07:47:00.003-04:002020-06-10T07:47:56.596-04:00Retrospective #480: CGMs for Non-Insulin Dependent Type 2s?<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">That’s a
question, friends, <i><u>not</u></i> news of
a new Medicare policy on insurance coverage. The fact still is: Medicare will
only cover a Continuous Glucose Monitor (CGM) for type 1s and <i><u>type 2s who inject meal-time (not just
basal) insulin</u></i>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Current
government policy is designed to help mealtime insulin users<i> avoid hypos</i> and is cost-driven. Hypos
from accidental overtreatment with insulin <i>by
the</i> <i>patient</i> are acute and can be
life threatening if not addressed quickly. They frequently result in emergency
room visits and hospitalizations. Regrettably, for non-insulin dependent type
2s, <b>Medicare does <u>not</u> foster a long-term approach to blood glucose
self-management (BGSM).</b> They do not consider the <i><u>costly complications and co-morbidities</u></i> from higher levels
of glucose in the blood. And, IMHO, as the cost of treating complications <i>and</i> co-morbidities<u> </u>of T2D soars, Medicare <i>should</i> cover CGMs for non-insulin
dependent T2s.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Diabetic
complications take many years to develop. <b>Microvascular</b>
complications include 1) nerve damage (peripheral <b>neuropathy</b>), the leading cause of amputations; 2) loss of sight (<b>retinopathy</b>), and 3) end-stage kidney
disease (<b>nephropathy</b>), requiring
dialysis. The co-morbidities of T2D that are <b><i><u>macro</u></i>vascular</b>
include some cancers, stroke, and heart disease; <i><u><a href="http://www.thenutritiondebate.com/2016/09/type-2-diabetes-dietary-disease-345-how_11.html"><span style="color: windowtext;">the ADA "compliant" patient</span></a><a href="http://www.thenutritiondebate.com/2016/09/type-2-diabetes-dietary-disease-345-how_11.html"><span style="color: windowtext;">s</span></a><a href="http://www.thenutritiondebate.com/2016/09/type-2-diabetes-dietary-disease-345-how_11.html"><span style="color: windowtext;"> (with an A1c of 7.0%), </span></a><a href="http://www.thenutritiondebate.com/2016/09/type-2-diabetes-dietary-disease-345-how_11.html"><span style="color: windowtext;">have</span></a> <a href="http://www.thenutritiondebate.com/2016/09/type-2-diabetes-dietary-disease-345-how_11.html"><span style="color: windowtext;">TWICE the risk of CVD</span></a></u></i><span style="color: blue; mso-bidi-font-style: italic;"> </span>as non-diabetics<span style="color: blue;">. See </span><a href="file:///C:/Users/Owner/Documents/The%20Book/Revised%20columns/Type%202%20Nutrition#345R%20-%20How%20Diabetic%20Do%20You%20Want%20to%20Be%20(Part%202).docx">Type
2 Nutrition #345R - How Diabetic Do You Want to Be (Part 2).docx</a>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">Why does the
government set such a low standard for doctors <i>and</i> patients? Because achieving the ADA’s modest ≤7.0% A1c control
goal is still difficult to achieve, given<b><i><u> the government’s one-size-fits-all
Dietary Guidelines</u></i></b>. <b><i><u>Type 2 diabetes is a DIETARY disease</u></i></b>,
but the Dietary Guidelines for <b><i><u>all</u></i></b> Americans are still based
on an eating pattern that is <b><i><u>very</u></i></b> high (55-60%) in carbohydrates.
<b><i><u>All</u></i></b>
carbs become “sugar” (glucose) in the blood. Eating <i>so many</i> carbs while trying to manage your blood glucose <b><i><u>requires</u></i></b>
increasingly more meds. But the USDA/HHS is stuck in the status quo.<b><o:p></o:p></b></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, if the <b><i>patient</i></b>
understands this and wants to lower their blood sugars <b><i>on a day-to-day basis</i></b>,
they need to know what foods (and other factors such as hormones) affect their
blood sugar (glucose) over the course of the day. The best way to do that is to
monitor your blood sugar continuously, and “eat to the meter,” i. e., change
what you eat. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">As I am <i><u>not</u></i>
an insulin-dependent type 2 who injects meal-time insulin, my options for
obtaining a CGM are limited to cash-only, i.e., out-of-pocket. I recently looked
into this and learned the following:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">For context,
I treat my type 2 diabetes primarily with a Very Low Carb “Eating Pattern.” My
only diabetes med is <b>Metformin</b>, and
I am assured by my physician, “You can’t get a “hypo” (hypoglycemia) from just
Metformin.” My own experience since 2002 confirms this. I am in <i>no danger whatsoever</i> of hypos, even with
extended fasting. <b>Metformin</b> works on the liver (and gut) and improves insulin
sensitivity. <i>Metformin has <b><u>no</u></b> effect on the pancreas</i>.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">So, if you
are not able to use insurance to cover the cost of purchasing a CGM system
(sensors and readers, or transmitters and receivers), you have 2 choices: <b>Dexcom</b> and <b>Freestyle Libre</b>. But, if you don’t have or aren’t eligible to use
insurance, <b><i><u>cost is the main factor</u></i></b>. That eliminates one choice for
me.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">The new
Dexcom G6, introduced 3/18, is about $5,000 US a year. That’s expensive. It is
more accurate in hypos, includes alarms and has an integrated mobile app. It
automatically downloads results to a Bluetooth-enabled device. The 10-day
sensor is a little bulky, but <b><i><u>if you’re insurance eligible</u></i></b>,
<b><i><u>and
get hypos</u></i></b>, it’s definitely the way to go.<o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">The new Freestyle Libre 14-day (8/18) is <i><u>much</u></i> less expensive, but still costly at $1,620 a year
($135/mo.). The old Freestyle Libre included sensors good for 10 days, but the
new FDA approved 14-day sensor is now in pharmacies. It may be slightly less
accurate than a Dexcom, but it has a shorter “warmup” period (1 hr. vs. 2 hr.)
for new sensors. However, it has <b><i><u>no alarms for hypos</u></i></b>. It has a
90-day memory and an excellent suite of reports (daily reports <i><u>and</u></i> 14-day summaries). It does
not have its own integrated mobile app and must be “read” every 8 hours.
However, a startup, Ambrosia, has a workaround called BluCon. <o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">Given my needs, and the cost disparity, it’s a
no-brainer. If I decide to do it, I’ll opt for the Freestyle Libre 14-day.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com5tag:blogger.com,1999:blog-7410445500476013619.post-2098659682800804022020-06-09T09:09:00.000-04:002020-06-09T09:09:00.645-04:00Retrospective #479: “If you’re over 65 and have diabetes…”<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">“If you’re over 65 and have diabetes, you should have a
DEXCOM,” a guy in a white coat exhorts the viewer in a TV ad. Have you ever
thought about using a Continuous Glucose Monitor (CGM)? You’re supposed to
assume the huckster is a doctor, not an actor shilling for the maker of this
CGM. You’re also supposed to believe that his spiel is guided by “best medical
practice.” But is using a CGM “best medical practice”? In an ideal world? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">For context,<i><u> just a day earlier</u></i> I had read that
the American College of Physicians (ACP) concluded that “home monitoring of
blood glucose does not benefit blood glucose control.” In this case the ACP was
denigrating the finger-stick home monitoring <i><u>that I</u></i><i><u> do</u></i><u> <i>every</i> morning</u>. How could they, with <i>such conclusiveness,</i> dis this practice, with <i>no</i> conditions or <i>no</i>
exceptions? <i>I <u>know</u> home monitoring
has helped me a lot</i> with <i><u>my</u></i>
blood glucose control.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Now, back to the CGM. The Dexcom CGM TV ad is <i><u>very</u></i>
misleading. The huckster says “<i><u>every</u></i>
65yr old diabetic should have a CGM.” Unfortunately, he doesn’t say that Medicare
(and supplemental) insurance will only cover the cost of a CGM and its ongoing
supplies, for <i><u>some</u></i> diabetics. <i>Coverage is qualified and severely limited</i>.
<b><i><u>It is only “for diabetics who use insulin to control their blood
glucose,” and, more specifically,</u></i></b><u> <b><i>ONLY for diabetics who take</i> <i>insulin</i></b><i> <b>with every meal</b></i></u>.”
They cover their ass with small print at the bottom of the screen: “Patients
must meet coverage criteria.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">CGM’s are attached to your body and connected via a small
skin prick which monitors your interstitial fluid every 5 minutes 24/7. The
DEXCOM CGM sends downloadable readings and/or audible alarms to your phone or
your caregiver’s phone. So, contrary to what the ACP said, CGMs are certainly a
type of “home monitoring of blood glucose” that <b><u>DOES</u></b> benefit blood glucose self-management (BGSM). <i>Quid erat demonstrandum</i> (QED). <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">So, as much as I personally would <i><u>like</u></i> to have a CGM to monitor and help <i><u>me</u></i> control <i>my</i>
blood glucose, I am very happy that now <b><i><u>CGMS ARE COVERED FOR TYPE 1 DIABETICS AND
INSULIN-DEPENDENT TYPE 2S WHO INJECT MEALTIME INSULIN</u></i></b>. Of course, I
would argue that there<i> <b>should</b> </i>be<i> <b>NO</b> </i>insulin dependent
type 2s <b><i><u>if diet rather than pharmacology</u></i></b><i><u> was considered </u></i>“best medical practice” -- by the medical
establishment <b><i><u>or just BY THE PATIENT</u>!</i></b><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<b><i><u><span style="font-size: 11.5pt; line-height: 115%;">Insulin is a dangerous drug,</span></u></i></b><span style="font-size: 11.5pt; line-height: 115%;"> <b><i>especially in the hands of a patient who injects it multiple times a
day every day</i></b> and who has to know a great deal about carbohydrates <i><u>and</u> the insulinogenic properties of
some proteins</i>…<i><u>and</u></i> estimate
portion size and other variables. It’s complicated and risky. That’s why 1)
doctors prefer to err by <i><u>under</u></i>
dosing, <i>with consequent higher blood
sugars and A1c’s</i> and 2) patients sometimes <i>under</i> dose insulin, <i>because
overdosing on insulin</i> <i><u>can</u></i><u>
</u>(and sometimes <i><u>does</u></i>) lead
to hypos (hypoglycemia), coma, expensive hospitalizations and death!<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The irony is that once a <b>type
2 patient</b> has learned so much about carbs and insulinogenic proteins, they <b><i>could</i></b>
just as easily <b><i><u>eat</u></i></b> low carb, even <b><i><u>VERY</u></i></b> low carb, <b><i><u>AND
DISPENSE ALTOGETHER WITH THE NEED TO INJECT INSULIN!</u></i></b><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">But what about the finger stick? How does it benefit me? With
a daily Fasting Blood Glucose (FBG), I am reminded that <b><i><u>I CONTROL MY TYPE 2 DIABETES
BY DIET</u></i>. </b>If I ever cheat, my FBG will invariably be in the
prediabetic range (100-125mg/dl) the next day. If not, it could be anywhere
from 65 to 99mg/dl, depending on how many days in a row I was “good” (didn’t
cheat). My FBG is also a reliable indicator of what my A1c will be at my next
doctor’s visit.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Years ago, when I was still learning about which foods
elevated my blood glucose, testing before a meal and 1-hour after taught me
about <i>my</i> <i>insulin resistance</i>. Everyone’s different, depending on the severity
of your Insulin Resistance. Thus, it was a <i>useful</i>
aide to me <b><i>in the learning process</i></b> for <b><i>self-management</i></b> of my
type 2 diabetes.<o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">For most type 2s that I know, or for
“pre-diabetics” or folks who are just overweight and in cahoots with their
doctor about their metabolic state (“denial is not a river”), Blood Glucose
Self Management (BGSM) is a way for <b><i>patients</i></b> to take responsibility for
their health. But if that’s not you, your doctor will be happy to track your
A1c and say nothing (except maybe “lose weight”) until you are a certifiable
type 2 diabetic. Then, as Tom Hanks was told by his doctor, he’ll say, “<a href="http://www.thenutritiondebate.com/2013/11/the-nutrition-debate-160-letterman-to.html"><span style="color: blue;">Congratulations, you've graduated</span></a>,” and he’ll
write you a prescription. What else can <b><i><u>he</u></i></b> do?</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-55990107318146131712020-06-08T07:27:00.001-04:002020-06-08T07:27:06.820-04:00Retrospective #478: Why I still use stevia.<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">While the debate raged on about artificial sweeteners, I
always took comfort from the knowledge that the sweetener I used, in coffee and
iced tea, was <i><u>not artificial</u></i>;
it was a <i><u>pure natural extract</u></i>
from the leaf of a South American plant, Stevia rebaudiana. To be clear, I'm <i>not</i> talking about a combination product
like Truvia, packaged with a sugar alcohol, or Stevia in the Raw, combined with
dextrose or maltodextrin (both 100% glucose chains) as "bulking
agents." I am talking about <i><u>100% refined stevia leaf extract</u></i>,
either in powder or liquid form.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">I use stevia powder in my coffee in the morning. I started
out with a 16oz cup, with 12oz of coffee, about 2oz of heavy whipping cream
(HWC) and a rounded 1g measure of stevia powder. When I decided that was too
much fat from the cream, I downsized to a 12oz cup with about 1 1/2oz of HWC
and a level 1g measure of stevia. When I discovered that I needed less than a
cup to take my pills, I started experimenting with half a cup of coffee (and
less HWC and stevia). That worked too… but I <i>like</i> my cup of coffee in the morning.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">I also use stevia in liquid form in the cold-brew Lipton iced
tea I make in half-gallon glass bottles for my go-to beverage during the day.
It's quite refreshing when it's been chilled overnight in the refrigerator. I
have 2 bottles and rotate them so one is always cold. After the tea
"brews," I squirt in a couple eye droppers of liquid stevia and mix.
I drink <i>at least</i> a half-gallon a day
year-round -- more in summer -- to remain hydrated.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Because I generally eat <i>Very
L</i>ow Carb, I am usually "keto-adapted." When the food I eat has
been digested and absorbed, my body transitions <i><u>without hunger</u></i> from a fed to a fasted state. My metabolism switches
from relying on the food I ate to the food it has stored on my body, <i><u>without</u></i><u> <i>slowing down my metabolism</i></u>. That's the theory and practice of
being "keto-adapted," And since I lose weight easily <i><u>without hunger and with lots of energy</u></i>
when I follow this Way of Eating, I haven't felt the need to change my
"stevia habit." <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">But there is this nagging thought:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Doesn’t the stevia I take in my morning coffee raise my blood
<b><i><u>insulin</u></i></b>?
It <i><u>surely</u></i> must, to some
extent. <i><u>It is sweet!</u></i> And although I probably lost my " <a href="https://www.medscape.org/viewarticle/483307_2"><span style="color: blue;">first-phase
insulin release</span></a>" decades ago, nevertheless, the Cephalic Phase
of digestion is still there, isn't it? <b>Or</b>,
is the secretory response of insulin inhibited by not being hungry? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Likewise, if every glass of my sweetened iced tea is laced
with stevia, won't it also put the brakes on my keto-adapted metabolism? Again,
it doesn't seem to. But my description of my metabolic state as being
“keto-adapted” is entirely subjective; I do not have a keto meter or use keto
test strips to test my urine. Perhaps I am <i><u>not</u></i>
in a state of “nutritional ketosis” after all. Maybe <b><i><u>I am just able to
use body fat for fuel because I eat Very Low Carb, and therefore always have a LOW
SERUM INSULIN, and therefore can always burn either the food I eat (mostly protein
and fat) OR the food stored around my waist (all fat).</u></i></b><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<i><span style="font-size: 11.5pt; line-height: 115%;">But, again, if my body
senses the "sweet" tea and coffee, won't that <u>stop</u> the
breakdown of my body fat for fuel? And if that happens, and I have offered the
body no carbs for a quick energy pick-me-up -- and only tricked it into
thinking it would receive some glucose energy by the "sweet" (stevia)
signaling -- won't that slow my metabolism? It's supposed to, but again it <u>doesn't</u>.
My body is pumped -- all day long -- <u>on an empty stomach</u>.</span></i><span style="font-size: 11.5pt; line-height: 115%;"> <b><i><u>Answer? "<span style="background: white; mso-highlight: white;">When APPETITE is depressed, this part of the
cephalic reflex is inhibited</span></u></i></b><span style="background: white; mso-highlight: white;">," per this link in </span><a href="https://en.wikipedia.org/wiki/Cephalic_phase"><span style="background: white; color: blue; mso-highlight: white;">Wikipedia</span></a><span style="background: white; mso-highlight: white;">.</span> Go ahead, open it and
read it.<u><o:p></o:p></u></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">So, after I take a few hours of exercise (garden
work), I drink a glass of cold, stevia-sweetened iced tea, in summer with a few
dill pickle spears and pickle juice for electrolyte balance. I know that by
eating <i>Very</i> Low Carb, I maintain a
very <b><i><u>low
level of circulating INSULIN</u></i></b>, and I am, therefore, <b><i><u>never
hungry</u></i></b>. My body knows that it can <b><u>always access my stored body fat to get all the energy it needs</u></b><i>. Thus, it maintains <b><u>energy balance (homeostasis</u>), </b>and a <b><u>stable blood glucose, without slowing my metabolism</u></b></i>. Or
so it seems to me. In fact, I think this is the “natural state of man.”</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-38359531963199863662020-06-07T07:42:00.001-04:002020-06-07T07:42:21.035-04:00Retrospective #477: “Deprescribing antihyperglycemic meds…”<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Okay, I admit it. I was predisposed to riff on and dis this
story in Medscape Medical News, “<a href="https://www.medscape.com/viewarticle/890429">Diabetes Medications: Should
You Deprescribe Them in the Elderly?</a>” By posing a question, the headline was
written, I thought, to suggest a hypothesis that tight control was neither
necessary nor desirable <b><i><u>IN THE ELDERLY,</u></i></b> generally. It
turns out, I am in general agreement with the author’s ideas and her specific
recommendations.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">When I first saw this headline I told my wife that if, when I
read the piece later, the first paragraph didn’t de-sensationalize the subject,
I was going to write a rant condemning it on the principal that such an idea
should be advocated <i><u>only</u></i> on a <i><u>very</u></i> limited basis. Well, the
first paragraph <i><u>did</u></i>
de-sensationalize the subject.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The thrust of the article was “lowering the dose of ‘these’
drugs in <i><u>patients at risk of hypoglycemia</u></i> or other antihyperglycemic
adverse effects, or in whom the drug’s benefit is uncertain, due to <i><u>frailty, dementia, or limited life
expectancy</u></i>. Since the authors define “elderly” as age ≥ 65 years, I would
strongly disagree over the definition of “limited life expectancy,” Haven’t the
authors heard that 85 is the new 65? I guess not. ;-)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">It turns out Medscape was reporting on yet <i>another</i> deprescribing project of the
Bruyère Research Institute (BRI) in Ottawa, Canada. This deprescribing idea, in
general, sounds like a laudatory objective, especially since <i>the <b><u>primary</u></b><u> antihyperglycemic
target of this report was <b>sulfonylureas</b>
(SUs), specifically <b>Glyburide</b></u></i>.
In this, I totally agree. Glyburide depletes the pancreas’ insulin supply, thus,
while lowering the patient’s blood glucose, <i><u>also depletes the organ’s
capacity</u></i> to continue to make insulin <i><u>and</u> puts the patient at</i> <i>high
risk of hypoglycemia</i>, which is BRI’s point.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">The <b><i><u>secondary</u></i></b><i><u> target of the report
is <b>injected insulin</b></u></i>, specifically
an old-fashioned, “high risk” form, NPH. The BRI report suggests, instead,
“deprescribing” NPH and substituting insulin detemir or glargine. And instead
of prescribing glyburide, it suggests that doctors switch their patients to
“short or long acting gliclazide.” <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Where the BRI report, and Medscape, miss the mark, in my
opinion, is in the overly broad statement that “many older patients with
diabetes are still being treated to A1c <7%.” <i>They explicitly accept the suggestion that people over 65 should be
held to a more lax standard: <7.5% in healthy older adults</i> and <8.5%
in the very frail elderly. BRI’s purpose is to <i>avoid</i> “those medications that can contribute to a low blood sugar” –
in other words, hypos.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">Regrettably, this relaxed standard is only necessary because
of the failed <i><u>treatment</u></i> protocol dictated by the failed <i><u>dietary</u></i>
paradigm prescribed by government and the entire medical establishment. Such <i><u>high</u> A1c’s</i> are totally unnecessary.
Type 2 diabetes is a <i><u>dietary</u></i> disease.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">But the report does provide evidence of the adverse clinical
effects <i><u>associated with</u></i> tight glycemic
control (with medications) on the elderly: cardiovascular events, cognitive
impairment, fractures, reduced quality of life, increased emergency room
visits, and hospitalization for hypoglycemia associated with a poor prognosis. <b><i><u>All
of these are outcomes of medication regimens</u></i></b>, and all <i>can be</i> mitigated by “deprescribing” in
the way BRI advocates, they assert.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">There is, however, <i><u>another way</u></i>, a way that
achieves a <i>safe and low</i> blood sugar <i>without</i> the high risk associated with SU’s
like glyburide, and injected insulins like NPH, or even detemir or glargine.
The article suggests various antihyperglycemic agents that have no risk of
hypoglycemia, such as DPP-4s, GLP-1s agonists, and Metformin. My doctor actually
<i>laughed</i> when I asked him if I could
get a hypo from Met <i>while practicing
extended fasting</i>. ;-)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 6.0pt;">
<span style="font-size: 11.5pt; line-height: 115%;">There is also <i><u>another way</u></i> for the “elderly” to
manage their blood sugar and also <i><u>to completely avoid the risk of
hypoglycemia</u></i>: to <i><u>eat in a way
that doesn’t raise your blood sugar</u></i>. That way: eat Very Low Carb (VLC).<o:p></o:p></span></div>
<span style="font-family: "Calibri",sans-serif; font-size: 11.5pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">I
was able to quickly <b><i>stop all my diabetes meds</i></b> (except Metformin) <i>and</i> lower my A1c from the mid 6s to 5.0%,
by eating VLC. <b><i>My doctor had to immediately <u>deprescribe my diabetes meds</u></i></b>
to <i>“treat” several hypos in the first
week</i>! That was almost 18 years ago, and I haven’t had a hypo since, and <b><i><u>I
am now considered, clinically, non-diabetic</u></i></b>. Now, I think you’d
agree that that’s an even better outcome than switching from one
antihyperglycemic med to another.</span>danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0tag:blogger.com,1999:blog-7410445500476013619.post-38983228543057573622020-06-06T09:50:00.000-04:002020-06-06T09:50:12.603-04:00Retrospective #476: Martin/Hopkins, “a better LDL calculation method”<br />
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">In mid-2018
I noticed that Quest Laboratories had changed their method of <i style="mso-bidi-font-style: normal;"><u>calculating</u></i> low-density
lipoprotein (LDL-C) on my lab report. For more than 40 years the method used to
<i><u>calculate</u></i> it was the <b style="mso-bidi-font-weight: normal;">Friedewald</b>
formula (LDLC = TC – HDL – TG/5), where TG/5 (TG<400mg/dl) was a surrogate
for VLDL cholesterol. The method Quest uses now is the <b>Martin/Hopkins</b> method.
Quest says that this “novel” method is “more accurate than the usual method.”<o:p></o:p></span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="_gjdgxs"></a><span style="font-size: 11.5pt; line-height: 115%;">Of course, the most accurate method to measure LDL-C is a <b>DIRECT</b>
assay, not a calculation. Dr. Michael Eades explains this on <a href="https://proteinpower.com/drmike/2009/06/22/low-carbohydrate-diets-increase-ldl-debunking-the-myth/"><span style="color: blue;">his website</span></a> and I discuss it <a href="http://www.thenutritiondebate.com/2017/11/type-2-nutrition-406-triglycerides-and.html"><span style="color: blue;">here</span></a>. It requires another test – a special test
which is expensive and generally not done unless <i style="mso-bidi-font-style: normal;"><u>you</u></i> request it and your doctor and insurer agree.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">I’m writing
about this change because, based on what Dr. Eades wrote, <i style="mso-bidi-font-style: normal;">and <u>from my own affirming data</u></i>, I assumed that Quest changed
to the new method because the new method reported a <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">lower</i></b> LDL-C. To my
surprise, while doing some research recently, I discovered that the new method
actually shows a <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">highe</i></b><i style="mso-bidi-font-style: normal;">r</i> LDL-C.<span style="mso-spacerun: yes;"> </span>I found the story <a href="https://www.medpagetoday.com/cardiology/dyslipidemia/73465"><span style="color: blue;">here</span></a> in MEDPAGE TODAY, under Cardiology >
Dyslipidemia. The sub-title of the article is, “Friedewald lowballed lipids; <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b> was on par with lab
reference” [for patients with stable CVD].<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">“According
to an analysis of the FOURIER trial, the median <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b> LDL cholesterol level was <i style="mso-bidi-font-style: normal;">2mg/dl</i> <i style="mso-bidi-font-style: normal;">below</i> the
reference standard of preparative ultracentrifugation – a statistically similar
result, <i style="mso-bidi-font-style: normal;">whereas the Friedewald method <u>underestimated</u>
LDL cholesterol by 4mg/dl</i> (<i style="mso-bidi-font-style: normal;">P</i><0.001)”
(all emphases added by me). <i style="mso-bidi-font-style: normal;">So, relative
to <b style="mso-bidi-font-weight: normal;">Friedewald</b>, <b style="mso-bidi-font-weight: normal;"><u>Martin/Hopkins yielded an LDL-C that was closer to “reference”
(assayed value) and</u></b><u> <b style="mso-bidi-font-weight: normal;">2mg/dl
higher</b></u> than Friedewald.</i><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">“While 22.9%
of <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b> LDL cholesterol
values were at least 5mg/dl different from reference and 2.6% were off by more
than 10mg/dl, these proportions were 40.1% and 13.3% with <b style="mso-bidi-font-weight: normal;">Friedewald</b> estimation.” Noto Bene: “<b>The difference between
methods was more pronounced when triglyceride levels exceeded 150mg/dl</b>.”<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">While the
MEDPAGE TODAY article did not give the whole <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b> formula, it did reveal that “the <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b> method ‘uses the same
standard lipid measurements of total and HDL (high-density lipoprotein)
cholesterol and triglycerides as the <b style="mso-bidi-font-weight: normal;">Friedewald</b>
equation does, but it uses a personalized rather than a fixed conversion factor
in calculating LDL cholesterol levels,’ Martin and colleagues noted.” This is “the
nut” of it.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">But, I
wondered, does this apply equally to low triglycerides? If Quest’s use of a personal
conversion factor usually results in an LDL-C <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u>higher</u> </i></b>(even if
only 2 mg/dl), I find it intriguing that on the three lab reports I’ve had since
Quest switched to the <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b>
method, my personal LDL-C values have all been <b><i><u>lower</u></i></b> than they
were before. This is <i style="mso-bidi-font-style: normal;">why I presumed</i>,
based on what Dr. Eades had said about a <b>DIRECT</b> measurement, that my own
values would probably be <i style="mso-bidi-font-style: normal;">lower</i>, not <i style="mso-bidi-font-style: normal;">higher</i>, using the new method as it was
intended.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 11.5pt; line-height: 115%;">For the 3
tests before the switch from <b style="mso-bidi-font-weight: normal;">Friedewald</b>
to <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b>, my LDL-C values
were 101, 114 and 100mg/dl. Then, using <b style="mso-bidi-font-weight: normal;">Martin/Hopkins</b>,
the Quest reports for my last 3 labs were 87, 79 and 83mg/dl. Of course, my
labs were for different samples, but I have not changed my Way of Eating. So,
then, I wondered, why are my LDLs lower?<o:p></o:p></span><br />
<span style="font-size: 11.5pt; line-height: 115%;"></span><br />
<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse; width: 379px;">
<colgroup><col style="mso-width-alt: 4644; mso-width-source: userset; width: 95pt;" width="127"></col>
<col span="6" style="mso-width-alt: 1536; mso-width-source: userset; width: 32pt;" width="42"></col>
</colgroup><tbody>
<tr height="21" style="height: 15.75pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td class="xl63" height="21" style="height: 15.75pt; width: 95pt;" width="127">Cholesterol</td>
<td class="xl72" style="width: 32pt;" width="42">198</td>
<td class="xl65" style="width: 32pt;" width="42">201</td>
<td class="xl66" style="width: 32pt;" width="42">196</td>
<td class="xl64" style="width: 32pt;" width="42">184</td>
<td class="xl64" style="width: 32pt;" width="42">173</td>
<td class="xl64" style="width: 32pt;" width="42">189</td>
</tr>
<tr height="21" style="height: 15.75pt; mso-yfti-irow: 1;">
<td class="xl67" height="21" style="height: 15.75pt; width: 95pt;" width="127">HDL</td>
<td class="xl73" style="width: 32pt;" width="42">85</td>
<td class="xl69" style="width: 32pt;" width="42">74</td>
<td class="xl70" style="width: 32pt;" width="42">74</td>
<td class="xl68" style="width: 32pt;" width="42">83</td>
<td class="xl68" style="width: 32pt;" width="42">81</td>
<td class="xl68" style="width: 32pt;" width="42">92</td>
</tr>
<tr height="21" style="height: 15.75pt; mso-yfti-irow: 2;">
<td class="xl67" height="21" style="height: 15.75pt; width: 95pt;" width="127">Chol/HDL ratio</td>
<td class="xl73" style="width: 32pt;" width="42">2.3</td>
<td class="xl69" style="width: 32pt;" width="42">2.7</td>
<td class="xl70" style="width: 32pt;" width="42">2.6</td>
<td class="xl68" style="width: 32pt;" width="42">2.2</td>
<td class="xl68" style="width: 32pt;" width="42">2.1</td>
<td class="xl68" style="width: 32pt;" width="42">2.1</td>
</tr>
<tr height="21" style="height: 15.75pt; mso-yfti-irow: 3;">
<td class="xl67" height="21" style="height: 15.75pt; width: 95pt;" width="127">LDL (calc.)</td>
<td class="xl73" style="width: 32pt;" width="42">101</td>
<td class="xl69" style="width: 32pt;" width="42">114</td>
<td class="xl70" style="width: 32pt;" width="42">100</td>
<td class="xl71" style="width: 32pt;" width="42">87*</td>
<td class="xl71" style="width: 32pt;" width="42">79*</td>
<td class="xl71" style="width: 32pt;" width="42">83*</td>
</tr>
<tr height="21" style="height: 15.75pt; mso-yfti-irow: 4;">
<td class="xl67" height="21" style="height: 15.75pt; width: 95pt;" width="127">non-HDL</td>
<td class="xl73" style="width: 32pt;" width="42">113</td>
<td class="xl69" style="width: 32pt;" width="42">127</td>
<td class="xl70" style="width: 32pt;" width="42">122</td>
<td class="xl68" style="width: 32pt;" width="42">101</td>
<td class="xl68" style="width: 32pt;" width="42">92</td>
<td class="xl68" style="width: 32pt;" width="42">97</td>
</tr>
<tr height="21" style="height: 15.75pt; mso-yfti-irow: 5; mso-yfti-lastrow: yes;">
<td class="xl67" height="21" style="height: 15.75pt; width: 95pt;" width="127">Triglycerides (TG)</td>
<td class="xl74" style="width: 32pt;" width="42">60</td>
<td class="xl69" style="width: 32pt;" width="42">67</td>
<td class="xl70" style="width: 32pt;" width="42">108**</td>
<td class="xl71" style="width: 32pt;" width="42">56</td>
<td class="xl71" style="width: 32pt;" width="42">53</td>
<td class="xl71" style="width: 32pt;" width="42">56</td>
</tr>
</tbody></table>
</div>
<div class="MsoNormal">
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<span style="font-size: 11.5pt; line-height: 115%;">* calculated by Martin/Hopkins
method ** first TG > 100mg/dl in 12
years<o:p></o:p></span></div>
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<span style="font-size: 11.5pt; line-height: 115%;">And here’s the answer: The <a href="https://jamanetwork.com/journals/jama/fullarticle/1779534"><span style="color: blue;">JAMA article explains</span></a>: <b>Martin/Hopkins</b> uses statistics for <b><i><u>3 stratifications of TGs from
100 to 399mg/dl</u></i></b>, which resulted in <b><i><u>higher</u></i></b> LDLs. My <b><i><u>lower</u></i></b>
LDLs are because <b><i><u>my 3 most recent TGs have all been</u></i></b><u> <b><i>in
the mid-50s</i></b></u></span><span style="font-size: 11.0pt; line-height: 115%;">.
Martin/Hopkins does not account for low TGs. They’re “off the chart,” so to
speak!<o:p></o:p></span></div>
</div>
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<br />danbrownhttp://www.blogger.com/profile/00119737446791634173noreply@blogger.com0