You all (or y’all, as we say around these parts) submitted so many good questions for Wheat Belly author Dr. William Davis, we decided to make this a two-part Q & A.  We’ll probably have part two ready early next week.

Fat Head: You’re a cardiologist by profession, and yet you just wrote an in-depth book about the negative health effects of consuming wheat.  How did wheat end up on your radar?  What first made you suspect wheat might be behind many of our modern health problems?

Dr. Davis: It started several years ago when I asked patients in my office to consider eliminating all wheat from their diet. I did this because of some very simple logic: If foods made from wheat raise blood sugar higher than nearly all other foods (due to its high-glycemic index), including table sugar, then removing wheat should reduce blood sugar. I was concerned about high blood sugar since around 80% of the people coming to my office had diabetes, pre-diabetes, or what I call “pre-pre-diabetes.” In short, the vast majority of people showed abnormal metabolic markers.

I provided patients with a simple two-page handout on how to do this, i.e., how to eliminate wheat and replace the lost calories with healthy foods like more vegetables, raw nuts, meats, eggs, avocados, olives, olive oil, etc. They’d come back three months later with lower fasting blood sugars, lower hemoglobin A1c (a reflection of the previous 60 days’ blood sugar); some diabetics became non-diabetics, pre-diabetics became non-pre-diabetic. They’d also be around 30 pounds lighter.

Then they began to tell me about other experiences: relief from arthritis and joint pains, chronic rashes disappearing, asthma improved sufficiently to stop inhalers, chronic sinus infections gone, leg swelling gone, migraine headaches gone for the first time in decades, acid reflux and irritable bowel symptoms relieved. At first, I told patients it was just an odd coincidence. But it happened so many times to so many people that it became clear that this was no coincidence; this was a real and reproducible phenomenon.

That’s when I began to systematically remove wheat from everyone’s diet and continued to witness similar turnarounds in health across dozens of conditions. There has been no turning back since.

Fat Head: You cite quite a bit of academic research in your book, but you also cite case histories from your medical practice.  So, as a chicken-or-the-egg issue, which came first?  Did you start noticing that patients who consumed a lot of wheat had more health problems and then go looking for the research to back up your suspicions, or did you come across research that prompted you to take notice of what your patients were eating?

Dr. Davis: The real-world experience came first. But what surprised me was that there already was an extensive medical literature documenting all of this, but it was largely ignored or didn’t reach mainstream consciousness nor the consciousness of most of my colleagues. And a lot of the documentation comes from the agricultural genetics literature, an area, I can assure you, my colleagues do not study. But I dug into this area of science and talked to people at the USDA and in agriculture departments in universities to gain a full understanding of all the issues.

One of the difficulties that partly explains why much of this information has not previously seen the light of day is that agricultural geneticists work on plants, not humans. There is a broad and pervasive assumption followed by these well-meaning scientists: No matter how extreme the techniques used to alter the genetics of a plant like wheat, it is still just fine for human consumption …no questions asked. I believe that is flat wrong and underlies much of the suffering inflicted on humans consuming this modern product of genetics research still called, misleadingly, “wheat.”

Fat Head: So after pinpointing wheat as a driver of various health problems, you started counseling your patients to eliminate wheat from their diets.  What inspired you take the extra step – and it’s a big step – of writing a book?

Dr. Davis: What I witnessed in the thousands of people removing wheat from their diet was nothing short of incredible. When I saw weight loss of 70 pounds in six months, energy and mood surging, reversal of inflammatory diseases such as ulcerative colitis and rheumatoid arthritis, relief from chronic rashes and arthritis — and the effects were consistent over and over again — I realized that I could not just let this issue pass quietly in my office practice.

Admittedly, the world is going to need more confirmatory data before wheat, or at least the modern genetically-altered version of wheat we are being sold, is removed from the world’s dinner plate. But the data that are already available are more than enough, I believe, to bring this information to the public for people to make the decision themselves. I liken this situation to living in a village where everyone drinks water from the same well.  Nine out of 10 people get sick when they drink water from the well; all recover when they stop drinking from it. Drink from the same well, they all get sick again; stop, they get better. With such a consistent and reproducible cause-and-effect relationship, do we need a clinical trial to prove it to us? I don’t.

This is going to be a long, hard battle in the public arena. Wheat comprises 20% of all human calories. It requires a huge infrastructure to grow, harvest, collect seeds, fertilize, herbicide, process, and distribute. This message is going to potentially hurt the livelihoods of thousands, perhaps millions, of people who are part of the infrastructure. It reminds me of the battles that were fought (and still being fought today) when it became widely accepted that smoking cigarettes was bad. When people within the tobacco industry were asked how they could work for a company that destroyed people’s health, they replied, “I had to support my family and pay my mortgage.” The eliminate-all-wheat-in-the-human-diet argument that I make will hurt many people where it counts: right in the pocketbook. But, personally, I am not willing to sacrifice my own health, the health of my family, friends, neighbors, patients, and the nation to allow the incredibly unhealthy status quo to continue.

Fat Head: The more of the book I read, the more I found myself thinking, “Wow, I knew wheat was bad for us, but it’s even worse than I thought.”  Did you have the same reaction while researching the book?  Were you surprised at how many physical and mental problems wheat can cause?

Dr. Davis: Yes. I knew wheat was bad from the start of this project. And there were times when I wondered if I was missing something, given the unanimous embracing of this grain by agribusiness, farmers, agricultural scientists, the USDA, FDA, American Dietetic Association, etc. But the opposite happened: The deeper I got into it, this thing being sold to us called “wheat” appeared worse … and worse, and worse, the farther I got.

I am mindful of the “For a man with a hammer, everything looks like a nail” trap we can all fall into, but when you see disease condition after disease condition vanish with elimination of wheat, you can’t help but become convinced that it plays a crucial role in hundreds, literally hundreds, of common conditions.

Fat Head: You described in your book how today’s wheat is the product of energetic cross-breeding.  Is cross-breeding inherently bad?  Doesn’t cross-breeding take place in nature all the time?

Dr. Davis: Yes, it does. Humans, along with all plants and animals, are the product of cross-breeding or hybridization. Love, sex, and cross-breeding make the world go ‘round and make life interesting. The problem is that these terms are used very loosely by geneticists.

For example, if I subject wheat seeds and embryos to the potent industrial poison sodium azide, I can induce mutations in the plant’s genetic code. First, let me tell you about sodium azide. If ingested, the poison control people at the Centers for Disease Control advise you to not resuscitate the person who ingested it and stopped breathing as a result —just let the victim die—because the rescuer can die, too. And, if the victim vomits, don’t throw the vomit in the sink because it can explode (this has actually happened). So, expose wheat seeds and embryos to sodium azide and you obtain mutations. This is called chemical mutagenesis. Seeds and embryos can also be exposed to gamma irradiation and high-dose x-ray radiation. All of these techniques fall under the umbrella of hybridization or, even more misleading, traditional breeding techniques. I don’t know about you, but cross-breeding among the humans I know doesn’t involve slipping each other chemical poisons or a romantic evening in the cyclotron to induce mutations in our offspring.

These “traditional breeding techniques,” by the way, are markedly more disruptive to the plant’s genetics than genetic engineering. Americans are up in arms about genetically-modified (GMO) foods (i.e., the insertion or deletion of a single gene). The great irony is that genetic engineering is a substantial improvement over “traditional breeding techniques” that have gone on for decades and are still going on.

[Note from Tom:  I tried talking my wife into stepping into a cyclotron with me on our honeymoon.  She told me to stop drinking the champagne and go to sleep.]

Fat Head: I met you in person over a year ago, and you’re a very lean guy, so I was surprised to learn from the book that you used to carry around your very own wheat belly.  Describe the differences between you as a wheat-eater and you now, both in terms of your physique and your health.

Dr. Davis: Thirty pounds ago, while I was still an enthusiastic consumer of “healthy whole grains,” I struggled with constant difficulties in maintaining focus and energy. I relied on pots of coffee or walking and exercise just to battle the constant stuporous haze. My cholesterol values reflected my wheat-consuming habits: HDL 27 mg/dl (very low), triglycerides 350 mg/dl (VERY high), and blood sugars in the diabetic range (161 mg/dl). I had high blood pressure, running values around 150/90. And all my excess weight was around my middle—yes, my very own wheat belly.

Saying goodbye to wheat has helped me shed the weight around the middle; my cholesterol values: HDL 63 mg/dl, triglycerides 50 mg/dl, LDL 70 mg/dl, blood sugar 84 mg/dl, BP 114/74—using no drugs. In other words, everything reversed. Everything reversed including the struggle to maintain attention and focus. I can now concentrate and focus on something for so long that my wife yells for me to stop.

All in all, I feel better today at age 54 than I felt at age 30.

Fat Head: How has learning what you now know about wheat and other grains changed your medical practice?

Dr. Davis: It has catapulted success in helping people regain health into the stratosphere. Among people following this diet, i.e., eliminate wheat and limit other carbohydrates (along with the other heart-healthy strategies I advocate, including omega-3 fatty acid supplementation with fish oil, vitamin D supplementation to achieve a desirable 25-hydroxy vitamin D level of 60-70 ng/ml, iodine supplementation and normalization of thyroid dysfunction), I no longer see heart attacks. The only heart attacks I see are people whom I’ve just met or those who, for one reason or another (usually lack of interest) don’t follow the diet.  A priest I take care of, for instance, a wonderful and generous man, couldn’t bring himself to turn down the muffins, pies, and breads his parishioners brought him every day; he had a heart attack despite doing everything else right.

This diet approach, though it seems quirky on the surface, is extremely powerful. What diet, after all, causes substantial weight loss, corrects the causes of heart disease such as small LDL particles, reverses diabetes and pre-diabetes, and improves or cures multiple conditions ranging from rheumatoid arthritis to acid reflux?

Fat Head: You’ve seen hundreds of your own patients become cured of supposedly incurable diseases after giving up wheat.  Describe one or two of the most dramatic examples.

Dr. Davis: Two people are on my mind nearly every day, mostly because I am especially gratified about the magnitude of their response and because I shudder to think what their lives would have been like had they not engaged in this diet change.

I describe Wendy’s story in the book, a 36-year mother and schoolteacher who had nearly incapacitating ulcerative colitis; so bad that, despite three medications, she continued to suffer constant cramps, diarrhea, and bleeding sufficient to require blood transfusions. When I met Wendy, she told me that her gastroenterologist and surgeon had scheduled her for colon removal and creation of an ileostomy bag. These would be lifelong changes; she would be consigned to wearing a bag to catch stool at the surface for the rest of her life. I urged her to remove wheat. At first, she objected, since her intestinal biopsies and blood work all failed to suggest celiac disease. But, having seen many amazing things happen with removal of wheat, I suggested that there was nothing to lose. She did it. Three months later, not only had she lost 38 pounds, but all the cramps, diarrhea, and bleeding had stopped. It’s now been two years. She’s off all drugs with no sign of the disease left—colon intact, no ileostomy bag. She is cured.

The second case is Jason, also described in the book, a 26-year old software programmer, in this case incapacitated by joint pains and arthritis. Consultations with three rheumatologists failed to yield a diagnosis; all prescribed anti-inflammatory drugs and pain medication, while Jason continued to hobble around, unable to engage in much more than short walks. Within five days of removing all wheat, Jason was 100% free of joint pains. He told that he found this absolutely ridiculous and refused to believe it. So he had a sandwich: Joint pains rushed right back. He’s now strictly wheat-free and pain-free.

Fat Head: Your patients are lucky – you’d rather change a patient’s diet than write a prescription whenever possible.  Unfortunately, you’re in the minority.  As I recounted on my blog recently, a co-worker’s wife was finally cured of her pounding headaches when an acquaintance suggested she stop eating grains.  She’d been to several doctors who merely prescribed medications.  So … why are so few doctors aware of how grains can affect our health?

Dr. Davis: I believe healthcare has detoured towards high-tech, high revenue-producing procedures, medications, and catastrophic care. Too many in healthcare have lost the vision of helping people and fulfilling their mission to heal. While that sounds old-fashioned, I believe it is a bad trend for healthcare to be reduced to a financial transaction bound by legal constraints. It needs to be restored to a relationship of healing.

I believe that many in healthcare have also been disenchanted with the ineffectiveness of dietary advice. Because dietary “wisdom” has been wrong on so many counts over the past 50 years, people have become soured on the ability of nutrition and natural methods to improve health. From what I’ve witnessed, however, nutrition and natural methods have enormous power to heal—if the right methods are applied.

Fat Head: Do you hope your book will educate more doctors on the topic, or is this one of those situations where the public will have to ignore their doctors and educate themselves?

Dr. Davis: Regrettably, many people will read the message in Wheat Belly, experience the life-changing health and weight transformations that can result, then they will then tell their doctors, who will declare their success “coincidence,” “mind over matter,” “placebo effect,” or some other dismissal. Many of my colleagues refuse to recognize the power of diet even when confronted with powerful results. That can only change over a very long time.

Thankfully, more and more of my colleagues are beginning to see the light and not look for the answer in drugs and procedures. These are the healthcare providers that I hope will emerge to assist people as advocates and coaches in conducting an experience like that described in Wheat Belly.

Fat Head: If more doctors were informed of the issues you wrote about in Wheat Belly, do you think they’d change their dietary advice, or is the “fat is bad, grains are good” mentality too ingrained in the profession?

Dr. Davis: There is absolutely no question that the “fat is bad, grains are good” argument will persist in the minds of many of my colleagues for many years. However, I believe if they were to read the arguments laid out logically in Wheat Belly, they would first come to recognize that “wheat” is no longer wheat but an incredibly transformed product of genetics research. Then they would begin to follow the logic and understand that the long menu of problems associated with consumption of modern “wheat” begins to explain why we’ve all been witnessing an explosion in common diseases. That’s when I hope we all hear a collective “Aha!”

Here are a couple of videos I think you’ll enjoy.  The first is a speech delivered by Dr. Andreas Eenfeldt at the Ancestral Health Symposium in which he describes causes of obesity and the diet revolution in Sweden, where he practices medicine.

If you don’t already read Dr. Eenfeldt’s new English-language blog, you should.

The second video is a lecture on how cancer cells hijack fuel.  If you weren’t already convinced it’s a bad idea to jack up your glucose level several times a day, this may do the trick.

I can’t believe a third of the students couldn’t answer the doctor’s final question correctly … how do you watch that lecture and conclude that dietary fat would increase the growth of tumors?

I receive occasional emails and comments from people who can’t believe wheat isn’t health food. Some have quoted Bible passages about our daily bread, the staff of life, breaking bread with family, etc. Others have pointed out that Americans ate plenty of bread and other wheat products 100 years ago, but weren’t as likely to be fat and diabetic as people today.

I usually reply that the wheat products we consume today aren’t the same as those consumed by people in Biblical times, or even in more recent times. But I didn’t realize just how different today’s wheat is until I read Wheat Belly, a terrific new book by Dr. William Davis, the cardiologist you may already know from his Heart Scan Blog.

The title, of course, refers to the big gut that so many people today are carrying around in front of them these days.  While he’s no fan of sugar or other refined carbohydrates, Dr. Davis believes wheat is a primary (if not the primary) driver of the rise in obesity we’ve witnessed in the past quarter century, and he makes a strong case for that belief.   But getting fat is hardly the only price we pay for our love of bagels, breads, cereals and muffins. As Dr. Davis explains in the book’s introduction:

While much of the Wheat Belly story is about overweight, it is also about the complex and not fully understood range of diseases that have resulted from it – from celiac disease, the devastating intestinal disease that develops from exposure to wheat gluten, to an assortment of neurological disorders, curious rashes, and the paralyzing effects of schizophrenia. Documented peculiar effects of wheat on humans include appetite stimulation, exposure to brain-active exorphins (the counterpart of internally derived endorphins), exaggerated blood-sugar surges that trigger cycles of satiety alternating with increased appetite, the process of glycation that underlies diseases and aging, inflammatory and pH effects that erode cartilage and damage bone, and activation of disordered immune responses.

And later, in Part One:

There’s hardly a single organ system that is not in some way affected by wheat products. The health impact of Triticum aestivum, common bread wheat and its genetic brethren, ranges far and wide, with curious effects from mouth to anus, brain to pancreas, Appalachian housewife to Wall Street arbitrageur. If it sounds crazy, bear with me. I make these claims with a clear, wheat-free conscience.

In the rest of the book, Dr. Davis back up those claims. He delves into quite a bit of nutrition science and some biochemistry, but writes in a clear (and often humorous) style that makes for easy reading. As a doctor who’s treated thousands of patients, he has the added advantage of being able to cite case histories from his own practice – patients who came to him unknowingly damaged by wheat, but were cured by wheat-free diets.

One patient, a thirty-eight-year-old woman, was told by her doctor that she’d have to have part of her colon removed and replaced with an external bag. After Dr. Davis talked her into going wheat free, her colon healed itself. Another patient, a twenty-six-year-old man, was experiencing so much pain in his joints, he could barely walk. Three different rheumatologists failed to identify a cause. When he visited Dr. Davis for a heart condition, Dr. Davis suggested he try a wheat-free diet for the joint pain. Three months later, the young man strode into the office pain-free and reported he’d been jogging short distances and playing basketball. His heart condition had cleared up as well.

Before the chapters detailing the many ways wheat can damage our bodies and brains, Dr. Davis begins by recounting the history of wheat itself. It’s a fascinating story — in a Stephen King sort of way, that is. Here are a few quotes from that chapter, which is titled Not Your Grandma’s Muffins: The Creation of Modern Wheat.

Bread and other foods made from wheat have sustained humans for centuries, but the wheat of our ancestors is not the same as modern commercial wheat that reaches your breakfast, lunch and dinner table. From the original strains of wild grass harvested by early humans, wheat has exploded to more than 25,000 varieties, virtually all of them the result of human intervention.

The first wild, then cultivated, wheat was einkorn, the great-granddaddy of all subsequent wheat. Einkorn has the simplest genetic code of all wheat, containing only 14 chromosomes.

Shortly after the cultivation of the first einkorn plant, the emmer variety of wheat, the natural offspring of parents einkorn and an unrelated wild grass, Aegilops speltvoides or goatgrass, made its appearance in the Middle East. Goatgrass added its genetic code to that of einkorn, resulting in the more complex twenty-eight-chromosome emmer wheat.

Emmer wheat, Dr. Davis explains, was probably the wheat of biblical times. Later the emmer wheat mated naturally with another grass and produced Triticum aestivum, the forty-two-chromosome wheat that humans consumed for centuries – right up until the past 50 years or so. That’s when the story of wheat becomes a bit of a modern Frankenstein tale.

Like Dr. Frankenstein, the scientists who created today’s wheat had good intentions: the goal was to produce more wheat per acre in a shorter span of time, thus vastly increasing yields and preventing worldwide starvation as the planet’s population swelled. To that extent, they succeeded. Geneticist Dr. Norman Borlaug, who created the short, stocky, fast-growing “dwarf” wheat most of us consume today, is credited with saving perhaps a billion people from starvation.

The problem is that dwarf wheat varieties were developed through a combination of cross-breeding and gene splicing. The result is a mutant plant with a genetic code that never existed in nature before. In fact, today’s wheat literally can’t survive in a natural setting. Take away the modern pesticides and fertilizers and it’s (pardon the pun) toast.

Perhaps overjoyed at the prospect of the feeding the world, the developers of modern wheat varieties weren’t interested in conducting tests to see if these genetically-modified strains were actually fit for human consumption. Dr. Davis believes they’re not. At the very least, we’re now consuming wheat that’s genetically different from what our ancestors consumed:

Analyses of proteins expressed by a wheat hybrid compared to its two parent strains have demonstrated that while approximately 95 percent of the proteins expressed in the offspring are the same, five percent are unique, found in neither parent. Wheat gluten proteins, in particular, undergo considerable structural change with hybridization. In one hybridization experiment, fourteen new gluten proteins were identified in the offspring that were not present in either parent plant. Moreover, when compared to century-old stains of wheat, modern strains of Triticum aestivum express a higher quantity of genes for gluten proteins that are associated with celiac disease.

Hybridization efforts of the past fifty years have generated numerous additional changes in the gluten-coding genes in Triticum aestivum, most of them purposeful modifications of the “D” genome that confer baking and aesthetic characteristics on flour. It is therefore the the “D” genome of modern Triticum aestivum that, having been the focus of all manner of shenanigans by plant geneticists, has accumulated substantial changes in genetically determined characteristics of gluten proteins.

In other word’s, this ain’t your grandma’s wheat.  Little wonder that when researchers compared blood samples taken from thousand of soldiers 50 years ago to blood samples from today’s soldiers, they found that celiac antibodies are five times more common today among today’s soliders.

Dr. Davis recounts an experiment he conducted on himself to compare the different impacts of ancient wheat and modern wheat on his blood sugar. He managed to find some einkorn wheat and made bread from it. Two slices of that bread raised his blood sugar from 86 mg/dl to 110. Not bad. Then he made bread from modern whole wheat – you know, the stuff the USDA says is the key to great health. Two slices raised his blood sugar from 84 mg/dl to 167. That’s diabetes territory. As Dr. Davis writes in another chapter after explaining the specific types of carbohydrates found in wheat:

Wheat products elevate blood sugar levels more than virtually any other carbohydrate, from beans to candy bars.

As the graph I displayed in a previous post showed, the typical American consumes somewhere around 1,000 calories per day in the form of sugars and grains.  Our dominant grain by far is wheat — wheat that was never part of the human diet until 50 years ago.

The rest of the book details the damage modern wheat can do to our bodies and brains, with plenty of references to both academic studies and case histories from Dr. Davis’ medical practice. He covers the addictive properties of wheat, the effects wheat can produce in our brains (including actual brain damage), and of course the many ways wheat can wreak havoc on our digestive systems. Compared to those chapters, the chapters on skin conditions, accelerated aging, and heart disease seem almost tame. Sure, it’s not good to produce mostly small, dense LDL … but heart disease will kill you later. Untreated celiac disease will make you miserable for life – and most celiac sufferers are never diagnosed.

This is an excellent book, and also an important book. A story a co-worker told me last week illustrates why: his wife suffered from debilitating headaches for years. She went from doctor to doctor, but none could offer an explanation or solution, other than pain medications that basically knocked her out. Then a few months ago, she mentioned the headaches to some acquaintances over dinner. One of them – not a doctor – told her the headaches could be caused by a reaction to wheat gluten and suggested she try a gluten-free diet. She did … and headaches went away.

As my co-worker told me, “I’m glad someone finally gave her the answer, but why did she have to hear this from some Joe Schmoe after years of suffering? Why didn’t any of the doctors we consulted think of that?”

The doctors didn’t think of that because they weren’t trained to think of that. Ask the vast majority of doctors for dietary advice, and they’ll tell you to limit your fats and eat your “healthy whole grains.” They can’t teach what they don’t know.

I hope you all read this book. But more than that, I hope you buy a copy and stick it in your doctor’s hands. The next time a patient shows up suffering from splitting headaches (or irritable bowel, or stomach cramps, or acne, or psoriasis, or depression, or emotional problems, or high triglycerides, or high blood sugar, or arthritis, or asthma), perhaps the doctor will take a careful dietary history and suggest trying a wheat-free diet before reaching for the prescription pad.

Next week I’ll be posting a Q & A with Dr. Davis.  I have a list of questions I want to ask, but if you have questions of your own, post them in a comment.  I’ll pick some to add to my list.

A couple of interesting tidbits about salt and health came my way via Facebook this morning.  Check out the Q & A from this online article:

Q: Isn’t there universal agreement that these low sodium targets are best for everyone?

A: Although most researchers agree that excessively high sodium intake is not good for health, there is disagreement about the ideal level of daily sodium intake. Dr. David McCarron and other researchers from the University of California at Davis and Washington University in St. Louis have questioned the feasibility of aiming for such low sodium intake targets. McCarron and colleagues point out that contrary to popular belief, sodium intake has not increased or decreased during recent decades and that humans naturally consume significantly more than the new recommendations for potentially valid physiological reasons.

It is well-known that sodium is one of the few nutrients for which humans have a “specific appetite,” meaning that if we are low in the nutrient we crave, we seek out foods that provide it. McCarron stresses that when sodium levels in the body drop too low, there are a series of hormonal responses that may have undesirable long-term consequences.

Q: What are some possible negative consequences of excessive reduction of sodium intake?

A: Two studies out of Australia, hot off the press in the journal Diabetes Care, report that for both type 1 and type 2 diabetics, low sodium intake was associated with increased risk of mortality from cardiovascular disease and all other causes. This was not completely surprising because it is known that low sodium intake results in increased insulin resistance. This means that more insulin is needed to stimulate insulin-sensitive cells to remove glucose from the blood. Although these studies do not prove cause and effect, they do stress the need for caution in making sodium recommendations and the need to conduct appropriately controlled human studies.

Another study found that when adults (ages 40 to 65 whose blood pressure exceeded 120 over 80) added vegetable juice containing 480 to 960 mg of sodium to their daily diet, their blood pressure dropped during this 12-week study. This juice also added a similar amount of potassium to their diets.

McCarron points out that worldwide sodium intake varies between about 3,100 and 3,800 mg per day. When sodium intake drops too far below 3,000 mg per day, hormonal changes apparently trigger the drive to seek out food sources of sodium.

Low sodium intake increases insulin resistance?  Have to admit, that was a new one on me.  But here’s a link to a study that came to exactly that conclusion.

Yeah, uh, but, you see, there’s this one tribe in the Amazon where people have a low sodium intake and they’re really, really healthy …

In case you missed it in comments, a reader recommended this documentary about sugar from 1986. I’d never heard of it before, and obviously it wasn’t popular enough when it aired to make much of an impression on the public, considering what’s happened since then.

I was pleased to see Dr. Linus Pauling mention that there’s no correlation across populations between saturated fat intake and heart disease, but there is a correlation between heart disease and sugar. Too bad the anti-fat hysterics weren’t listening. We’ve spent another 25 years since then shooting at the wrong target.

The only place the documentary went off the rails a little was when it got preachy about how many advertisements for sugary foods are directed at kids. Yes, that’s right, kids see a ton of ads for junk foods. But unless I’m missing something here, they don’t respond to those ads by getting in their cars, driving to the store, and spending their hard-earned money on Lucky Charms. Their parents do that for them.

I was also amused when the host announced near the end that new federal rules would soon require food manufacturers to list the amount of sugar and other ingredients on food packages – the implication being that people would respond to the labels by consuming less sugar. Yeah, that worked out really well, didn’t it? Now, of course, the same happy prediction is being made by those who want to force restaurants to display calorie counts. You’d think they would have learned their lesson, but as Milton Friedman once said, in government failure is usually viewed as a justification to do the same thing again, only bigger.

By pure coincidence, I happen to be in the middle of an audiobook narrated by the host of this documentary, John Rubenstein. He’s an excellent reader who can change his voice quite dramatically. He even goes a good version of a rough-and-tough, deep-voiced cop.

Well, you folks have kept the drumbeat going, improving your health, spreading the word about Fat Head and healthy eating, driving the numbers  on Hulu and Netflix, and DVd sales.  All of which gets Tom invited to places like the Ancestral Health Symposium at UCLA to present his “Science for Smart People” speech.

So he’s already gone again and I’m already back again.  You have no one to blame but yourselves.

First, a quick housekeeping note.  It sounds like Tom’s going to be severely out of pocket for the next few days and the comments on the site are already piling up.  In the interest of keeping the dialog here moving, I’m going to approve the ones that I don’t think require his attention.  If you’ve submitted one and don’t see it, please be patient.

I was going to put up a post about some amazing BLT’s The Wife and I make — including low-carb options — along with some hints on bacon and avocados ( I know, add a couple of eggs to the bacon and avocados and you’ve got the whole paleo food pyramid, right?).

But I had an interesting experience this week and I thought I’d share it.  It’s not nutrition or food, but it is about your health, so here goes…

This past Wednesday, being a guy over 50 who generally manages his health by avoiding doctors, I finally went to a new doctor.  It took an hour and a half, which was amazing.

Normally, there’s nothing amazing about spending an hour and a half at the doctor’s office.  In fact, that would generally fall under “completely normal.”

You know the drill.  Get there 15 minutes early so you don’t lose your place, spend 15 minutes refilling out the same paperwork you filled out the last ten times you were there and letting them copy your insurance card again (OMG, you didn’t change insurance companies, did you?  Start over!)

Half an hour after your appointment time, the nurse escorts you back to the exam room and spends five minutes asking you some questions, writing your answers, and taking some measurements (height, weight, blood pressure, etc.).  The nurse disappears and hopefully after only another fifteen minutes or so your doctor comes in and asks you most of the same questions again.  She’ll determine a few tests for the lab to do.  If you’ve got a particular ailment, she’ll probably want a few extra tests.  Then off she goes.

You get escorted to the lab, wait there for fifteen minutes, a tech spends another ten or fifteen minutes drawing blood or whatever needs doing, then back you go.  After another wait — again, fifteen minutes qualifying as a lucky day — your doctor returns, spends up to several minutes reviewing your test results with you, and then tells you that you need to be on statins.  Har!

So what’s so different about spending an hour and a half at my new doctor’s?  Well for starts, I spent the entire hour and a half — brace yourself — with my doctor!  This is him — Dr. Craig Backs

Craig has over 30 years experience as an Internal Medicine Physician, is a past president of the Illinois State Medical Society, and recently returned to private practice after a stint as Chief Medical Officer at Saint John’s Hospital in Springfield. Good person to know.

Almost the entire time was spent with Dr. Backs, except for maybe the first three minutes, which I spent in his reception area, which looks like this…

The seating is comfortable, but this is probably about as crowded as it’s going to get.  More on that in a minute.

And when the nurse came to take me back to the exam room?  Well, that didn’t happen.  He doesn’t have a nurse.  Anything that has anything to do with my medical experience, he does.

Also, we spent the first hour of that hour and a half sitting here:

Since this was my first visit, we spent an hour not only going over my medical history, but also any current complaints (coincidentally, I happened to be having a flare-up of sciatica from old injuries) and my goals regarding maintaining and improving my general health.  We also spent some time on my conviction of the benefits of, and my personal results from moving to the low-carb lifestyle.  With a couple of short detours into politics and economics, of course.

Craig has been a personal friend for years (his son and The Oldest Son went to school with each other from preschool through high school, and remain close friends).  As a result, I’d recommended Gary Taube’s Good Calories, Bad Calories in a social conversation before he started his new practice and he read the whole thing.  Craig is not a low-carb or paleo (or anything else) physician, but he was comfortable with my decisions about nutrition and health.  He’d also support a patient intent on the low-fat approach.  Imagine that — a doctor who wants to help his patients work their way towards their health goals on their patients’ own terms.

After building the foundation of our doctor/patient relationship, we moved into a standard exam room for the actual physical, including all of the usual equipment, although most of them were hooked up so they would load results directly into his laptop and my medical records, which are now all electronic.  This all took most of the other half hour, including some helpful suggestions on addressing the sciatic flare-up.

[It also unfortunately included the usual test for a guy over fifty, which I was not able to get Dr. Backs to waive for an additional fee.  I suppose it's nice to know your doctor has professional integrity, but it's even more important that their hands aren't too big, if you get my drift.  Sorry -- just had to throw that in as a final shout-out to Kenny M -- Tom's vegetrollian stalker!]

In case I come up with another question or problem, in addition to his office number, I’ve got Dr. Back’s email address.  And his cell phone number.  Not because he’s a personal friend, but because he’s my doctor.  When I called to schedule my first appointment, I asked when I could get in.  His office manager asked when would it be most convenient for me?

As I said, none of this occurred because Dr. Backs is a personal friend — it’s all part of his practice that any patient receives.  By now you should be wondering how this could all happen.  The answer is very simple:

Because I pay him.

I know that may sound strange in a society that’s reached a point where most people think that either their employer or the government is responsible for providing health care for them.

Instead, this is how Craig’s practice operates:

I pay an annual fee for his services.  It’s a little more than my cable/internet service bill is for the year, but not enough to be called “concierge health care.”  Craig’s term for it is “personal medicine.”

For that fee, I get my annual checkup and his email and phone numbers.  There’s a nominal fee for additional office visits (probably a polite way to discourage hypochondria overuse) and I pay for any lab work.   I also get a commitment from Craig that he’ll limit the number of clients his practice will accept, probably no more than 500 to start.  I won’t be dealing with nurses, physician assistants, or — under normal circumstances — answering and message services.  When I have a problem or question, I’ll be talking directly to him.  The fee covers kids in the household (up to a certain age), and also any friends or family who are visiting from out of town.

I don’t have to worry that some insurance company is going to tell me I’ve got to pick a new physician because Craig is no longer on the “preferred provider” (low bidder) list.  Or that any tests or treatments Craig suggests are dictated by an insurance company policy manual instead of my doctor’s judgement.

Since I’m paying a decent fee up front, Craig doesn’t have to payroll an entire accounting and clerical staff to code, process, submit and follow up on insurance and government reimbursement claims.  He doesn’t have to wait until the state scratches enough money together to send him some percentage of money he’s due.  He doesn’t have to wonder if the feds are really going to cut his reimbursement rates for seniors by 30 percent next year.  He can also respond and help with many patient issues via email or phone.   This is something many physicians are understandably hesitant to do, because they’re still using their time and putting themselves on the hook for liability concerns, but reimbursement in the insurance systems all center on an office visit.

That reception area will continue to be lightly populated, as it doesn’t have to be sized and used as a revenue queue/holding pen like under the current medical paradigm, where contracts and reimbursement rates mean if the pipeline isn’t full and the doctors aren’t seeing 30 or more patients a day, they’re losing money.  Craig  won’t have to order batteries of tests to give him information that he can instead glean with the time he can now spend with each patient.

I believe that this is to health care what the real and local foods movement is to eating and nutrition.  That is, this is a modern adaptation to get back to the fundamentals that we lost in the march towards bigger, faster, cheaper.  It costs more, but the quality difference is obvious and meaningful.

I’ve always said that although we can all use experts, the bottom line is no one can care about your kids, your money, or your health as much as you can.  Personal medicine is a trifecta.

See you in the comments.

Cheers,

The Older Brother