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What is Paleo Truly Guilty Of? – Carb Addiction and the Industry That Supports It

17 Feb

When people are passionate about things, they tend to get very defensive.  Question someone’s child, and they are bound to get upset in a hurry.  I certainly do!  So why is it people get so defensive when you start explaining the Paleo diet to them?

Today I saw a lady at my office.  Fairly typical middle-aged, over weight female with poorly controlled diabetes.  She recently started on an insulin pump but her glucose control is no better at all.  I had a suspicion why, and again started to question the details of what she eats.  Of course, she eats carb after carb after carb.  Whole wheat this, and low fat that.  She has tried to cut the carbs in the past, and actually had pretty decent success, but quickly falls back into your carbilicious ways.  Why?  Why go back when a change in diet shows clear improvement in her sugars?

Another gentleman today saw me for his second visit with me.  He changed from another physician because he heard I was good at treating diabetes, and felt his prior physician was not doing a good job.  During his first visit he explained what he was looking for; excellent sugars with minimal medications, and to be able to eat what he wants.  No problem right?!  Over around 20 minutes I proceeded to deflate his balloon to the point it may have actually been a black hole by the end of the visit.  He was very frustrated because his sugars were regularly bottoming out, yet his Hemoglobin A1C (90 day sugar average we use to direct care of diabetics) was still too high.  He was essentially convinced that the labs were repeatedly wrong.  He swore his sugars were always “around 100.”  So, luckily for me, and unluckily for him, I did a 72 Hour Glucose monitor on him.  This is a device that is connected to your belly via a microscopic fiber, and it checks your glucose every 5 minutes for 72 hours.  What did we find?  For three days in a row the pattern was clear…  Every evening his sugar shot up around 7:30 like one of the Blue Angels during an air show.  It would hover around 400 a few hours, then slowly drop overnight.  In the morning, as he would typically skip breakfast it would plummet.  By noon he would eat a “sandwich and chips” and it would shoot up to around 300 for a few hours before things started again before dinner.  So, clearly his prior physician was doing a terrible job (insert sarcasm here) and all I had to do was change a few things up and it would be ok!

On todays visit we reviewed the 72 hour glucose monitor, and I broke it down for him that if HE wanted to control his sugars we could do it, but HE would have to make some significant changes.  What kind of changes?  Changes of OMISSION.  I started to tell him the typical Paleo diet rules…and he became, you guessed it, very defensive.  “But how do I eat a sandwich???….”

I would love someone to please answer this question for me; What is so terribly crazy about the Paleo Diet?  You hear it talked about on the news and they make it sound so revolutionary or “different.”.  Simply stated, Paleo is not about what you eat, it’s about what you DON’T eat.  The Paleo diet does not ADD anything to your diet that is out of the ordinary, extremely controversial, or generally crazy.  Even the devil that is an egg is getting off the hot seat lately.  All it truly does is OMIT certain things from your diet.  But not all diets of omission are so highly scrutinized.  Remove meat and become a Vegan and it’s “chic and trendy,” cut out carbs and it’s reckless and dangerous!  Give me a break!  So why is it so crazy?  Why are people so, and I mean this literally, offended by the notion of changing to a Paleo lifestyle?  It’s because they are passionate about their carbs…

People are addicted to carbs.  Tell a heroin addict you are going to take away their heroin, and they get very defensive.  Tell a carb addict you are going to take away their pasta Primavera and it’s time to break it down Bruce Lee style.  Let’s look at this simply, eating Paleo allows you to eat meat, vegetables, fruit, eggs, and nuts.  All these are 100% natural, nothing fancy here.  Please, how is this dangerous or controversial?  The extra meat you eat to replace the pasta is dangerous?  “But there is no data that so much meat is good for you…”  Well guess what, there is plenty of data that too much pasta is BAD for you.  Want data?  Talk to my two patients above.  They both love pasta, and they are both diabetics in their 50’s who keep eating pasta and can’t control their blood sugars.

Can meat hurt you?  Can vegetables hurt you?  Can fruit hurt you?  Can eggs hurt you?  Can nuts hurt you?  Barring actual allergies, I say the answers are no.

Ok, let’s look at the other side.  Can dairy hurt you?  Can grains hurt you?  Can sugar hurt you?  Can artificial crap hurt you?  I’m going to go with yes on these, and there is science to prove it.  (See rising rates of diabetes, lactose intolerance, fatty liver, cancer, auto-immune disease etc, etc)

So, what is Paleo truly guilty of?  In my opinion, it is guilty of exposing people for what they are…carbohydrate addicts.  It can’t possibly be guilty of making people eat un-natural foods, or unrecognizable concoctions companies sells as “food.”  It’s not a fad diet, as fads make you eat things that come in and out of style.  What is a fad anyway?  It is defined as: an intense and widely shared enthusiasm for something, especially one that is short-lived and without basis in the object’s qualities; a craze.  Last I checked meat, vegetables, fruit, eggs, and nuts have been around a long time.  Probably a little longer than a tortilla chip or fat-free cheese.  A rice cake…now that was a fad!

What do addicts do?  They generally know what they do is bad for them, and they have periods of clarity where they do better.  Eventually though, the pull of their drug of choice draws them back in.  Or, they slip up and use just a little and BAM…right back to square one.  They feel shame for their addiction, people look down upon them for it, and they wish so badly they could make a permanent change, but they always fall back into old habits.  Now, imagine a heroin addict who is advised to control the addiction by sticking with “moderation” because of course, everything is good in moderation right?

Sadly, if you insert carbs as the addiction in this scenario, you might as well see pictures of my two patients above.  They literally can’t imagine life without eating their daily carbohydrates.  There is real fear and confusion when I try to take away what makes them feel best. Heroin is clearly bad for you, but a loaf of french bread or rice and gravy certainly can’t fit in the same category can they?  Well they certainly are not as ACUTELY dangerous for you, but a long-standing addiction to carbs lead to the same result as any other addiction.  Without the same pattern of addiction is there regardless of the “drug” of choice.

What’s worst than that?  Diabetics are told to control their sugars by using the very carbs they are addicted to in “moderation”…and somehow we are surprised that they can’t stop over eating carbs.  As the Hartwig’s in their book It Starts With Food label it, OVER-carbsumption.  Paleo simply OMITs the drug…and somehow it is a bad thing…  The current food pyramid does the same thing with obesity!  Lose weight by eating the things that make you gain weight in moderation.  It’s a lose-lose situation.

Oh, and one more thing Paleo is guilty of.  It makes the sugar people, and the wheat people, and the dairy people, and the soybean people, and the corn people….you guessed it, defensive 🙂  Their “bottom line” is very defensive about their products potentially being a major cause for obesity and chronic disease.  They rely on the government to make sure that nothing about their industry gets labeled as a potential problem.  Can I blame the government?  Yes and No.  But, that’s a whole other blog post entirely…

Meat, vegetables, fruit, eggs, nuts…these actual foods, 100% natural FOODS can’t hurt you.  Instead Paleo is guilty of simply exposing people, industry, pundits etc for who they are.  They are either addicted to carbs, their livelihoods depend on your carb addiction, or their election depends on your carb addition.  It’s sad, it’s true, and I’m afraid it’s here to stay.

-Ernie

By the way, do you agree with this post?  Do you know people who could stand to hear it?  Do me a favor, share it everywhere you can.  Post on Facebook, tweet it to followers, reblog it, pin it on pinterest to your heart’s content.  In many ways I preach to the choir.  Most who follow my blog agree with these concepts because you already follow a Paleo Lifestyle.  But, many do not.  The only way to bring about change is to spread the word!  So, if you want to help, share away!  Thanks for reading, and thanks for your support.  Please comment all you want, conversation is a good thing!

 
18 Comments

Posted by on February 17, 2015 in General Paleo Discussion, Paleo Advice

 

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How Has My Transition to Paleo Changed My Approach To Treating the Big Three In My Patients?

09 Aug

It has been around a year now since I changed to a Paleo lifestyle in my own life, and I thought it would be interesting to look back on my practice and see how I think I have changed in how I approach three common problems: Hypertension or High Blood Pressure, High Cholesterol, and Diabetes.  I can’t stress to everyone how fundamentally different a “Paleo” way of thinking is compared with what I was taught in school.  Most physicians are simply not exposed to information other than the status quo, and whose fault that it is a long story…so, let’s just look at me!

High Blood Pressure:  Statistically, this is the number one problem that I treat in my office on a day to day basis.  95% or so of hypertension (HTN) is of an unknown cause, and is known as “Essential HTN.”  Even over the 8 years I have been out of training our approach to HTN has changed.  We are much more aggressive from the start in treating people’s blood pressure because the more we study the problem, the more it is linked with medical badness in the form of strokes, heart attacks, and kidney failure (among others).  There used to be something called “Pre-Hypertension,” which is now simply known as Stage I HTN.  There are lots of conspiracy theories on the internet about Statin medicines for cholesterol and the evils that they bring.  Notice this though, you DON’T see much bad press for high blood pressure treatment.  The simple answer for this is that HTN kills, and treating it helps prevent death.  It’s very clear cut, our medication options are affective and affordable, and the standard of care is to be aggressive with medical treatment.

Another interesting thing about HTN is that it does not traditionally respond tremendously to weight loss.  Although you can see modest decreases in blood pressure with the shedding of pounds, it’s not often as effective as people wish it would be.  Don’t get me wrong, it helps, but shedding 15-20 pounds rarely leads to the elimination of HTN medications for the grand majority of people.

The one side of Paleo that does certainly help HTN is the decreased sodium intake which accompanies the elimination of processed foods from one’s diet.  What this does is help control a patient’s BP with LESS medicine in many cases.  I used to tell patients that HTN is like a train rolling down the tracks…it’s always rolling, even ever so slowly, and we would have to increase their meds over time to keep up.  I suspect that lowering sodium intake over time MAY help shut the train down.  As I said, the train will likely still be there, just more under control.  Ultimately if I can control blood pressure and keep it from getting worse I will be happy.

So how has Paleo changed my treatment of HTN?  I recommend Paleo to all as an overall way to best improve their health, but I don’t expect people to be able to stop their BP meds, particularly if they are on multiple meds with difficult to control blood pressure.  I emphasize Paleo to limit lifetime drug burden and keep things controlled with hopefully less medicine.  I never partially treat high blood pressure with “watchful waiting.” Take home: don’t mess with your blood pressure!  If it’s high, see your doctor and control it one way or the other.

Cholesterol:  This is a condition that has certainly changed when it comes to the way that I approach patients.  I have always been very aggressive as a doctor overall, and I was typically aggressive in getting a patient’s cholesterol down.  Don’t get me wrong, I still am!  I just may approach it a little differently.  I’ll concentrate on one particular patient type.

In generally healthy patient’s with high cholesterol, but without a known history of cardiovascular disease or strong family history of CV disease, I am definitely less quick to prescribe a statin.  I have an honest discussion with the patient and explain that we need to decide whether or not to treat their high cholesterol.  I am increasingly ordering a more sophisticated cholesterol profile known as a VAP cholesterol to help make that determination, along with assessing how serious the patient is in changing his/her diet to create a generally healthier cholesterol environment in their bloodstream.  What I’m interested in is lowering the bad cholesterol in their body, and also changing the characteristics of that cholesterol from a more dangerous small/dense cholesterol to a less dangerous large/fluffy cholesterol.  If we can do that with a Paleo lifestyle, awesome! This is ALWAYS my first choice.  If patients are unwilling to do that, the next step is cholesterol meds.  The newer statins have indeed shown the ability to shift particle size in the right direction, but I feel it is no where near as powerful as the shift we can see with a strong Paleo lifestyle.  This is my BELIEF, and it is my hope that over time we will have the data to support that.

I treat people, and some people are more willing and able to approach medical problems with lifestyle changes, while some are simply “give me a pill” type of people.  I encourage, but I do not judge.  I’m honest and realistic with all my patients, and I just want to try to help everyone that I can.  I explain my position, and allow them to take a position they are comfortable with…after all, I am treating THEIR health, not mine!

The use of statins in patients with known heart disease is a very complex topic fraught with questions, controversy, and medico-legal issues I’m not up for entertaining.  It would be easy, but foolish to preach on this subject.  If you have known heart disease I’ll simply tell you: educate yourself, consult a physician you are comfortable with, and come up with a plan together you are each comfortable with.

Diabetes:  This is the condition I probably have been most affected by when it comes to my approach to patients and the Paleo lifestyle.  I have had many diabetics commit to a Paleo lifestyle, and the results have been remarkable.  I am currently working on a prospective study looking at the effectiveness of going Paleo on diabetics over a three month period (but more on that later!).

For me, treating diabetes has always been the most difficult of the big three because of how much a patient’s habits ultimately decide the “success” of my treatment regimen.  Blood pressure high?…I can bring it down no problem!  Cholesterol up?…just take this medicine and you’ll look great on paper in 6 weeks!  Diabetes on the other hand is no where near as simple.  Patient’s can quite easily overwhelm their pancreas’ ability to produce insulin, a medicine’s ability to assist their pancreas, or both!, by simply eating the wrong things.  I became quite frustrated as traditional “diabetic” diets seemed useless at improving LONGTERM control of a patient’s disease process.

My Paleo journey began as a personal one.  I did it to feel better, get fitter, and live longer.  The more I researched the science behind it, the more it was obvious to me that it should be a tremendous treatment for diabetes.  It may not eliminate the treatment of the disease with pills or shots, but it could be a great baseline on which to manage everyone.  Again, there is no argument that elevated blood sugars are bad for you, and must be corrected at all costs.  I see Paleo as an alternative for patients to keep their blood sugars lower with LESS medicine!  In the end, only one thing matters…get those sugars down.  Paleo adds another weapon in the arsenal.

Again, with my diabetics I sit down and explain why I feel Paleo will benefit them.  I do this in detail, and utilize some simple handouts I’ve written up as to how making the right food choices can truly help control blood sugar.  I then discuss the experiences my other patients have had after adapting their lifestyle.  I make it perfectly clear that in my opinion, their best chance for long term sugar control and limiting the meds they will need to use is to adapt an 85-90% Paleolithic lifestyle.  If I can get them to bite, I hand them a flash drive with my clinic’s Nutrition Guide we obtained from our friends at Whole 9 Life.  This is all they need to be successful right in the palm of their hand.  Do all patient’s follow through? Absolutely not.  But, it’s a crack in the armor.  Eventually we will have the discussion again, and the next time they may be more willing to give Paleo a more serious try.  As always…one patient at a time.

I’ll admit, it really bums me out when people won’t give it a try.  I practically beg for patient’s to try it for 30 days because I know they won’t go back.  Literally, I have not had one patient who went 30 days go back to eating non-Paleo.  100% success rate for my patients…not too shabby.

There are many applications of the Paleo diet to chronic disease, but my passion at the moment has to do with it’s application in the diabetic population.  From the hormonal standpoint it strikes at the core of the disease, and offers AMAZING potential for REAL change in people’s lives.  I have so many plans…and so little time…

——-

My personal journey in the Paleo lifestyle is far from over, as is my re-orientation as a PaleolithicMD.  I would have never thought a year ago that I would have changed my personal health and diet so much, or that my views on the treatment of these three diseases would have changed so much.  I certainly would not have guessed I would be moderating this blog in an effort to spread the word that Paleo is a valid addition to the traditional fight against chronic disease.  Basically it shows that you can indeed teach an old dog new tricks!  So, let’s see what the next year will bring!

-E

 
21 Comments

Posted by on August 9, 2012 in General Paleo Discussion

 

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Real Patient Data on an Insulin Pump Patient Plus 1

22 Jun

I saw a lady in follow up yesterday that was a great addition to our growing list of successful “Real Patient Data” series.  She is a 59 year old obese African American female with high blood pressure, diabetes, high cholesterol and sleep apnea.  I’ve seen her for many years and she has really struggled controlling her diabetes.  She actually ended up retiring a little early from her job over a year ago because she was finding it impossible to care for her diabetes and work at the same time.  We ramped up her insulin for a while and eventually convinced her to go on an insulin pump that should have taken care of things.

After starting the pump we saw a great decrease in her Hemoglobin A1C which dropped from above 12 to10 and then to 9.  The problem is that it got stuck on 9 and we have not been able to lower it much more.  I increased the basal insulin pump rate several times, and it just did not have much influence.  We reviewed her diet and she truly does not eat too much or too badly, but she continue to eat her “heart healthy” oatmeal and cereal for breakfast and other carbs that she has been told for years are good for her.

I have broached the subject of Paleo with her a few times, but she never really considered it.  A month ago I saw her and she was convinced her numbers would be better because she had really stuck to her diet and not cheated at all.  The good news for her is that her A1C dropped!  Bad news is, it dropped from 9.01 to 9.00.  Dejected does not touch where she stood at this point.

I talked to her again about Paleo and asked her what she had to lose?  She is a little different than many patients in that she REALLY wants to control her diabetes, to the point that as I mentioned she retired early to be able to concentrate on doing so.  We went over the entire thing again, I really took the time to explain WHY she could not eat the things Paleo restricts, and she finally realized what I already see…what she is doing is not working!  She agreed to give it 30 days and on her way she went.

She came back yesterday and felt pretty good.  When someone really tries to get better over time, and fails over and over, their confidence gets drained.  She had no confidence that Paleo would work, so imagine her smile when I told her that after 32 days of Paleo, her Hemoglobin A1C had dropped from 9.00 to 7.45, and she had shed 9 pounds.  I might add that we made NO adjustments to her insulin pump prior to starting Paleo, so this can be attributed to her diet as nothing else changed.

Several years of frustration corrected by a simple dietary change.  Will she get off her pump?  Absolutely not.  Will she get her diabetes under control?  I truly believe so as long as she can maintain her current diet.  Will we be able to cut her insulin requirements?  I hope so!  This is a real lady, with a real problem, and real problems controlling it.  She had tried hard the traditional way (heart healthy diet and more insulin) and gotten no where.  I don’t think she’ll be going back to the traditional way any time soon!

I’ll also share a quick story about another patient I saw yesterday.  I had spoken to him and his wife 3-4 months ago about Paleo, and they had agreed to give it a go.  He is mid 50’s and healthy aside from his high blood pressure, diabetes, and the stroke he suffered around a year ago!  They missed their 30 day follow up, so I figured they had not done the diet.  As expected they came in and they did not mention it at all (figure they hoped I had forgotten!)  We went over everything, and his numbers looked great.  His blood pressure was perfect, his cholesterol was lower than treatment goals, and his Hemoglobin A1C was in the “non-diabetic” range.  He smiled, looked at me and said “You see, I don’t need that crazy diet after all!”

That’s when I smiled and said “You are right, your numbers are perfect, and we can be happy with that.  My problem is this…your numbers have been perfect for the 4 years I have taken care of you.  They are always perfect…they were even perfect when you had your stroke!  So are you ok with that, having perfect numbers and having a stroke?”  He looked at me with a little smirk as if to say that I love when I’m right; and I do love when I’m right!

As we talked a little more I discovered that they had indeed taken some of my advice, and changed much of what they ate.  He still ate cheese, but had been able to cut much of the carbs from his diet…just not all.  As we looked at his numbers, we saw that even with these minor changes, we saw improvements in his A1C, Total Cholesterol, Triglycerides, HDL, and LDL.  They are not what I have seen with strict Paleo, but they were something.  I encouraged him to keep trying the best he could, and we would squeeze everything out of his dietary changes that we could.  Take home message: In patient care, 50% improvement is better than no improvement!

I hope these patient experiences do two things for everyone.  First, I hope they encourage all of you doing Paleo to keep doing it, and those considering it to give it a try (especially if you already suffer from chronic disease).  Second, I hope it encourages you to talk to others and try to convince them to change their ways as well.  What better gift to another than to help extend their quality of life and limit chronic disease!

Hope all have a great weekend, and keep a look out next week for the first in a series of collaborative posts with Sarah at ThePaleoMom.com!

-E

 
1 Comment

Posted by on June 22, 2012 in Patient Experience

 

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Why I Do What I Do: Check This Out! (Plus a Little Advice)

14 Jun

I hope most of you read my last post about my high school classmate turned patient who after several years of “gentle” encouragement finally decided to go Paleo and has done great. He texted me yesterday after he read the post and told me he is going strong! He is out of town working, and is faithful to his Paleo ways.

I got a wonderful surprise this morning in my inbox in the form of a comment to this post. Here it is…

Thank you for “bitching” at him to change his life. You have also changed mine, I am his mother and I also have diabetes and he has convinced me to start the diet also. I am feeling so much better and my fasting sugar has gone from 178 to 119 in 2 1/2 weeks and I have lost 5 lbs. Great diet, easy to do and I am proud of him and the support that his wife is giving to him and changing the children’s eating habits also. Thanks again Dr G!

Now tell me, how awesome is that!   My friend had often shared his concern about his mother and his desires for her to come see me.  Of course, I would always challenge him that the best way to help his mom change was to change himself. Well, he has listened, and so has she!

I want to take a moment to really commend these two people for changing their lives and giving Paleo a chance. I do not have diabetes and I can honestly say it would be an extremely difficult diagnosis to deal with. I ask all of you to not only encourage those around you with diabetes to talk to their doctors and try Paleo, but to do so with compassion. Most diabetics do poorly with their diet mainly out of a sense of rebellion; they just don’t want to live the life of, or accept the diagnosis of diabetes. If you do not have diabetes, you simply will never understand what they go through on a daily basis. If you are frustrated with a friend or family member because they won’t “listen,” try to put yourself in their shoes. Compassion, not criticism will ultimately lead to success!

Pass it on…

-E

 
3 Comments

Posted by on June 14, 2012 in General Paleo Discussion, Patient Experience

 

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How an Old Classmate, Now Patient Changed His Life With Paleo

13 Jun

Being a doctor is always hard, but at times it can definitely be harder than others.  Taking care of friends is especially challenging as some of you may have experienced.  Most doctors, I believe, especially those who have long-term relationships with their patients, have more than just a business relationship with patients.  After a while you get to know them well, get to know their whole families (often take care of the whole family!), and you genuinely start to care for their well being on a different level.

When taking care of a friend that process is accelertated immediately.  Around 3 years ago an old high school classmate of mine came to see me.  He is a state trooper, in fact a very good trooper, and works in an area of law enforcement that takes a special person.  Growing up he was skinny as a pole, and I was very surprised to find out that he was a very poorly controlled diabetic.  When he came to see me his numbers were horrible, and he was not caring for himself at all.  That said, it was not all his fault!  He had been diagnosed as a Type 2 diabetic, and was really Type 1.  We tested his pancreatic function and it was essentially non-existent.  We put him on insulin, and so began the several years of too infrequent visits where I steadily yelled at him about having to change his life.

When you are young, skinny and healthy on the outside, and a cop; its very, very hard to change your life.  Youth can make you think you are invincible despite a bad disease, add a badge to that and it’s a nightmare!  He would come in and say all the right things, nod his head in agreeance, and come back the next time with worse numbers.  As his insulin requirements went up I talked to him about switching to an insulin pump.  His wife was worried that he would feel it was a liscence to eat as he wanted.  She was right, but he already thought he held that liscence so what harm could it do?

We put him on a pump and he initially did a little better.  His improvement was of course from the pump, but he was soon able to out eat the pump and his numbers worsened again.  Now before anyone says anything, I had several long and frank discussions with my friend about diabetes, what it would to to him, how his wife and kids needed a dad…all that stuff…even how diabetes would lead to premature erectile disfunction; nothing worked.  He just WANTED his cake and to eat it to (pun intended).  It’s so hard to talk to someone who is young, intelligent, and really knows what is going on; yet does not want to change much of what he is doing.  He hoped that, as his wife predicted, the pump would be his ticket to eating what he wanted.  Despite increasing his insulin, and increasing the amount we bolused him before meals, we got no where.

He started to dabble with CrossFit, that was great, but he still did not address his diet in any significant way.  Now it is easy for people in the Paleo community to just say “change your diet man, it’s easy!”  Most people who eat Paleo do so out of CHOICE…my friend felt he HAD to do it.  It is absolutely human nature to fight anything you feel you are forced to do, and he fought corageously!  Now I think he was right in that he was being forced, but it did not make it any easier.  I continued to see him and do my best to scare him into changing.  When I started Paleo myself I immediately talked to him about it.  He did it for a day or so, even texted me a few pictures of his Paleo meals, but it did not last.

On a recent visit we once again discussed his life and health long term.  He has kids, and life was starting to show him that he is not as invincible as he thought.  We looked deep into his kidney function and I explained that although “normal,” it is nowhere near normal for someone his age.  He realized that his body was changing.  We went over Paleo AGAIN, and he once again told me he would do it.  I didn’t hold my breathe…

I saw him a week ago and for once, he had actually changed.  Even more than that, his MIND had changed that he not only could do this, but that he HAD to.  His wife and kids were with him, she has been supportive, and he finally felt like he was getting somewhere.  More than anything, for the first time I did not have to do any…well, bitching for lack of a better term.  He was on board, he was happy with what he was doing, and he had all the determination in the world to continue.  Essentially I think my friend had finally seen his mortality, and he realized he has way to much to live for not to change his ways.

So what did he accompish in 30 days?

He lost 8 pounds

His fasting sugar went from 198 to 169

His liver functions (AST/ALT) went from 105/51 to 61/37

His Hemoglobin A1C went from 8.46 to 7.32

The numbers are great, but most importantly my friend saw his life for what it is, and he decided to take control of it.  If he follows Paleo the numbers will take care of themselves.  For those who know me they will certainly know who this is about.  He actually ASKED me to be on the blog and wanted a picture posted, but we will withhold for now 😉  He experienced the same thing I did that made me start this blog; the amazement that comes with changing your diet and seeing real results in how you feel followed closely by wanting to tell everyone you know!  I will keep everyone posted on how he does, and once he is a little farther along the way, I’ll try to convince him to write up his experience for all of you. (That statement was absolutely intended to pressure him into doing so!)

-E

 
7 Comments

Posted by on June 13, 2012 in Patient Experience

 

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EVEN MORE Exciting REAL patient Data!

21 May

Ok guys, I was pretty excited because I knew that one of my diabetic patients who agreed to try Paleo was coming in today.  She is in her early 60’s, and has multiple medical problems including diabetes, high blood pressure, high cholesterol, and suffered a fairly big Stroke several years ago.  34 days ago I saw her at my clinic and she was frustrated.  Her exact words were “the harder I try, the worse my blood sugar gets.”  She weighed 212 pounds, and her BMI was 35.  Her labs showed a Fasting Sugar of 176, Hemoglobin A1C of 9.8, Blood Pressure 112/78 (On medicine), Total Cholesterol 174, Trigs 245, HDL 49, and LDL 76.  She wanted desparately to avoid starting more pills, and I went over the Paleo concept with her.  She cringed because it would require nothing short of a complete overhaul of her eating habits.  She agreed with me on one thing though, you can do ANYTHING for 30 days!

So she came back in today.  Her weight was 200 and BMI 33 and she felt much better.  She lost 4 inches off her waist.  Her NON-fasting sugar was 123, Hemoglobin A1C AMAZINGLY dropped to 7.38…a 2.5 % drop in 34 days…unreal.  Her Cholesterol was 160, Trigs 112, HDL 49, and LDL 72.  All in all, these are amazing results.

Here is a lady with a history of a stroke who had tried for years to make changes, and thought she was doing all the right “heart-healthy” things.  Despite those efforts, her HgB A1C was steadily rising, and she feared another stroke.  She made a bold decision to change her life, and the look in her eyes when she heard her numbers and saw the scale told you she would not be going back to her old ways.

THIS…is why I enjoy what I do!

-E

 
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Posted by on May 21, 2012 in Uncategorized

 

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Rising Rate of Childhood Diabetes and the Consequences

03 May

Before we get too far into this post, I need you to click and read this article.

Obesity-Linked Diabetes in Children Resists Treatment

Many posts and books have discussed the link between today’s American carb-based diet and the rise in Type 2, or Insulin Resistant Diabetes.  But, for completion, I’ll quickly give you my simplest explanation of the cause.  When your diet consists of mainly carbohydrates, you live in a state of insulin over activity.  When you take in carbs your body digests them as simple sugars and your blood sugar quickly rises.  In response to this your pancreas secretes insulin whose job it is to shift glucose into your cells and out of the blood stream.  This increase in insulin also does two important things: it makes you hungry, and causes storage of excess glucose in the fat cells as fat.

Over time your body kind of stops paying attention to it’s own insulin, and thus you require more and more insulin to keep your blood sugars under control.  This is what we call developing a resistance to insulin.  If this resistance becomes severe enough, you develop frank insulin resistant diabetes.  Now keep in mind, as your resistance builds, your insulin levels also continue to rise.  So, according to above this will cause you to become hungrier and fatter.  Nice little hormone insulin isn’t it?

We live in a world of simple, cheap carbohydrates being the main staples in the diets of our youth.  More meals come through the car window than from mom’s kitchen.  As a consequence the youth ofAmericaare exposed to highly refined carbs from a very early age that causes them to live a life of insulin over activity.  What used to be a disease of 40 and 50 year olds is becoming a teenage disease.

Diabetes is what we call a coronary artery disease “equivalent.”  That means that when we treat a diabetic patient we ASSUME they have heart disease.  If we look for it, it will be there.  That is why diabetics traditionally have very high rates of heart attacks and strokes.  At it’s core, diabetes kills people by it’s affect on our vascular systems.  Once diabetes ruins our arteries it slowly kills our eyes (blindness), heart (heart attacks), brains (strokes), kidneys (kidney failure), circulation (amputations)…etc.  Trust me, you do NOT want diabetes; and if you have it, you want to control it.

So enough boring stuff, what about this article?  Just listen to what it says!!!  Kids are getting diabetes more, and our treatment doesn’t work well in them.  How scary is that?

There is a clear pathway that leads to insulin resistance, carbs, so there is no way to explain the dramatic rise in childhood obesity other than what we are feeding our children.  If we do not stop and address our diets fast; kids will get fatter younger.  This will lead to diabetes earlier in life, heart attacks and strokes earlier in life, disability earlier in life, and death earlier in life.  This is not rocket science people!  And let’s not even think about cost.  We can’t afford to care for everyone now…try adding thousands of people to the hemodialysis rolls soon.  America HAS NO FUTURE if this does not stop!

So, how does Paleo help?  When you eat a Paleo diet you are eliminating all food items that can either increase systemic inflammation (topic for another post) or cause a rapid increase in insulin secretion.  Essentially you cut off the fuel supply to the fire, and stop everything downstream from happening.  Seems so simple doesn’t it?

It IS simple, so when will we all figure it out?

-E

 
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Posted by on May 3, 2012 in General Paleo Discussion

 

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Real Patient Data – A 65 Y/O Diabetic Male

27 Apr

Over time I plan on sharing patient experiences from my practice of people to take me up on my challenge to try a Paleo lifestyle. As the number grows, I continue to be impressed with the early results.

I have taken care of this gentleman for around 3 years. When I first met him his diabetes was tolerable, but not good. The key measurement for a diabetic is what is called a Hemoglobin A1C. It is a way for us to know the patient’s 3 month blood sugar average, and the goal for a diabetic is <7. His was initially around 8.5, and we were able to lower it to 7.5 with medication changes. At that point we got stuck, and began discussing insulin shots. On a recent visit he asked if he had any hope to avoid insulin, and I took the time to detail the Paleo diet, and why I felt it would be beneficial to him. He eagerly accepted the challenge, and went on his way with an appointment to return in 30 days. Here’s what we got…

Traditional Diabetic Diet to Paleo Diet 30 Days

Weight 255 to 245
Blood Pressure 140/80 to 116/70
Hgb A1C 7.36 to 6.57
Total Cholesterol 186 to 141
LDL (Bad) Chlesterol 98 to 60

Remember, we are talking about 30 days here. In real numbers he dropped his average blood sugar from 164.5 to 141.8. Please don’t forget, this is in 30 days, so his prior 60 days not on Paleo are still in the equation. For a true A1C we would have to get 90 day data (which we will in a few months!) If a drug company developed a drug that could get a 0.8 drop in Hgb A1C, they would be sitting on a solid little chunk of gold. Let’s not also discount the significant improvement in weight, blood pressure, and cholesterol. Pretty amazing if I say so myself.

So, what does this mean? We will have to see the sustainability of it as we continue to follow him over time. Now, not everyone may respond as well, and some will respond less. As I continue to interact with my patients, I will continue to fill everyone in on the results. I hope this is an encouragement for some, it certainly is to me.

Ernie

DISCLAIMER: Although I am a physician, this information is not meant as medical advice for you or anyone you know. These are simply my experiences with patients and the Paleo diet. Please consult your personal physician before making any significant changes in your diet or medication regimen.

 
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Posted by on April 27, 2012 in General Paleo Discussion, Patient Experience

 

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