Backing Off My Nutritional Advice Enthusiasms

I've seen the light. Or at least, a light.

Lose Weight, Fast! Part 3

I don’t know enough.  That’s my epiphany of the week.  I do not know enough. 

Once I posted my thoughts on keto, low-carb eating (KLC) I was told about many health challenges and struggles from the people I know.  Maybe 10 or 12 people (!!) told me, in a lot of detail, about their health challenges.  Each one was completely different.  None of them were in the arena of KLC.     

I couldn’t know enough to comment on them.  All I could do was listen, which, for the most part, I am happy to do.  But in the course of this, I realized that I didn’t even know enough about the area I supposedly knew a lot about, to espouse any health recommendations to anyone.   All I could do, at most, would be to describe what I was learning as I learned it.  But always with the caveat that I didn’t know a lot.  That I was one data point. And increasingly, I knew I was not prepared to make pronouncements.  

I also have my own biases.  For example, I think – as a rule of thumb, that standard medicine is about 85 – 90% right.  It works.  If you’ve taken an antibiotic in your life, you are probably alive now because of it.  Vaccines work.  Life-saving surgery happens all the time.  I was saved from a cancer that would have killed me if not for standard medicine.  

Even so, I think 10 – 15% of standard medicine has it wrong.  Which would make sense.  We are learning new things, and new studies are being done, and the results need time to be vetted and to make their way into standard care.  (I have some things that I personally think that standard medicine has completely wrong.) 

On the other hand, non-standard medicine, I think, is 85 – 90% wrong.  I think there’s a lot of  snake oil salesman.  Salespeople.  As soon as a treatment is ordered that isn’t covered by insurance, I am a skeptic.  Even though I could list you two or three treatments right now that I think are unfairly not covered by insurance.  And being 85 – 90% wrong means that 10 – 15% of the time they are right!  There is an element of truth to their diagnosis, or even a lot of truth. 

That’s my bias.  I like it and I’m sticking with it.  But I also know I have it.  That means I can’t just hear about something and automatically think it’s great or correct. I would have to have a lot more information to have an opinion. 

Here’s where I’m at right now.  I spent a year on KLC. It had enormous effects on my life.  I am now safely out of the diabetic range (that’s maybe stretching it, my A1c is on the edge between pre-diabetic and not diabetic.  (5.7 – 5.8)   I am 50 pounds lighter and I think that is a help for my overall health.  I feel much better, for what that’s worth. 

But it could be that now I need to concentrate on other things, while keeping my life style in check so I don’t slip back into the diabetic range.  And one of those things is that I may have been eating too much saturated fat. I don’t want to write that, here.  Horrors!  I am not totally convinced yet.  But it could be that for me, my LDL cholesterol is more important than I thought.  I do have high LDL. (Last July, 2 months into KLC, it was 168.) 

My family has a history of heart disease. Both my parents had multiple heart attacks, but died from other things, primarily complications from diabetes and emphysema.  I always thought it was their lifestyle – smoking (my father, 2 packs a day) and drinking (a lot!) and no exercise and eating a diet high in ultra-processed carbs and sugar.  I smoked for 10 years (quit at 35) drank 2 drinks a day until about 5 months ago (now 2 a week on average) exercise a lot, but was still edging toward full-blown diabetes.  But now, not. 

There are implications from my past.  There is a thing called, “residual risk.” 

What galvanized my action to change was learning about the connection between dementia and diabetes.  My mother had dementia, and to me it is the worst-of-the-worst conditions.  From what I understand, having diabetes makes you, at least, about 25 – 30% more likely to get dementia.  In fact, many health practitioners call dementia: Diabetes Type 3.  My mother’s condition scared me straight.

One thing that surprised me was learning, when I had cancer years ago, that there could be treatments that are really great for one part of your body, and terrible for another part of your body.  In the Woo Woo Wellness World (WWWW) they often speak as if your body is a cohesive unit, that your body (in some cosmic way) wants to live and be healthy and thrive.  But that is not true.  Yes, generally your body wants to live, but your body is more like a city.  There are bad neighborhoods and over developed neighborhoods and they can compete for resources.  There might be areas with bad administrators and perhaps the public transportation system is crumbling, but the water treatment plant is especially superb.  You get the idea.

And, if you are past reproductive age, Nature doesn’t even care if you live.  I mean, we probably only have human old-age at all because we were, on balance, useful grandparents.  Nature doesn’t give a crap about old people.     

However, for obvious reasons, we do!  And additionally, things we do for ourselves may help one part of our bodies, while endangering another part of our bodies.  

So.  It could be that my particular KLC lifestyle was great for my encroaching diabetes, but not great for the plaque in my heart.  Ugh.  That’s hard to admit.

Anyway, at the end of July I’m going to have my annual physical, and I have asked that in addition to my LDL cholesterol test, I would like an ApoB test.  This will give me and my doctor more information about the type of LDL I have, and if it’s the type that may become plaque.  I also have asked for a test that will give me a CAC score.  CAC stands for Cardiac Artery Calcium.  It will measure the calcified plaque in my arteries. This is important because coronary plaque is the main underlying cause of, and precursor to, cardiovascular disease.    

I had a CAC test done in Chicago, about 10 years ago, when I declined to go on statins.  My score was 3.   It’s true that the only good score is 0.  But 3 is not terrible.  I will be interested if it is higher than 3.  If it is, I may have to modify my KLC lifestyle to have less saturated fat in it.  This will be hard for me.  I like my saturated fat.  It keeps me feeling full. I can’t imagine succeeding on KLC without it in the future, and I cannot imagine that I would have succeeded so far without the animal fats.  Nothing kept me away from carbs like a belly full of bacon and eggs.  I could go hours and hours without thinking about food at all.  The success I had was linked, crucially, to satiety. And that I was losing weight while feeling so good, and so full, and so alert?  It was wonderful.  It is wonderful.  It’s how I eat now.

However, if it is the case that I have some scary results, I will have to either go on a statin, or reduce the saturated fat in my diet.  I am highly motivated not to take a satin, so I think I would try to do it with diet.

I think I can do that.  I think.  

But the bottom line is that I really don’t know enough to be writing with any authority about KLC.    

Michael, my husband, who is a trained scientist, said this thing… (I can hear him, now, over my shoulder saying, “Don’t make me sound like an oracle or anything like that!”)  Anyway, he said, (and I’m paraphrasing) that most people are skeptical at first. Usually, they have a problem and they are evaluating solutions to the problem.  And then, when you do something that solves the problem, or substantially solves the problem, you think: Problem solved. Yay! Case closed.

But the better scientists and skeptics continue to think about the problem.  They notice that maybe the problem wasn’t completely solved.  It was, say, 80% solved.  And maybe the solution worked for reasons that you didn’t consider.  And often, he would realize that the entire underlying question had to be re-thought, and re-asked.  And that we always have to be skeptical, all the way through.  Not so much that you are paralyzed and don’t act.  But, even in success, you need to be vigilant about what you thought was the answer.

I thought that was pretty profound. (He would say that is simply basic science.) But let’s give it to him, profound. Yes. So, while I felt I had reached a great way of eating that solved a lot of my problems, the truth is that I will be continuing to learn and tweak what I do to accommodate new information.  For example, it may be that I have to modify the amount of saturated fat I eat a bit.  Or a lot.  Or not. We will see when I get my Apob test results and my CAC score.

The main thing to relate here is that I no longer am planning to write a book or even give anyone advice about diet unless asked directly, and my answer will probably be that I don’t know enough about it to give an unequivocal answer.

I did want to end on something I learned that I can’t stop thinking about.  It’s called The Care Effect.  Our standard medical doctors are pressed for time.  Their solutions are scientific.  Yes, they may be able to look into your eyes and show deep caring, but they haven’t been selected for those qualities. 

In the WWWW land, practitioners tend to excel at care.  They spend more time with their patients.  They look in your eyes.  They probably do, sincerely, care.  The patient feels it.  That, in itself, can have physiological effects.  But it’s also a sneaky way to convince someone to spend a lot of money. Also, you tend to spend a lot of time with non-standard health practitioners, because their treatment involves many visits.  It creates a bond.  It’s easy to get hoodwinked into whatever it is they’re selling. I know, because I’ve done it myself. 

When I had cancer and was getting radiation, I stopped going to my trainer at the gym, and instead got acupuncture three times a week. My treatments included Moxibustion, a traditional technique that involved burning mugwort on my abdomen. Later, I took a course at CFI (The Center for Inquiry) here in Los Angeles about science and the healthcare industry.  I found that there is no evidence at all for Moxibustion working and I probably would have gotten a lot more benefit from continuing with my trainer lifting weights.  But I bonded with my acupuncturist and I felt he was healing me.  I’m sure he was sincere and sincerely thought that what he was providing was essential. It was a good learning experience. (Btw, there is some evidence of some acupuncture techniques working in very specific areas, but not Moxibustion.)

This week my friend Irene came over for lunch and we were talking about all this and she said something I keep laughing about.  She was at a medical conference at either USF or Stanford, and people were asking doctors various questions.  And one asked, “What is the most frightening kind of patient?” And the doctor answered, “A white woman with extra time and money who watches a lot of things on the Internet.” 

Okay, first of all, HAHAHA. That is hysterical and undoubtably true. 

Secondly, that’s me!  That’s me!  OMG, that’s me.

So, I have seen the light.  I can see me and I can see me going down rabbit hole after rabbit hole. I can see me giving people advice about what I think they should do for this reason and that reason.  I’m still going to research things (what else can I do with all the time and money and Internet access I have!?) But I’m not going to be a spokesperson for anything.  I’m going to post things here on Substack occasionally, in this subset called “Lose Weight, Fast!”  It may be infrequent and it probably won’t have a tone where it seems like I’m giving advice.

xoxo