Friday, December 28, 2012

An obvious question is "why is there confusion about something so basic as proper nutrition" ? In the world of medicine, with so many technological advances, you would think that someone could once and for all do a study, analyze the data with lots of smart computers, and give a definite answer as to what is the best way to eat.

Think of it this way: when you go to the doctor with a sore throat and a fever, and the doctor says you have a "nasty throat", is there any question that you need antibiotics ?  if you break a bone in your foot - is there any question that you need a cast ?

Well, in fact, there is. As time goes on, we learn things in medicine that challenge previous "knowledge". The vast majority of people with a fever, sore throat and pus on their tonsils, do NOT need antibiotics, as the cause is a virus (which does not respond to antibiotics). And some bone fractures in the foot do not need a cast. More than that, sometimes you cast even when there is no fracture. When I went to medical school in the 80's, I was taught a lot of "facts". if I were to practice medicine today according to those same facts, I would occasionally be held liable for malpractice.

So medicine is in a constant state of learning. And when dealing with something as complex as diet and its effect on health, it is not surprising that there would still be such controversy.

But that does not help "John" or "Mary" who today, need to do something to help improve their health. That does not help them when they need to find a way to deal with their high blood pressure or diabetes.

Let me already jump to the end of my train of thought and share with you some simple conclusions about ALL diets, whether low carb, high carb, vegetarian, high animal protein and so forth. There are some common threads to all of these diets. And it is those threads that make up the fabric of a healthier eating style. Along with these conclusions about all diets, I also sneak in some of my personal recommendations.
  1. Reduce your intake of processed foods. Let me already be clear - this does not mean that you need to dress like Grizzly Adams and chew on organic free range tree bark. It means simply that when possible, always choose less processed foods. So, if you can eat a can of tuna instead of "out of the box tuna pancakes" then great. If you can have freshly made chicken (yes, even with the skin) instead of chicken nuggets (even when they are fortified with B12) then eat the plain chicken. When you can have a baked potato (with yes, its atmospheric glycemic index) instead of french fries or potato pancakes (with real potato flakes !!), choose the baked potato.

    Almost every diet requires that you reduce processed foods. So if you are low carb, you will skip the pizza because of its crust. If you are low fat, you will skip the pizza because of its cheese and oil. This is one of the reasons it is so hard to differentiate between many diets - because as unique as they may be, they still have such a basic tendency in common - which is to reduce your intake of many problematic foods.

    I feel comfortable saying that JUST this one basic principle would be transformative to a large number of people and would potentially curb their tendencies towards many diseases.
  2. Do not drink too many calories. if you have a choice between drinking orange juice and eating 2 fresh oranges (with a glass of water), then go for the regular oranges. Many juices may have added sugar and most often deny you many of the healthier benefits of fresh fruit or vegetables. And if you have a choice between drinking regular soft drinks versus diet drinks, yes, it is better to skip the sugar.

    One of the problems with drinking calories is that you don't really "feel" them. As such, you can drink a liter of regular sweetened cola without feeling full. Moreso, you can easily keep drinking such fluids until your calorie count approaches that of Michael Phelps on one of his heavy training days. It is just THAT easy to drink extra calories.

    Does this mean "don't drink milk". Or what about a glass of juice every morning with breakfast? is that so bad ? And then there is the issue of a glass of wine every day as being the magic potion to a long and healthy life (at least in France). So are ALL of these verbotten ?

    This brings us to our next basic principle.
  3. Don't think in absolutes. You get the impression from some diet plans that if, say, on a low carb diet, you take in ONE extra gram of carbs, you will explode in a fashion that would qualify you as a weapon of mass destruction. Contrarily, for those on low fat diets, you would sometimes think that you must live your life in a way that makes the Essenes look like the ultimate party animals - "no cake for you. No shtrudel. No home made apple pie. No No No".

    The key in all of this is not to get extreme. It is great if you have managed to stabilize your weight and get off your diabetic medication by sticking to a low carb diet. But if you do break down and once a year/month/week have a brownie, the world will not end. MOST people need to eat better and "cleaner". But they do NOT need super strict eating regimens to achieve their health goals. So, relax and enjoy life, at least once in a while.
  4. It actually is not about your weight. I realize that most people start a diet primarily to lose weight. Well, ok, the vast majority. Alright. EVERYBODY starts a diet to lose weight. And because of this, the word diet is immediately associated with hunger, misery, punishment, new shoes, and so on.

    But believe it or not, there really is such a thing as eating to improve one's health INDEPENDENT of weight. More so, a person could have quite a few "extra pounds" on their body  and still be fit and healthy with perfect blood sugar and low cholesterol.

    The point is that if someone switches from a poor quality, high calorie way of eating to a healthier way of eating, they will lose weight as a by product. And well before they hit some magical number on the scale, they will likely have already dramatically reduced their risk of heart disease, cancer, stroke and lots of other fun diseases.

    Contrarily, if your only focus is a number on the scale, then you will have a much greater risk of losing and then regaining weight. If the way you choose to lose weight is not sustainable (such as 500 calorie a day diets, or 3 hours a day of intensive aerobics), then once you lose the weight, you will revert to your "old habits" and watch your weight rise again.

    As hard as it is for so many people to accept, our natural state is NOT a six pack abdomen. Models and fitness professionals, whether female or male, live a very strict lifestyle which demands a great deal of physical activity and/or very controlled food intake. And yes, some of them (maybe most of them) have a genetic gift that lets them stay leaner than the "average bear". It is interesting to look at some of the great athletes of 20, 30 and more years ago, to see how they look when they are older. And there are those who once had the bodies of gods but who now look like they ate one of those gods. And that is called age and life.

    Give yourselves a break. Accept your bodies, strive for better health and THEN enjoy the extra prize of losing a few pounds in the process.
  5. There is a difference between someone who is 200 pounds overweight and someone who is 30 pounds overweight. I am always astounded at how the exact same principles of eating and exercise are touted for people who need to lose some weight versus those who are trapped within a morbidly obese body that even limits their ability to breath.

    When a person walks into a doctor's office with a 20 year history of trying to lose weight, who is already diabetic and after a heart attack, and is carrying 200 extra pounds on their body, does it seem reasonable that their treatment should be "walk 20 minutes a day and eat green leafy vegetables". Would these things help ? They might. But the likelihood that this is the "cure" is very small. And to attack such people with vicious and hateful comments, blaming them for being "too lazy or stupid" to lose weight is nothing short of EXTREME cruelty.

    Can you imagine screaming at a young, severely underweight girl because she refuses to eat? Can you imagine a doctor telling a person suffering from anorexia that she is "being silly"? Can you imagine it ever working to just tell such a person that she needs to eat more to be healthy? Yet when it comes to obesity, it is "clear" that the only problem is laziness and gluttony. Sometimes those people who claim to be the most tolerant of different view points, cultures and people in general, have NO tolerance or sympathy for the obese. Why is that ?

    So, for those who have a severe weight problem, you will most likely need professional help. Modern medicine has a number of options to help people with severe obesity. And it is NOT any sign of personal failure when you struggle with your own weight. And for those who do not have this issue, rather than pat yourselves on the back congratulating yourselves for clearly being superior human beings with amazing will power, take a Valium, put in between your teeth and stop talking.
  6. Question everything. Trust no one. Or as the greatest physician of all time, Dr Gregory House, has said, "Everybody lies".

    Whenever you flip on a youtube video and see an "expert" talking about any topic, you assume that they must know something. No one would speak authoritatively about a topic they were not experts at. And if such a presenter states that the "literature clearly shows ...", then he or she must be well read and really smart. How is it then that there are fundamental arguments over the same sets of data ?? How can two people quote the same research and come to opposite conclusions ?

    There are studies often quoted in the health world that are the "go to" study to prove a point. And yet, you will have authorities (what does that mean, you ask?) who challenge the conclusion of that very study. More than that, you will have people delve into the actual data collected for that study, re-analyze it, and come to very different conclusions.

    So how is anyone supposed to know who to trust and what to do? I have no easy answer. The march to knowledge is a slow one. And there are many points along the way that require one step back. We are getting better in the sense that more scrutiny is in place whenever anyone makes a grand claim. Still, even pure research can be tainted. Sometimes it is a matter of trial and error. So, if one treatment does not work, you try another. If one diet does not work for you, you try another. The key is to do things slowly and under supervision to really track success or failure. But it is not easy and again I say, I have no magic answers to make you feel safer.

    But consider this: we must be doing something right because people are living longer and not dying of simple infections, at least in those areas that have access to proper medical care. So, it is fair to say that overall, Penicillin is a good thing. But low carb versus low fat ? Still not clear.
  7. Give yourself time. If I told you that I lost 10 pounds in 3 months on my "new super eat anything before 12 and then only fat until 2 and then only fiber until three" diet, would you consider that a success or failure? I think most people would say "nice job" but under their breath would say "who notices 10 pounds when he needs to lose 70".

    On the other hand, let's do some simple math. If this same person CONTINUES to lose weight at the same rate of 10 pounds every 3 months, then in 1 year, they will lose 40 pounds and in 2 years, 80 pounds. Now in practice, weight loss usually stops at some point (sooner than you want). But you should never judge the success or failure of a new healthier life style based on the  weight you have lost in the first weeks. What you should be able to see very soon after starting a healthier lifestyle is improvements in your blood tests. You should see your blood sugar and cholesterol improve (if they needed improving) within the first month. The degree of improvement will depend on how high these were before you started, and how much of an effort you are making ("skipping desert" versus transforming your whole way of eating").

    But again, give it time. Do NOT be discouraged. Think "how will I feel and look" in a year, not in a month. 

This is not the complete list of all common threads, but I think it is a good start. It definitely helped me put things in perspective.

Thanks for listening

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