Archives for 2008

How would you react if, instead of asking for a handout, the next bum you see — smelly and dressed in rags — approaches you and offers to be your "success coach" for a fee?

Have you pondered anything quite so absurd in a while?

Coronary heart disease prevention and reversal specialist, Dr. William Davis, wonders why it is, then, that people tolerate the advice of fat and even obese dietitians, who perhaps number in the thousands in hospitals and clinics around the country.

When I go to the hospital, I am continually amazed at some of the hospital staff: 5 ft 4 inch nurses weighing over 200 lbs, etc.

But what I find particularly bothersome are some (not all) hospital dietitians – presumably experts at the day-to-day of healthy eating — who waddle through the halls, easily 40, 50, or more pounds overweight. It is, to say the least, credibility-challenging for an obese dietitian to be providing nutritional advice to men or women recovering after bypass or stent while clearly not in command of nutritional health herself.

I note the same thing in general, both when visiting a hospital and daily around a large medical clinic less that a block from our residence. In fact, it is quite rare to see any lean person going in or out of that building, scrubs or "civvies."

Dr. Davis thinks they're by and large following the standard dietary advice. Perhaps they are, perhaps not, but here's the thing: "frankenfood" manufacturers have become ruthlessly clever, and that goes even beyond the political clout they and grain growers enjoy. Low fat is good? Food manufacturers deliver. They line the shelves with products that are low in fat, but high in sugar. Whole grains are healthy? They line the shelves with appealing — to many — products based on grains, and bonus: low in fat. Butter is bad? They give you margarine, for decades. Oops… Trans fats, now universally recognized as poisson. Alright, so now let's create a whole new line of synthetic "spreads" based on vegetable oils — formerly used as industrial machinery lubricants — extracted by heat and petroleum solvents that have to be deodorized to eat. Perhaps it won't take another four decades to determine that those are as bad or worse than the margarine they replaced. And what will they think of next?

Sadly, the "healthy, whole grain" message also contributes to heart disease via drop in HDL, increased triglycerides, a huge surge in small LDL, rise in blood sugar, increased resistance to insulin, tummy fat, and diabetes. Yes, the diet provided to survivors of heart attack increases risk.

The "healthy, whole grain" message also enjoys apparent "validation" through the enormous proliferation of commercial products cleverly disguised as healthy: Cheerios, Raisin Bran, whole grain bread, whole wheat pasta, etc. The "healthy, whole grain" message, while a health disaster, is undoubtedly a commercial success.

I'll bet that our fat dietitian friend enjoys a breakfast of healthy, whole grains in skim milk, followed by a lunch of low-fat chicken breast on two slices of whole grain bread, and ends her day with a healthy meal of whole wheat pasta. She then ascribes her continually climbing weight and size 16 figure to slow metabolism, lack of exercise, or the once-a-week piece of chocolate.

Wheat has no role in the Track Your Plaque program for coronary plaque control and reversal. In fact, my personal view is that wheat has no role in the human diet whatsoever.

Dr. Davis, a cardiologist who used to make a lot of money doing stents, angioplasties and other lucrative cardiac procedures gave that al up and now partially subsidizes a heroic and revolutionary program to detect, prevent, and even reverse heart disease. You don't have to take his ideas seriously, but you very well may live the consequences of them nonetheless.

He offers a list of relevant posts that I highly recommend reading.

• What's worse than sugar?
• The Wheat-Deficiency Syndrome
• Nutritional approaches: Large vs. Small LDL
• Are you wheat-free?

That last link has a bunch of testimonials, so if any of this sounds insane or unbelievable to you, you'll want to have a look at what people who've done it have experienced.

While driving down to the in-laws to spend the holidays, we listened to several of Jimmy Moore's podcast shows and one of them was a two-part Q&A with Dr. Mary C. Vernon, a physician who treats diabetes and other ailments by putting her patients on a low-carb diet.

At one point, she pointed out that all diets (presuming fat loss is the objective) are high fat diets.

Get it?

Let's say you have 50 pounds of excess fat you'd like to lose in order to get down to around 15% body fat or thereabouts. Assuming you'll be successful, what does that imply? It means, necessarily, that you're going to metabolize 50 pounds of your own fat in order to accomplish your objective. So, even if you do this by means of a "low-fat" diet, it's still high-fat, as you've got 50 pounds or 175,000 calories worth of fat to burn through. If you do it in six months, that's almost 1,000 calories of fat per day. Presuming a basal metabolism of 2,500 calories, and what you do eat is 20% fat (a "low-fat diet"), then you'd be eating 300 calories of fat and 1,200 calories of protein and carbs combined, for a total consumption of 1,500 calories. The remaining 1,000 would be coming from your own fat, released into your bloodstream and metabolized. Out of the total 2,500, 1,300, or about 50%, are calories from fat, and so:

All diets are high-fat diets. Now do you get it?

A couple of things to note is that, one, "experts" are full of it when they heckle low-carb on the basis that it's the spontaneous reduction in caloric intake that's responsible for success on low-carb. In essence, they're talking, pretending to make a point, but aren't saying anything. When you lose weight, fat doesn't just disappear, it gets "burned" and counts toward your caloric expenditure (if not your actual intake). Second, it's even more revealing when they make the point, as they often do, that dieters on low-carb often lower their actual intake to levels below similarly disposed dieters on low-fat or plain old calorie restriction.

What this all adds up to is that low-carb — beyond the metabolic advantages of stabilizing blood sugar and thus, insulin — is most effective over time at curbing hunger. In the end, this is the way to fat loss of important proportions. Either way, you've got to burn through your own fat, so it stands to reason that a diet that both satisfies your hunger relative to low-fat or "balanced" restricted, as well as keeps insulin low so your fat stores can more easily be released, is probably the best strategy you can implement. Moreover, the two are, of course, related. You're not hungry (or as hungry) because you're getting the energy from your own fat, while the low-fatter or balanced, "everything-in-moderation" genius is perpetually hungry because both diets typically involve a high proportion of carbohydrate, lots as crap frankenfood. Insulin remains elevated, body fat remains locked in, they're hungrier, lose less weight, fail, and then get invited on Oprah because misery loves company. (I was going to do a post on Oprah's 1,000th diet failure; still might, but it may instead come in bits & pieces asides and diversions.)

Want a laugh? Next time someone mentions that they're dieting, ask what method. When they tell you low-fat — so you can congratulate them on their "wisdom" and they can feel like one of the crowd, which other than being oxymoronic, curiously seems important to a lot of people — you can inquisitively inquire that you thought they meant they were trying to loose weight. When they say they are, you can say, oh, then you meant a high-fat diet. Get it? How long do you think you can keep that up?

When finally you've explained, and they've understood, you can then ask them how come they're not afraid of clogging their own arteries with all the fat they intend to be releasing into their own bloodstream.

Isn't the age of ignorance grand? Well, at least we can have some fun with it.

I just gave $100 to Wikipedia.

I've heard all the stuff over the years about how it can be unreliable, or worse, to which I say: then go fix it! That's the whole point. If you don't like what you see, think it's inaccurate, plain false, or could be improved, then do something about it if you care. If you don't, then it must not be that important to you. For me, for the things I reference — mostly historical or scientific things of import to non-trivial people — I find it to be not only adequate, but frequently amazing. The idea is brilliant and I'm happy for my friend Jimmy "Jimbo" Wales whom I've never met in person, but had frequent email and USENET exchanges with from about 1995 – 1999 or so. Sadly, I lost touch with him after that (Diana, if you know how to reach him, could you clue him into this post — and my pseudonym from back in the day?).

Here's what Jimmy has accomplished.

At its core, Wikipedia is driven by a global community of more than 150,000 volunteers – all dedicated to sharing knowledge freely. Over almost eight years, these volunteers have contributed more than 11 million articles in 265 languages. More than 275 million people come to our website every month to access information, free of charge and free of advertising.

But Wikipedia is more than a website. We share a common cause: Imagine a world in which every single person on the planet is given free access to the sum of all human knowledge. That's our commitment.

I can imagine getting pretty excited about such a lofty goal.

So, if you use Wikipedia yourself, or, you enjoy other resources (such as this blog) that make heavy use of it, won't you consider a donation today?

I haven't actually listened to it, yet. Today was spend driving from San Jose, CA down to Vista, CA for the holidays. Coincidentally, Bea and I listened to a number of Jimmy's shows that I'd loaded on my iPhone. I synced up yesterday, and, it turns out, mere hours prior to this latest episode.

I feel quite confident recommending it to you even in advance of listening. I'll probably do so tomorrow.

Here's the entry from Jimmy's main site, and here's the one from his show site.

Hey, anyone wanna up their HDLs by a whopping 1.7? So, for instance, if you're on the low end of what's considered acceptable (40 mg/dL), you might be able to get it all the way up to 41.7 on average, maybe even 42 is in your future if you respond to the advice of the authorities in an above average way.

Stunning, exciting news.

"Experts" in nutrition and diabetes are now considering changing the dietary advice for type 2 diabetics.

People with Type 2 diabetes on a high-fiber diet kept their blood sugar under better control when they ate foods like beans and nuts instead of the recommended whole-grain diet, researchers have found. […]

Participants on the low-glycemic diet also saw significant improvements in cholesterol after six months, with increases in HDL, the so-called “good” cholesterol associated with a reduced risk of heart disease, the study found.

It is to laugh. An average increase of 1.7 in HDLs is a "significant" improvement? Increasing your HDL by 1.7 is really measurably associated with a reduced risk of heart disease?

The high-cereal high fiber diet emphasized “brown foods” such as whole-grain bread and breakfast cereal, brown rice and potatoes with the skin on. The low-glycemic diet included beans, peas, lentils, pasta, quickly boiled rice and certain breads, like pumpernickel and rye, as well as oatmeal and oat bran cereals.

Both diets are low in saturated fat and trans fat. Both groups were told to limit their consumption of white flour and to eat five servings of vegetables and three servings of fruit each day.

Participants on the low-glycemic diet saw their hemoglobin A1C levels — a measure of blood glucose levels over recent months — reduced slightly, by 0.5 percent on average, but experienced significant improvements in HDL, which increased by 1.7 milligrams per deciliter of blood on average. Those on the high-cereal diet saw smaller reductions in hemoglobin A1C and slight drops in HDL.

Alright, now let's hear from the Village Idiot.

“We’ve been telling people to eat whole grains for a long time," said Emmy Suhl, a nutrition and diabetes educator at the Joslin Diabetes Center in Boston. "What this study shows is that it’s not enough to have whole grains. It’s these very specific low-glycemic carbohydrates that do a much better job."

Well, Ms. [I presume] Suhl, you really ought to consider not continuing to give people advice that's killing them.

You want HDLs? How about mine, at 106. And what triglyceride levels are you seeing with diabetics following your "eat whole grains" mantra "for a long time?" Given the average in America is continually on the rise, what are you seeing? 180s and above, 200? Mine is 47, sugar. A1C levels? Very low end of the range.

You guys boast of an increase in HDL of 1.7? How about 20? My wife also reduced her triglyceride on my recommended diet by 20 points, down to 52, the very low end.

Ms. Suhl: You're an idiot. And, you're a danger to diabetics.

Later: Want more? I just finally got around to reading Dr. Eades' takedown of this similar study. Have a look. Study organizers Thomas Wolever, Alison Gibbs, Christine Mehling, Jean-Louis Chiasson, Philip Connelly, Robert Josse, Lawrence Leiter, Pierre Maheux, Remi Rabasa-Lhoret, N. Wilson Rodger, and Edmond Ryan — as well as study reviewer Xavier Pi-Sunyer — ought to be ashamed of themselves. Then, they ought to be pelted about the heads and shoulders with rotten fruit, vegetables, and eggs. They ought to recieve no quarter with honest scientists.

Back when I answered some reader questions the other day, I forgot to address a couple of things. Trygve had asked:

Also read that you eat less fat now? why is that? and how much are you eating now of the different nutrients?

He also asked how to get down to 6-8% body fat, a question I’ll answer in the immediate: I’ll let you know when I get there.

First I should clarify that I really don’t know, for sure, that I’m eating appreciably less fat. It certainly seems so (I don’t count anything), but it’s also the case that I no longer obsess over it. That is to say: I just increasingly go with what I have an appetite for and I don’t try to single out animal fat for consumption most times. Sometimes it’s a ribeye smothered in melted butter — or a fat-dominant sauce of my own creation — and sometimes I slightly gorge myself on fruit. There’s an aspect of this that takes time — that is: a year to two. I have a clue on that score, which I’ll save for a future blog. Hint: your body fat composition; i.e., what is your own body fat made of in terms of fatty acids: saturated, monounsaturated, and polyunsaturated, and how long does it take to shift those ratios? Think about that.

I make myself laugh, sometimes. While I was never one to sit in front of a TV and munch on pure junk (well, very occasionally), I did used to munch on sunflower seeds by the pound, in shells. You see, when I was a kid, my dad ate sunflower seeds. He tossed a small handful in his mouth and shelled, ate them, and spit out the seeds one at a time — all “see mom, no hands” style. All very impressive to a five-yr-old. In short order, I could do it too (it’s all in the tongue), and that habit persisted for decades (hundreds of pounds worth). But I’ve never sat regularly and munched sweets, potato chips, or any of the related products. In spite of that, I ballooned to 230 pounds, at least 50 pounds overweight.

But now, if I do munch or graze over a period of hours in front of the tube — which is less and less — I’m just not that desirous, anymore — it’s gonna be nuts and fruit. For fruit, various grapes are my absolute favorite. It’s my new candy. Cherries, sweet and in season, will certainly do too.

The question really raises a much larger issue: the conflation of adequate healthful diet and optimal healthful diet. I describe my diet as “Paleo-like,” which means I generally ascribe to The Paleo Diet as espoused by Loren Cordain. However, I have a really huge problem with his stance on animal fat — which review of his book I’ll definitely get to later. Why? Because the way I eat is in fairly true “paleo” fashion in terms of quality. But he’s telling me that in term of quantity (relative macro-nutrient ratios: protein, fat, carb), I’m not eating paleo. I’m eating too much fat: “artery clogging saturated fat.” He’s full of shit. To wit:

While Stephan is far too much the detached scientist and gentleman, I — on the other hand — suffer no such limitations. That’s why Stephan would never claim to have put Cordain in short pants, but I believe he has.

The Myth of the High Protein Diet

You really owe it to yourself to get a load of that. It’s really simple mathematics. We really can’t eat that much protein for very long (I have tried). For nearly a week I was eating around only 1,000 calories per day, 95ish% protein and I was stuffed — and probably nutritionally starving. My wife had the same experience.

As a result, I will never even experiment with an unsustainable diet ever again (wait until my Oprah post — maybe tomorrow). Why?

The phrase “low-carbohydrate diet” is a no-no in some circles, because it implies that a diet is high in fat. Often, the euphemism “high-protein diet” is used to avoid the mental image of a stick of butter wrapped in bacon. It’s purely a semantic game, because there is no such thing as a diet in which the majority of calories come from protein. The ability of the human body to metabolize protein ends at about 1/3 of calories (1, 2), and the long-term optimum may be lower still. Low-carbohydrate diets (yes, the ones that are highly effective for weight loss and general health) are high-fat diets. [emphasis added]

Stephan always knows how to give you the overview in the first paragraph. Let me get to my point, mix up another cocktail (not paleo), and admonish you once more to read and grasp Stephan’s — what I consider – inviolable deduction.

I think there’s a huge conflation going on. Remember: it only takes one single observation that contradicts the hypothesis to send you back to the drawing board. I’m not going to take time at the moment to cite examples, but what we know is that we have observed healthful primitives (generally no cancer, heart disease, diabetes, auto-immune diseases, etc.) from both extremes. You have the Inuit at about 80-90% animal fat with all but about 1-2% of the balance protein, and you have — on the other extreme — the Kitavans and Kuna, upwards of 50-60% cabohydrate.

What’s the difference? They don’t eat derivative, processed crap produced by large, state-protected corporations marketed  via TEEVEE to your kids, subsidized through the euphemism of “taxation” (in the Animal world: theft; try it: you’ll see what I mean).

Five minutes later: I forget to make my point about the conflation of adequate with optimal nutrition. The point is, we don’t really know. I question whether it’s worth really finding out. My strategy is intermittency in the relative quantitative consumption of naturally occurring fat (animal) and carbohydrate (fruits). Most vegetables are pretty irrelevant to the equation – so eat up.

Back in August, I alerted you to a Bryan Appleyard interview of Art De Vany in the UK Times Online (for a good laugh at lots of naïveté and idiocy, check out a lot of the comments to that article).

Now here comes Bryan again, this time in a short TV interview.

Here's a shot I clipped of his face from that interview.

Here's an "older" photo I dug up. Looks like it should be the other way around — by about 15 years or so.

You see, it's not just about "losing weight." It's about losing fat, getting leaner, changing the composition of your body fat (i.e., the fatty acid profile), and above all, gene expression. They really are willing and able to do the heavy lifting.

You just have to let them.