How things go downhill
You go to the doctor. Perhaps because you're feeling under the weather, perhaps for your annual physical -- because you've been told it's the right thing to do to.
The doctor says you need to lose a few pounds. (Trust me, doctors *always* say that. Even when they could stand to lose a few more pounds than you.) Your blood pressure's a bit high (whose isn't in the doctor's office. Between sitting around waiting, especially after fighting traffic to get there on time, and being a bit nervous it's not surprising if you have "white coat hypertension").
So they take an armful of blood, give you a prescription for BP medication, a lecture on weight loss and possibly the recommendation to cut back on red meat and animal fats, eat more healthy whole grains, cut back on caffeine, and drink less soda and alcohol. You make an appointment to come back in a couple of weeks to review your BP and the test results.
You come back. You're stressing about the results of the test, the traffic sucked, the doctor's running late. Guess what -- your BP's still high. Also your cholesterol. And you haven't lost any weight (it was only 2 weeks so what did they expect?). And the frosting on the cake? Your blood glucose is at pre-diabetic levels.
You get more dietary instructions. Well, the same ones, reiterated, but with emphasis on how you're at serious risk for type 2 diabetes unless you change your ways. You probably get an increase in your BP meds and a statin. And an appointment for 3 months later.
For 3 months you take your meds. You cut back on meat, drink decaf coffee and decaf diet soda, switch to Miller or Bud Lite, eat lots of healthy whole grains. And feel pretty craptacular. You get more digestive upsets: constipation, indigestion. You're not sleeping so well, your joints are aching. You wonder if it's just part of getting old, even though you're only in your 30s.
After 3 months you've lost maybe 5 - 6lb. You go in for another round of blood tests, then back to the doctor. Still with the white coat hypertension -- made worse by the fact you feel like death warmed over and are stressing over the results. Despite doing what you've been told, your fasting blood glucose is up again -- this time it's well into the diabetic range. Your LDL cholesterol's down a bit, but your HDL is too low and your triglycerides are too high.
The doctor sends you for a glucose tolerance test. You fail. Congratulations. You now have type 2 diabetes.
This begins an endless round of doctor visits (your PCP and an endocrinologist), nutritionist visits, drugs, blood tests -- including stabbing yourself in the fingers several times a day. You take drugs to boost your insulin production, to prevent your liver releasing glucose, etc. You eat the low fat, high grain diet the nutritionist recommends. You feel as if you're constantly eating -- 3 meals and 3 snacks a day -- yet you're frequently hungry, you're thirsty all the time and drinking decaf diet soda by the gallon. You have no energy.
And you don't get better. You start to get numbness in your feet. Small scratches and bruises don't heal the way they did. You get up several times a night to pee.
Eventually your pancreas starts to fail and you have to take insulin. Which means you have to eat at regular times and count carbs. Your life becomes completely focused on what you can and can't eat, and when you can eat it.
Everyone is very sympathetic, but this is just how it goes. Once you're a diabetic this is the course you're on. The signposts are there, the only variable is how long it takes you to reach the various milestones: heart attack, stroke, kidney failure, gangrene and amputations... it's all there in your future. Implacable, inevitable. All you can control is how long it takes to get there.
Some people can't deal with the regimentation and the constant attention to diet. They don't take the meds, they ignore the dietary advice and continue to consume the SAD with its emphasis on grains and sugars. Not surprisingly, these non-compliant diabetics don't last long.
But is this progression really the only way to go?
We've forgotten a lot of what we knew about type 2 diabetes 40+ years ago. Back then the advice given diabetics (in the UK at least) was to eat a diet that comprised less than 50g carb/day. There were fewer medications (and fewer diabetics). It wasn't that difficult to manage on that amount of carbs -- take out the added sugar, cut out most fruit, and limit bread and other grains (there were several bread-like products made for diabetics which were pretty nasty, but very low carb)
In the intervening decades we've seen a huge increase in processed foods, artificial sweeteners, and new improved medications for diabetics. As a result the diabetic diet has suffered from "carb creep". Today the ADA recommends a diet with between 150 and 200g carb/day. On that amount of carbohydrate, a diabetic needs drugs and insulin to survive.
So enter the various low-carb diets: Atkins, South Beach, and the various Paleo/Primal/Caveman diets. They go counter to conventional wisdom. But they work. And the Standard American Diet doesn't. Yet the conventional wisdom continues to insist that animal fat is bad for us, that dietary cholesterol causes heart disease, even though that particular hypothesis has been found to be flawed. Of course there's money to be made out of diabetics -- the endless rounds of doctor's visits, the prescriptions, the how-to books, the recipe books, the surgeries, and eventually the dialysis.
I doubt if there's one right way for everyone to maintain their health in the face of this challenge, but the LCHF thing seems to help a lot of people quite quickly and quite dramatically.
However it takes a huge leap of faith to turn one's back on medical advice and conventional wisdom. You get all sorts of well-meaning friends telling you that you'll "damage" your kidneys/liver/pancreas. That your brain needs 130g glucose a day (it might, guess what -- the liver makes all the glucose you need). That ketosis will kill you (nope, ketoacidosis might, but that's a whole different animal). That you're at risk of hypoglycemic episodes (probably not, as long as you're producing some insulin and not eating a lot of carbs, your blood glucose will remain pretty stable).
It's funny though, that no one tells vegans or vegetarians that their diet is "too restrictive", "excludes essential nutrients", or is "too difficult to maintain long term". All of which is said of LCHF, even though vegans are at risk for low levels of vitamins D & B12 and the LCHF diet covers that.
As for the whole "meat and animal fats are bad" meme. Umm... we're animals. We're made of meat and animal fat. As long as the source was healthy (dubious with modern factory farming) then animal products are an efficient form of nutrition. For omnivores and carnivores, and people are omnivores. Herbivores are different, but even they're not really designed to live on grains.
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comments.
You may comment here or there via OpenID even if you do not have a Dreamwidth account.
The doctor says you need to lose a few pounds. (Trust me, doctors *always* say that. Even when they could stand to lose a few more pounds than you.) Your blood pressure's a bit high (whose isn't in the doctor's office. Between sitting around waiting, especially after fighting traffic to get there on time, and being a bit nervous it's not surprising if you have "white coat hypertension").
So they take an armful of blood, give you a prescription for BP medication, a lecture on weight loss and possibly the recommendation to cut back on red meat and animal fats, eat more healthy whole grains, cut back on caffeine, and drink less soda and alcohol. You make an appointment to come back in a couple of weeks to review your BP and the test results.
You come back. You're stressing about the results of the test, the traffic sucked, the doctor's running late. Guess what -- your BP's still high. Also your cholesterol. And you haven't lost any weight (it was only 2 weeks so what did they expect?). And the frosting on the cake? Your blood glucose is at pre-diabetic levels.
You get more dietary instructions. Well, the same ones, reiterated, but with emphasis on how you're at serious risk for type 2 diabetes unless you change your ways. You probably get an increase in your BP meds and a statin. And an appointment for 3 months later.
For 3 months you take your meds. You cut back on meat, drink decaf coffee and decaf diet soda, switch to Miller or Bud Lite, eat lots of healthy whole grains. And feel pretty craptacular. You get more digestive upsets: constipation, indigestion. You're not sleeping so well, your joints are aching. You wonder if it's just part of getting old, even though you're only in your 30s.
After 3 months you've lost maybe 5 - 6lb. You go in for another round of blood tests, then back to the doctor. Still with the white coat hypertension -- made worse by the fact you feel like death warmed over and are stressing over the results. Despite doing what you've been told, your fasting blood glucose is up again -- this time it's well into the diabetic range. Your LDL cholesterol's down a bit, but your HDL is too low and your triglycerides are too high.
The doctor sends you for a glucose tolerance test. You fail. Congratulations. You now have type 2 diabetes.
This begins an endless round of doctor visits (your PCP and an endocrinologist), nutritionist visits, drugs, blood tests -- including stabbing yourself in the fingers several times a day. You take drugs to boost your insulin production, to prevent your liver releasing glucose, etc. You eat the low fat, high grain diet the nutritionist recommends. You feel as if you're constantly eating -- 3 meals and 3 snacks a day -- yet you're frequently hungry, you're thirsty all the time and drinking decaf diet soda by the gallon. You have no energy.
And you don't get better. You start to get numbness in your feet. Small scratches and bruises don't heal the way they did. You get up several times a night to pee.
Eventually your pancreas starts to fail and you have to take insulin. Which means you have to eat at regular times and count carbs. Your life becomes completely focused on what you can and can't eat, and when you can eat it.
Everyone is very sympathetic, but this is just how it goes. Once you're a diabetic this is the course you're on. The signposts are there, the only variable is how long it takes you to reach the various milestones: heart attack, stroke, kidney failure, gangrene and amputations... it's all there in your future. Implacable, inevitable. All you can control is how long it takes to get there.
Some people can't deal with the regimentation and the constant attention to diet. They don't take the meds, they ignore the dietary advice and continue to consume the SAD with its emphasis on grains and sugars. Not surprisingly, these non-compliant diabetics don't last long.
But is this progression really the only way to go?
We've forgotten a lot of what we knew about type 2 diabetes 40+ years ago. Back then the advice given diabetics (in the UK at least) was to eat a diet that comprised less than 50g carb/day. There were fewer medications (and fewer diabetics). It wasn't that difficult to manage on that amount of carbs -- take out the added sugar, cut out most fruit, and limit bread and other grains (there were several bread-like products made for diabetics which were pretty nasty, but very low carb)
In the intervening decades we've seen a huge increase in processed foods, artificial sweeteners, and new improved medications for diabetics. As a result the diabetic diet has suffered from "carb creep". Today the ADA recommends a diet with between 150 and 200g carb/day. On that amount of carbohydrate, a diabetic needs drugs and insulin to survive.
So enter the various low-carb diets: Atkins, South Beach, and the various Paleo/Primal/Caveman diets. They go counter to conventional wisdom. But they work. And the Standard American Diet doesn't. Yet the conventional wisdom continues to insist that animal fat is bad for us, that dietary cholesterol causes heart disease, even though that particular hypothesis has been found to be flawed. Of course there's money to be made out of diabetics -- the endless rounds of doctor's visits, the prescriptions, the how-to books, the recipe books, the surgeries, and eventually the dialysis.
I doubt if there's one right way for everyone to maintain their health in the face of this challenge, but the LCHF thing seems to help a lot of people quite quickly and quite dramatically.
However it takes a huge leap of faith to turn one's back on medical advice and conventional wisdom. You get all sorts of well-meaning friends telling you that you'll "damage" your kidneys/liver/pancreas. That your brain needs 130g glucose a day (it might, guess what -- the liver makes all the glucose you need). That ketosis will kill you (nope, ketoacidosis might, but that's a whole different animal). That you're at risk of hypoglycemic episodes (probably not, as long as you're producing some insulin and not eating a lot of carbs, your blood glucose will remain pretty stable).
It's funny though, that no one tells vegans or vegetarians that their diet is "too restrictive", "excludes essential nutrients", or is "too difficult to maintain long term". All of which is said of LCHF, even though vegans are at risk for low levels of vitamins D & B12 and the LCHF diet covers that.
As for the whole "meat and animal fats are bad" meme. Umm... we're animals. We're made of meat and animal fat. As long as the source was healthy (dubious with modern factory farming) then animal products are an efficient form of nutrition. For omnivores and carnivores, and people are omnivores. Herbivores are different, but even they're not really designed to live on grains.
This entry was originally posted at http://hugh-mannity.dreamwidth.org/1045853.html. That post currently has
comments.
You may comment here or there via OpenID even if you do not have a Dreamwidth account.