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

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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My Take on the New Diet Pills Approved by the FDA (Do You Really Need to Ask!)

I’m sure many of you have seen that two new “Diet” pills were recently approved by the FDA.  Once I saw this, I braced myself for the inevitable flood of people coming to my office asking to be prescribed the latest quick fix; and as expected, I was not disappointed.  I’ve had at least 10 people over the last month ask for one of the new pills, and I thought this would be a great topic to discuss in this setting.  I’ve mentioned in prior posts that in my 15 years of training and private practice I have prescribed diet pills a grand total of ZERO times.  So, will these new medicines change my habits?  Lets look and see what we got.

Qsymia is a combination of phentermine and topiramate and has been approved by the FDA for “chronic weight management in adults who are obese, or overweight with at least one weight-related medical condition such as high blood pressure, Type II Diabetes, or High Cholesterol”.  [I would vote that these conditions, although they are “weight” related, should be more properly described as “nutrition” related…but I digress]  That is a quote from the product web page, and lets keep the information coming from the same source, the producers of Qsymia:

-The effect of Qsymia on cardiovascular morbidity and mortality has not been established. [emphasis added]

-The safety and effectiveness of Qsymia in combination with other products intended for weight loss…has not been established.

-Qsymia can harm your unborn baby.

-Qsymia can increase your heart rate at rest.

-Qsymia increases the risk of suicidal thoughts or behavior.

-Qsymia may affect how you think and is associated with difficulty with attention and concentration, memory, and word-finding. Therefore, use caution when operating hazardous machinery, including automobiles [emphasis added]

-The most common side effects seen in Qsymia clinical studies were tingling in the hands and feet, dizziness, change in taste, trouble sleeping, constipation, and dry mouth.

Because Qsymia contains phentermine (a pharmacologic cousin to amphetamine) it is classified as a federally controlled substance, indicating it can be abused or lead to drug dependence.  It’s basic mechanism of action is to reduce hunger and increase the release of serotonin and dopamine in the brain.  It’s important to note that topiramate, also known commercially as Topamax is a seizure and migraine medicine that just so happens to make people feel full.

The other drug recently approved is called Belviq (lorcaserin hydrochloride) and is approved for essentially the same indications as Qsymia.  Again, let’s look at the package insert for some indications and cautions:

-The safety and efficacy of coadministration with other products for weight loss have not been established

-The effect of Belviq on cardiovascular morbidity and mortality has not been established [emphasis added]

-Warnings and Precautions were listed for:

1) Serotonin Syndrome or Neuroleptic Malignant Syndrome – which means this drug should be VERY cautiously given with traditional antidepressants

2) Valvular Heart Disease

3) Cognitive Impairment

4) Psychiatric euphoria and dissociation

5) Monitor for depression or suicidal thoughts

Most common adverse reactions (greater than 5%) in non-diabetic patients are headache, dizziness, fatigue, nausea, dry mouth, and constipation, and in diabetic patients are hypoglycemia, headache, back pain, cough, and fatigue.

Belviq’s mechanism of action is that it stimulates brain receptors for serotonin, a neurotransmitter that initiates feelings of fullness.  Basically, both of these drugs try to trick your brain into thinking that you are full.

So, will I prescribe any of these medicines for my patients?  Well you guessed it, the answer is no!  The reason is simple, SAFETY.  We may all remember Fen Phen, a diet pill from some years back that was taken off the market due to causing serious valvular heart disease resulting in congestive heart failure.  I remember vividly being called to the ER soon after I moved back to Louisiana to admit a young lady with heart failure.  I remember thinking it odd that a 32 year old female would be in severe heart failure, but the mystery was revealed once I got to the ER and spoke to her.  Turns out she had taken Fen Phen for TWO WEEKS in an effort to lose a few pounds and fit in a dress for a friend’s wedding.  She developed severe Mitral Valvular Heart Disease and resultant heart failure.  She had a valve replacement, but it never worked well and she had severe chronic congestive heart failure as a result.  The look on her face telling me the story said it all…”I was an idiot, looked for a quick fix, and look at me now.”  I really felt bad for her.

A year ago both of these drugs came up for FDA approval and they were denied…why?  They were not felt to be safe from the cardiovascular standpoint, and both seemed to have significant teratogenic effects.  It is simply not known if these drugs can potentially cause the same valvular heart disease that Fen Phen caused.  Now look, I’m not at all saying they will, but information from the MANUFACTURERS themselves clearly state that the risks are unknown.  Also not, the Phen is Fen Phen…yep, it’s short for phentermine.  The FDA stated that the medicines were given approval essentially because doctors needed “something” to combat the worsening obesity epidemic.  I see it as a basic act of desperation from the FDA, and truthfully I understand their viewpoint on this.  Do I agree with it? No, but I understand where they are coming from.  Regardless, this physician won’t be writing out scripts for these meds any time soon.

Now that I got this out of the way, let me make one simple point for anyone out there considering asking their doctor for one of these pills.  There is the misconception out there amongst many people that diet pills are an answer.  Some great conspiracy is holding back doctors from prescribing these meds and we should all be thinner and get to eat more of the things we want without consequences.  Well, let me ask you a few questions…

-If these pills worked, would there be ONE FAT DOCTOR IN THE WORLD? I may not be able to prescribe these meds for myself, but I certainly have 50 buddies on speed dial that could.  Think about it!

-Let’s take it a step farther, would there be any fat people in the world at all, especially those with money? Ever seen a fat rich person?  Sure!  There are plenty around.  Would there be ONE FAT RICH PERSON in the world if it was as easy as finding the right pill?

If you make a statement about your plan to lose weight, and the word “diet” is somewhere in the sentence, just give up because you are going to fail.  By definition a diet is something you are either “on” or “off”.  You will likely lose weight while on it, and gain it back when you get off it.  So essentially all “diets” will result in a yo-yo affect to your weight.

One other thing, the FDA has approved these medicines as “an addition to a reduced-calorie diet and exercise program.”  They are not designed to simply remove the weight without requiring any effort from the patient.  What does that mean?  If you simply take the pills and do not change any of your already bad habits…you will fail again in improving your health longterm through significant weight loss.

There are certain things in life that are easy, and some that are hard.  There are also differences in how difficult or hard those same things are for some to achieve versus others.  Take a look at this well demonstrated problem in America…

Obesity is a very complex problem and it’s rise in America is multi-factorial: lack of exercise, reliance on cheap food built on the backbone of highly processed carbohydrates, poverty, lack of nutritional education, reliance on “quick-fixes” as a society, government subsidies on corn and soy, the gradual extinction of cooking at home combined with increasing numbers of families chronically obtaining dinner through the car window, lack of sleep, an abundance of stress (and cortisol) in our lives!, manipulation of the food supply to promote weight gain, etc.  I could go on and on.  So, REALLY, does ANYONE think a little pill can even put a dent in any of this?

How do we fix obesity?  Well, it’s not easy, but we must get at the root cause if we are to get anywhere.  My motto is Real Food…Real Health.  In the end, the beginning of the end of obesity must itself begin with a transition back to eating Real Food as a society.  I’ve seen it around the web and twitter as JERF (Just Eat Real Food).  This must start on an individual level, with individual families deciding that enough junk is enough.  My family has made that choice, so can yours!

Know anyone thinking about asking their doctor for one of these new pills?  Invite them to read this post, and then ask them to join you on a journey to Real Health by emphasizing Real Food in their life again.  Need more information?  Browse around my blog for ways to change your life.  Are you a reader, check out It Starts with Food by my friends Dallas and Melissa Hartwig.  Don’t know where to start?  Easy…JERF!

-E

 
5 Comments

Posted by on August 25, 2012 in General Paleo Discussion

 

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