Archive for the “Random Musings” Category

Calories. Sheesh, here we go again. Apparently it’s the debate that will never die. Hardly a week goes by without yet another calories count vs. no it’s all about hormones dustup on the Fat Head Facebook group. I’ve addressed the topic many times, but I’ll give it another whack.

In online debates, people seem to take one of two positions: 1) gaining and losing weight is a simple, linear function of how many calories you consume, or 2) calories have nothing to do with gaining and losing weight.

I don’t subscribe to either position.

Hundreds of people have emailed me over the years to tell me after watching Fat Head, they finally lost weight after years of frustration with low-fat/low-calorie diets. I’m grateful for that. But in case you’ve forgotten (or never saw the film), here’s what I said before starting my fast-food diet:

So here’s my plan: using my functioning brain, I did a few minutes of research and found that a man of my size and activity level burns about 2500 calories per day. To create a calorie deficit, I’m setting a target of 2000 calories per day. I’ll also burn a few extra calories by walking six nights per week instead of my usual three. But, here’s the really important part: To make sure my body can burn its own fat for fuel, I’m going to keep my insulin down by limiting my carbohydrates to about 100 per day.

I didn’t pull that plan out of thin air. While researching diets, health and weight loss online, I came across a few posts by some doctor named Mike Eades that made perfect sense. I wasn’t previously familiar with him, so before getting in touch to ask about a possible interview, I read both Protein Power and The Protein Power Lifeplan, the books he wrote with his wife, Dr. Mary Dan Eades.

Both books were very enlightening. I finally understood why I’d failed to lose weight on low-fat/low-calorie diets full of hearthealthywholegrains! and other garbage carbs: I was trying to restrict calories while eating foods that were signaling my body to store fat. When you fight your own body, your body wins. If you want your body to cooperate, you need to get into a hormonal state where it’s willing to burn away stored fat. But willing to burn stored fat isn’t the same as has a need to burn stored fat.

Here’s a quote from Protein Power (bold emphasis mine):

Try to make it a habit to keep good records of what you’re eating, how much you exercise, and how you feel. Having an accurate written record also gives you some hard data to look at if you hit a plateau. Are you simply eating too much? Have you missed exercising regularly?

Protein Power includes a formula for guesstimating your daily protein requirement. Mine came out at around 120 grams per day. Later in the book, there are instructions for moving out of the initial (very low-carb) phase, through a second phase, and finally to a maintenance phase:

Increase your daily carbohydrate intake in 10-gram increments until you reach an amount approximately equal to your daily protein intake – e.g., if your daily protein intake is 75 grams, increase your daily carbohydrate gram total from 55 grams (the Phase II level) to 65 grams and finally to 75 grams.

Protein and carbohydrate roughly in balance … yeah, that sounded good.  So as someone who walked six miles several nights per week, I chose a target of 100 grams or more of protein per day, plus around 100 grams of carbohydrate. Yes, that’s more like a maintenance phase, but I was pretty sure that would get me into a hormonal state of willing to burn fat. Then I chose a target of 2,000 calories to create the need to burn fat.

Here’s another quote from The Protein Power Lifeplan (again, bold emphasis mine):

There are basically seven methods we use in our practice to improve insulin sensitivity, and all the but the last are part of the Protein Power Lifeplan:

1. Decrease carbohydrate intake
2. Decrease calorie intake
3. Exercise
4. Alter the dietary fat profile
5. Supplements
6. Deplete the body of excess stored iron
7. Medications

And later in the same chapter:

Carbohydrate restriction actually aids in the calorie-restriction process. A number of studies have demonstrated that when presented with unlimited quantities of foods containing high, moderate, or low amounts of carbohydrates, the group given the high-carbohydrate foods will eat more calories than the group given the low-carbohydrate foods …

And finally, here’s a quote from one of Dr. Eades’ blog posts, which he forwarded to me today in an email:

Although the lowered insulin and elevated glucagon open the doors to the fat cells allowing fat to come out to be burned, the fat comes out only if it’s needed. If you are meeting all your body’s energy needs with the food you eat, the body doesn’t need the fat in the fat cells. On a low-carb diet your body burns fat for energy. But it doesn’t care where this fat comes from; it can come from the diet or it can come from the fat cells or it can come from both. If you are consuming enough fat to meet all your body’s requirements, your body won’t go after the fat in the fat cells no matter how severely you restrict your carbs. You will burn dietary fat only and no body fat. And you won’t lose weight. It’s that simple.

That’s a pretty far cry from calories have nothing to do with it, wouldn’t you agree? That’s why you won’t see me melting a stick of butter into my morning coffee. I don’t see the point. It’s not going to help with weight loss unless you’re still creating a need to burn body fat by restricting elsewhere. I’d rather eat a few eggs for breakfast and get some protein into the equation.

But wait … haven’t I written a bunch of posts trashing the CICO theory? Why yes, I have.

My beef with the CICO crowd is that they’re constantly pushing a belief that simply isn’t true: namely, that our bodies work like simple bank accounts, with calories substituting for dollars. Cut 500 calories per day from you diet, and by gosh, you’ll automatically burn away one pound of fat per week. Cut 1,000 calories per day from you diet, and by gosh, you’ll double the fat loss to two pounds per week. Start eating an extra 500 calories per day, and by gosh, you’ll automatically gain a pound of fat per week, etc., etc. All based on simple, predictable, linear math.

In the Fat Head Kids book, we call that The Piggy Bank Theory. There are reams of evidence that it simply doesn’t work in real life. We mentioned some of that evidence in the book. You can read up on more of the evidence in The poor, misunderstood calorie by Dr. Bill Lagakos or The Calorie Myth by Jonathan Bailor.

The Piggy Bank Theory doesn’t work because it ignores the fact that the calories-in side of the equation affects the calories-out side of the equation.  Or to stick with a banking analogy, it ignores the decisions made by an account manager who controls all your spending and receives a constant stream of instructions from the bank — many of which are determined by what kind of currency you deposit, not just how much. (I used the account-manager analogy in an early draft of the book before switching to the biological-spaceship analogy.)

If the account manager has instructions to increase your savings account, she’ll probably start by sending you messages demanding bigger daily deposits. But if you refuse, she’ll turn down the thermostat to spend less on fuel. She’ll cancel the daily repair jobs to spend less on construction. Then she’ll take the savings and put them in your account.

Or if the account manager is under orders NOT to increase the size of your account even though you’re making bigger deposits, she’ll ratchet up spending. She’ll turn up the thermostat to spend more on fuel. She’ll spend your extra deposits by hiring construction crews to tear down and rebuild portions of the building, then do it again. She might even take some of the dollars you deposit and flush them down the toilet.

That’s why Piggy Bank math doesn’t work in real life. The account manager receives and follows instructions we can’t control simply by depositing fewer dollars. But that’s not the same as saying the number of dollars you deposit has nothing to do with the size of your savings account.  Of course your deposits affect your balance.

That doesn’t necessarily mean you have to count calories. Lots of people find that when they ditch the sugars and processed carbs, or go full-blown ketogenic, they finally lose weight after years of frustration and failure, even if they’re not counting calories. That’s because the change in diet changed the instructions sent to the account manager. She was informed that it’s okay now to start draining dollars from the savings account. So she kept the spending high and/or requested fewer deposits.

But once again, the fact that many people on a low-carb diet lose weight without counting calories doesn’t mean everyone on a low-carb diet will lose weight without counting calories. Here’s another quote from The Protein Power Lifeplan:

Patients come into the clinic or send us their diet diaries indicating that they have been keeping their carbohydrate intake within the prescribed limits or even lower, and yet they haven’t been losing weight, and they want to know why. We question them or look at their diaries and often find that they have indeed been keeping their carbohydrate intake low but at the same time have been eating enormous quantities of food.

The book goes on to describe how quite often, people eating these large quantities of food didn’t lose weight, but also didn’t gain. Dr. Eades mentioned that again in an email:

If people are extremely calorically restricted, they do about the same on any diet, because the body is using everything coming through the mouth.  Where it gets interesting is at the other end of the spectrum.  When people go on rigid low-carb diets, but overconsume calories, they don’t really gain weight.  They don’t lose, but they don’t gain, either.  Somehow the low-carb diet really ratchets up the energy expenditure when low-carb calories are high.  I’ve seen this in patients (as has MD) innumerable times, and I’ve had a number of readers write to tell me about it.

We know that’s not true for everyone, but it’s certainly been true for me. In fact, that’s what I consider the real gift of a low-carb diet: the resistance to weight gain. I’ve gone on cruises and eaten like a king for a week … bacon and sausage and eggs with hollandaise sauce, meat-and-vegetable salads with bleu cheese dressing, steaks and lobsters and shrimp cocktails, and plenty of butter with everything. Then I step on the scale at the gym when I get home and find I haven’t gained an ounce. Love it.

But that’s not the same as losing weight. So to wrap up, let’s return to The Protein Power Lifeplan:

We can take home a couple of lessons from this example. The first is that although cutting carbohydrates doesn’t necessarily mean you will lose a lot more weight than you would on a high-carbohydrate diet of equal calories, it does mean that if you eat a huge number of calories in low-carbohydrate form, you will be prevented from gaining the weight you would on a high-carbohydrate diet of the same number of calories. The second lesson is that if you want to lose weight, you have to watch the calories – even on a low-carbohydrate diet – particularly if you’re a small person…. To lose weight, you’ve got to create an energy deficit.

Hormones, not calories, determine whether your body wants to burn fat or store fat. But even when your body wants to burn fat, you still have to give it a reason to raid the fat stores.  Some people begin burning and/or excreting more calories than they consume automatically when they go low-carb or ketogenic.  But some people don’t.  I’ve heard from plenty of people who had to combine carbohydrate restriction with some degree of calorie restriction to finally drop the pounds.

So please, let’s stop insisting nobody has to count calories.  It simply isn’t true.

 

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Boy, I was really hoping we wouldn’t be found out. But now that it’s out in the open, I guess it’s time to admit it: I’m a member of a cult. Dr. Steve Nissen, the nation’s statinator-in-chief, exposed the cult in a recent editorial. Here are some quotes from an article in CardioBrief:

A leading cardiologist has unleashed a blistering attack on “statin denial,” which he calls “an internet-driven cult with deadly consequences.”

In an editorial in Annals of Internal Medicine, Steve Nissen (Cleveland Clinic) expresses grave concerns over statistics showing that only 61% of people given a prescription for a statin were adherent at 3 months. “For a treatment with such well-documented morbidity and mortality benefits, these adherence rates are shockingly low. Why?” he asks.

Good question: why are so few people taking their life-saving statins? Since I’ve employed several Svengali-like deception and persuasion techniques in my posts, many of you who read this blog probably think people are avoiding statins because the drugs don’t work as well as the pharmaceutical companies want us to believe.  Or because the side-effects are worse than reported by pharmaceutical companies.  Or because statins damage muscles.  Or because there’s no evidence statins prevent heart attacks in women or the elderly.  Or because statins screw up people’s brains.

But Dr. Nissen (who by pure coincidence receives a ton of money from pharmaceutical companies) has figured out the real reason:

Nissen writes that “we are losing the battle for the hearts and minds of our patients to Web sites developed by people with little or no scientific expertise, who often pedal ‘natural’ or ‘drug-free’ remedies for elevated cholesterol levels.” The anti-statin forces employ two distinct strategies, “statin denial, the proposition that cholesterol is not related to heart disease, and statin fear, the notion that lowering serum cholesterol levels will cause serious adverse effects.” Nissen admits that some patients will have statin-related adverse effects but “intolerance in many patients undoubtedly represents the nocebo effect.”

That is, of course, what happened with my mom. The only reason she experienced awful muscle and joint pains while on statins is that she believed they might cause muscle and joint pains. Granted, she didn’t believe statins could cause muscle and joint pains until she complained to me about the pains and I asked if she was on statins. But that’s the power of cult-like thinking: it can go backwards in time and cause a nocebo effect.

Anyway, now that the cat’s out of the bag, I may as well tell you about the cult. To make the confession more convincing, I clipped some “signs and practices of cults” from the internet as headings.

Authoritarian leadership. Cult members are expected to completely submit to a leader who is seen as a prophet, apostle, or special individual with unusual connections to God.

Our authoritarian leader is, of course, Dr. Uffe Ranvskov. All of us who joined the cult have a 10-foot-tall picture of him somewhere in our houses or apartments. We’re required to bow to the picture six times per day while chanting “cholesterol does not cause heart disease.”

Dr. Malcolm Kendrick is our Maximum Leader’s … uh, I mean Dr. Ravnskov’s second-in-command. His picture is only six feet tall and we only have to bow to it on Sundays. However, we all know that any command Dr. Kendrick issues is coming directly from Dr. Ravnskov and should be treated as such.

Opposition to Independent Thinking. Questioning, doubt, and dissent are discouraged or even punished.

I’m on the email list for THINCS (The International Network of Cholesterol Sceptics), and I can tell you there’s never any debate or discussion among the members. It’s just one email after another agreeing with whatever Dr. Ravnskov says.  This is, of course, exactly the opposite of what happens with doctors, who are constantly debating the risks and benefits of statins while attending seminars sponsored by Pfizer.

And I can attest to that bit about punishment. Remember when I told you all how I banged myself in the head with a t-post hammer while building a chicken yard? Well, that’s not what happened. I made the mistake of wondering aloud if perhaps statins were okay for some people. I was alone in the back pasture and didn’t think anyone was listening. But sure enough, I got a call from Dr. Ravnskov within the hour.

“Listen, doubter,” he told me. “Your brain clearly isn’t working correctly. I want you to go to the tool shed, grab a 16-pound steel hammer, and smack yourself in the skull with it. Do this, or be banished.”

Love Bombing. Cult members show great attention and love to a person to help transfer emotional dependence to the group.

After he ordered me to hit myself in the head with a hammer, Dr. Ravnskov had several cult members drop by and tell me how awesome I looked with a big wound on my head. Then we all played checkers and they let me win every game.  I never felt more loved.

Isolation. Subservience to the group requires members to cut ties with family and friends, and radically alter the personal goals and activities they had before joining the group.

I was hoping all those farm reports including pictures of Chareva and the girls would provide some cover. But the truth is, they left two years ago … perhaps because Chareva asked me why I’m always posting about the dangers of statins, and I offered to smack her in the head with a 16-pound steel hammer to help get her mind right.  Anyway, doesn’t matter.  Those pictures of us working on the farm together are all old.  I now live alone and dedicate all my time and energy to whatever Dr. Ravnskov asks of me.

Group Think. The leadership dictates, sometimes in great detail, how members should think, act, and feel.

Yes, that happens all the time in our cult. I don’t know how I feel about it because Dr. Ravnskov hasn’t told me yet.

Salvation. Members are often promised salvation from an apocalyptic future through association with the group and its Special Knowledge.

I can’t explain this one in great detail. I’ve only reached level nine in the cult, which means I haven’t been given all the details on the master plan. (To reach level 10, I have to start giving them 90% of my income instead of the current 75%.)

I do know, however, that the plan came to Dr. Ravnskov in the form of secret messages in Beatles songs. The gist of it is that if we convince everyone to stop taking statins, the current leaders in society will all die of heart attacks. With a leadership void created, the oppressed masses will rise up and kill all the oppressors and all the good doctors who prescribe statins. The cult members, of course, will be hiding out in the desert until it’s over. Then we’ll emerge from hiding, and the formerly oppressed people will welcome us as heroes and put us in charge. Then we’ll oppress them by refusing to let them take statins and other miracle drugs.

If for some reason the oppressed people decide instead to put themselves in charge and oppress us, we’ll all drink a special concoction of coconut oil and bacon fat, at which point a spaceship will pick us up and take us to another universe, where we’ll be placed on a planet with no human population, but an endless supply of eggs. Then our task will be to eat eggs and populate the planet.

I’m not sure how a planet without humans can be full of chickens to lay eggs, but like I said, I haven’t been given all the details.

Mind-Altering Practices. Meditation, chanting, speaking in tongues, and debilitating work routines are used in excess and serve to suppress doubts about the group and its leader.

I don’t know if we do this one or not. But I have to stop writing now. Dr. Ravnskov just called and told me to go out and mow the entire back of the property, then do it again tomorrow.

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Hey Fatheads!

I know I usually do the right thing and disappear for a few months after commandeering The Big Chair, but this was too good not to share.

I was perusing the local paper of record Monday and there was a story headlined “BEHAVIOR ANALYSIS: Free services offered to children with skill deficits.” It was about a”new intensive feeding clinic” developed by the Southern Illinois University’s Child Behavior Research and Training Lab. Its mission is to help parents use “Applied Behavior Analysis” (ABA) to overcome the dread “picky eater” crisis that’s sweeping the nation.

I’m assuming it must be a crisis, anyway, since one of our main public universities — in a state that is hundreds of billions behind on pension funding, hasn’t passed a budget in over two years, and has put half of the NFP social service agencies out of business — is devoting resources to it and running the program at no charge.

They’re applying some of their expertise from other areas of child behavior. One example, for instance, was how to avoid your kid having a tantrum in the store because you won’t buy them Skittles. So the solution offered by the expert is to give them one Skittle per minute while shopping.

Seriously. These are experts.

I’m accustomed to such credentialed idiocy (as are most Fat Heads, I believe), but another line regarding a predecessor program being used as a template for the picky eater solution had me howling out loud:

“Earlier this spring, Hirst rolled out an intensive, one-day potty training program that incorporates a mix of evidence-based procedures. “

Yep, there it is kids. Pre-adolescent turd disposal has joined the elite ranks of all things evidence-based. So if any of you still thought “evidence-based” had any real meaning, that swishing sound you hear is the last shred of any of the term’s rhetorical value swirling around the bowl.


Don’t worry, Mom — it’s evidence-based!

We now return to our regular programming…

Cheers!

The Older Brother

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Greetings Fat Heads!

Well, still here. Hope you had a great Memorial Day weekend. Special thanks to all vets and their families. Tom and family are back from the 2017 Low Carb Cruise, happily exhausted. I’m looking forward to getting the full report. I told him if he wanted to wait until next week, I’d fill in Thursday with an “evidence-based” rant.

Anyway, when I left off at the last post, Jimmy Kimmel’s son was doing great and I was in a bad mood. Not about Mr. Kimmel’s son of course. That was the wonderful part. The level of care we have available in this time and in this country is beyond the imagination of what was available to the richest people and kings even a few decades ago.

I wasn’t even particularly stirred up over Mr. Kimmel’s making the availability of the miraculous procedure that saved his son somehow tied in with keeping Obamacare intact. Between being a dad just past a major health scare and living in La La Land among the economically illiterate (seldom right, but never in doubt) I’m okay with him calling it any way he wants. I put it in there with the “all brides and babies are beautiful” protocol. It accomplishes nothing to argue, and it’s just plain rude.

The rest of the Idiocracy, however, deserves no so respect. Instead of politely giving Jimmy’s emotional description props and then moving on, they treated his completely sincere and completely uninformed comments on insurance and Obamacare as the Magnum Opus of the health care debate.

At any rate, I stated toward the end “It’s not like we don’t have major issues with the health care system in the good old U.S. of A. But the issues are with the availability of dollars, not doctors, …”

There are issues with dollars. As I mentioned, I was aware of Kimmel’s son’s condition because The Oldest Grandson had the same thing – and the same miraculous treatment – when he was born just about ten years ago (yes—before Obamacare).

His mom, my daughter-in-law, pointed out that back then just his hospital tab was over $300,000, which would break anyone without insurance, not to mention that he’s facing at least two more surgeries. Under insurance as it mostly existed prior to the current debacle, there could be real issues with lifetime spending caps and him trying to get health insurance as an adult with that type of pre-existing condition.

To paraphrase an old politician, $300,000 here, $300,000 there – pretty soon you’re talking real money! Definitely a dollars issue.

So what’s a libertarian to do? Is there a solution other than “I’m sorry, Mr. Kimmel, there’s nothing we can do?” That’s what you would hear in most of those countries where it’s “free.” Don’t we want to save babies in this country? Wouldn’t it be nice to be able to do that and not go broke? How can we do that today, and still be able for that kid to afford reasonable health care later?

Fortuitously, Dr. William Davis’ new book – “Undoctored” came out just recently, and Tom did a book review.

[Confession time – I don’t read Tom’s book reviews any more. When I see he’s written one, I just save myself the time and buy the damned book.]

Now, if you want a great book on the disastrous macro-economics of our health care system, and policy proposals to address insurance and health system availability at a national level, don’t buy this book. That’s totally not what it’s about.

What it is about is you getting control of your health, which Dr. Davis reiterates throughout is not particularly connected to medical care. In fact, unless you get yourself informed and proactive, medical care can often be inversely related to your health. Although he doesn’t do a deep dive on the economic history of the health care system, he does do a great job illuminating how the money and incentives in the current system don’t line up with attaining real health as an individual. Then you’re off on a terrific primer in how to evaluate, improve, and monitor your health, in conjunction with health care professionals who will work with you and at your direction when needed.

Seriously, buy the book.

Okay, so how’s that tie in with the subject at hand? Well, the idea that the medical industry is more responsive to money than patient outcomes was nothing new to me – or probably any Fat Head, really. “Have a $tatin with that hearthealthywholegrain muffin” vs. “have the bacon and eggs and take a walk,” right? So, I was already on board with the concept.

Right in the introduction to “Undoctored,” Dr. Davis noted that we spend (endlessly pointed out with delight by the single-payer cheerleaders) over $3 trillion dollars a year – 17% of our GDP — on health care. Which I also already knew.  But this time when I read it I’d been thinking about Kimmel’s performance, and my daughter-in-law’s point, and then pretty close in to the beginning of the book Davis points out that:

“The system is ready and willing to commit you to a life of taking drugs and injectable insulin for diabetes, … providing “education” designed by people who put commercial interests first, while no one provides the handful of inexpensive health strategies that have been shown to reduce, even fully reverse, type 2 diabetes.”

Once again, nothing I didn’t already know, but it kind of all came together at that point and I thought, “well, just how the hell much do we spend on all of this crap?!?”

So I looked it up.

I tend to do that. I just stopped reading and went Googling for info on how much money we spend on the various medical substitutes for good habits. I’d like to think it’s due to my insatiable inquisitiveness when I’ve got an intellectual conundrum, but it’s probably just ADD.

I struck gold fairly quickly when I found a JAMA paper from 2016 titled “US Spending on Personal Health Care and Public Health, 1996-2013.” They collected seven years of data from 183 sources and sorted them into 155 conditions. The numbers, which, once again, we’ve probably all heard at different times, are stunning when you look at the whole picture.

The total spending for 2013 – the last year in the study – was $2.1 trillion. The estimate for 2014 was $2.9 trillion, so Dr. Davis’ $3 trillion seems to line up well with the reports info, and it would be safe to assume that the numbers I’ve got increased proportionately.  So, pretty much every number I’ve got has likely gone up by 50%. But here are some of the things we see:

Right off the bat, “diabetes had the highest health care spending in 2013, with an estimated $101.4 billion in spending, including 57.6% spent on pharmaceuticals…”

Keep in mind, that’s more like $150 billion today. One hundred and fifty billion dollars. A year. For a “disease” that’s easily 90% treatable by just stepping away from carbs.

Heart disease – the one that Dr. Davis put himself out of business from treating by getting people to change their lifestyles vs. post factum medical treatment — was $88.1 billion, so I’m calling it $130 billion.  I’m not saying no one would ever have a heart attack if we all stopped cooking with vegetable oil and started taking an evening walk, but it wouldn’t be an industry that by itself would rank in the top quarter of the rest of the world’s GDP’s.

Plus, that $130 billion does NOT include treatment for hyperlipidemia (i.e., statins) which earns itself $52 billion ($75B?) all by itself, or high blood pressure.

Here’s some other big ticket items, almost all of which the case studies of folks in “Undoctored” either completely reversed or substantially improved – often within weeks – of making the simple changes that Dr. Davis promotes:

Blood Pressure:  $84 Billion

Back & neck pain (think largely obesity and sedentary lifestyle related, so I’m counting it): $88 Billion

Depression (think mood disorders and gut biome dysbiosis. Not considered are other “mental” health issues – ADD, bipolar, etc): $70 Billion

Dental (tooth decay, inflammation): $66 Billion

Skin conditions: $55 Billion

Alzheimers and other dementias (i.e., Type III diabetes): $36.7 Billion

The 2013 numbers for all of those come up to about $469 Billion, which scales up to over $700 Billion in today’s spending. Mostly avoidable by straightforward, understandable lifestyle modification.

Like I said, some people will still have heart attacks, or pull a back muscle, or get depressed and need some help so you don’t have a 100% savings on the table; but the largest part of these diseases are self-inflicted and self-treatable.

I also left out other categories (Osteoarthritis – $47.9B; Asthma – $32.5B; Endocrine, metabolic, and immune disorders – $19.6B; and cancers, which were disaggregated into 29 separate conditions); so there’s some pickup available from the same lifestyle changes in areas I’m not counting. The point is that nearly one quarter of our health care spending is going to conditions that we have the capability of exerting a large degree of control over. Quickly.

Preterm birth complications, BTW, ranked 73rd at just under $5 Billion, so it seems like if we could get a handle on our grain and industrial foods habit, Jimmy Kimmel’s son and my grandson shouldn’t cause too much financial discomfort to the system.

After thinking about this, I had an epiphany.

I know Tom and many others, including myself, have compared the various and sundry mandatory coverages — dictated via Obamacare and other legislated and regulatory bodies — to requiring your auto insurance provider to include free oil changes, tire rotation, tune-ups, etc.  in your policy. The point being that these are known conditions that are a routine part of automobile ownership. Inclusion in a policy would only increase overhead and incentivize over-utilization, resulting in inevitable, recurring premium increases.

We completely misrepresented the argument. It’s correct as far as it goes, but it stops so short of reality that I count it as a huge error.

Our entire medical cost reimbursement system, as currently comprised, is like requiring that all auto insurance companies include DUI coverage in your policy.

It was stupid that my health insurance covered the two or three doctor office visits for the ear infections we knew The Sons were each going to get each year when they were toddlers. Same for the bottle of pick stuff we’d pick up at the pharmacy after each visit.

But it’s insane that insurance would pay for insulin for the 90% of people who could avoid the pharmacy if they’d stop blasting their system with sugar in all its forms. Same with all those other diseases of civilization driving a quarter of our spending. We’re making it convenient and cheaper for people to engage in behavior that’s harming them.

Add in the USDA budget with its massive grain subsidies and the SNAP (food stamp) program, and it’s like after adding the DUI coverage, we then pass out free booze to the people with the worst driving records.

So what about this — I say we should remove mandated coverage of all of those lifestyle diseases – Type II diabetes, blood pressure, non-emergency heart disease treatment, etc.

Companies would be free to make them available, but they’d be add-on items to a base policy and they’d also be rateable. I’m not interested in preventing someone from purchasing diabetes “treatment” coverage with their insurance, but I don’t want to be forced to “chip in.”

Rateable means they could adjust the premium, for example, based on a periodic A1C, fasting insulin, or some other marker to account for the risk and behavior of the policy owner. Behavior instantly gets coupled to economic consequences.

So people could pay higher premiums for diabetes treatment coverage, pay out of their own pocket for drugs and medical attention, or eat more veggies and fat and cut back on the sugar. I predict immediate, dramatic changes.

I don’t see why we couldn’t reduce medical spending by half a trillion dollars, plus another $100 billion a year by driving a stake through the USDA’s heart.  Putting money aside for just a moment, can you begin to imagine the quality of life improvements people would get?

Of course, I do see why we can’t. Politics. Money. Bureaucracy. Power. The usual suspects. But that doesn’t mean it’s not technically possible or the right thing to do.

It also doesn’t mean that you can’t get started, or step up your game so that you can limit your interaction with the medical system as much as possible. Just because you have to sacrifice them your money doesn’t mean you have to sacrifice your health, too!

Cheers,

The Older Brother

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While I’ve been busy trying to finish the book and make serious progress on the film (which I’m supposed to show on the low-carb cruise in just 10 weeks), my inbox been piling up.  So here are some interesting items.

Why Arctic natives are getting fat

Here are some quotes from an article in the Siberian Times with the provocative title First-ever cases of obesity in Arctic peoples as noodles replace traditional diet:

Subtle changes in traditional lifestyle of native ethnic groups in the Yamalo-Nenets region have brought the first-ever cases of obesity. Until now, fatness has not existed in these population groups, but scientists say there has been a marked change.

Alexey Titovsky, regional director for science and innovation, said: ‘It never happened before that the small local indigenous peoples of the north suffered from obesity. It is a nonsensical modern problem. Now even a predisposition to obesity is being noticed.’

And what’s driving this unfortunate development?

Changes have seen the intake of venison and river fish cut by half, he said. ‘Over the past few years the diet has changed considerably, and people living in the tundra started eating so-called chemically processed products.’

Well, it sounds to me as if the natives are eating less red meat.  According to the experts at various government health organizations, that means they’re getting healthier.

Researcher Dr Andrey Lobanov says nomadic herders nowadays often buy instant noodles in villages on their pasture routes and this has led to  ‘dramatic changes to the rations of the people living in the tundra’.

Wait … are these whole-grain noodles?  Because if they are, according to the experts at various government health organizations, that means the Arctic natives are getting healthier.

‘The problem is that carbohydrates do not contain the necessary micro elements which help survival in Arctic conditions,’ he said. ‘The seasonal diet has also changed – the periods when they do not eat traditional food and replace it with carbohydrates has become longer.’

No, no, no!  Carbohydrates don’t make people fat.  I’ve heard that from countless internet cowboys.  If these people are getting fat for the first time in their culture’s history, it’s because they’ve become weak-willed and started eating too much. And they’re probably not exercising enough.  Maybe some of them should become contestants on The Biggest Loser and learn how to stay healthy through long sessions of tortuous exercise.

Biggest Loser trainer has a heart attack

As I replied to The Older Brother when he sent me a link to this story, if I were still a Catholic, I’d have to go to confession because of my reaction.  Here are some quotes from Yahoo news.

Fitness trainer and host of NBC’s “Biggest Loser” Bob Harper says he is recovering from a serious heart attack that left him unconscious for two days.

During which time he was on a very-low-calorie diet and lost some weight.

Harper tells TMZ he was working out in a gym in New York City this month when he collapsed. He says a doctor who also was in the gym performed CPR on him.

Jillian Michaels was spotted in the background saying, “I’m happy he had a heart attack.  He doesn’t work hard enough.”

The 51-year-old Harper, whose mother died from a heart attack, says he spent eight days in a New York hospital and has not yet been cleared to fly home to Los Angeles.

Harper has been a fixture on all 17 seasons of “The Biggest Loser.” He served as a trainer on the show from 2004 to 2015. He took over as host of the reality weight loss program last year.

Perhaps because the public grew tired of watching Jillian Michaels say she was happy when she drove contestants into throwing up during exercise sessions.

How Breaking Bad star dropped the pounds

I admire Bryan Cranston because of his amazing range as an actor.  Subtle humor in Seinfeld as Dr. Tim Whatley.  Slapstick humor as the father in Malcolm in the Middle.  And then … wow … the dramatic chops he put on display during six seasons of Breaking Bad.

Some years ago, Chareva and I attended a charity event featuring several big-name comedians … Robin Williams, Paula Poundstone and Jonathan Winters, to name a few.  Cranston was the emcee, and he was a stitch.  Very charming and very quick-witted.

Anyway, here are some quotes from an online article explaining how Cranston lost weight to make the chemotherapy treatments in Breaking Bad believable:

Howard Stern interviewed Bryan Cranston on March 4, 2014 and asked him how he lost weight so quickly for his role as Walter White on Breaking Bad.

HS: When you had chemo and was getting sick playing the part of Walter White, in order to go through rapid weight loss you deliberately didn’t eat for 10 days? True or false?

BC: False.

HS: How’d you lose all that weight?

BC: No carbohydrates. I just took out all the carbohydrates.

HS: How much weight did you drop?

BC: 16 pounds, in ten days.

HS: Painful?

BC: No. The first three days are really hard, ’cause your body’s changing and craving sugar and wants, you know, and then you deprive it of the sugar and it starts burning fat.

No, no, no.  That can’t be right.  People don’t lose weight by giving up carbohydrates.  If Cranston lost weight, it just means he finally had the willpower to eat less and consume fewer calories than he burned.

Obesity blame and politics

Speaking of willpower, do Republicans and Democrats have different opinions on whether getting fat is about willpower?  Apparently they do, at least to some degree.  Here are some quotes from a EurekaAlert article:

People’s political leanings and their own weight shape opinions on obesity-related public policies, according to a new study by two University of Kansas researchers.

Actually, Republicans — no matter how much they weigh — believe eating and lifestyle habits cause obesity, the research found.

But among Democrats there is more of a dividing line, said Mark Joslyn, a KU professor of political science. Those who identify themselves as overweight are more likely to believe genetic factors cause obesity.

I’m not a Republican or a Democrat, so I guess I’m allowed to say it’s both.

Of course genetics figures into it.  There’s a reason some people never gain or lose weight despite eating whatever and whenever they choose.  That’s how their bodies are programmed.  It’s genetics.  But among those of us not so genetically blessed, it’s largely about what kinds of foods we eat.  Genetics loads the gun, diet pulls the trigger.

Would you like actual chicken in your chicken sandwich?

When I order chicken at a fast-food restaurant, I kind of expect most of it to be made from chicken.  That seems to be the case for many chains, but not for one.  Here are some quotes from a CBC (Canada) article online:

A DNA analysis of the poultry in several popular grilled chicken sandwiches and wraps found at least one fast food restaurant isn’t serving up nearly as much of the key ingredient as people may think.

An unadulterated piece of chicken from the store should come in at 100 per cent chicken DNA.  Seasoning, marinating or processing meat would bring that number down, so fast food samples seasoned for taste wouldn’t be expected to hit that 100 per cent target.

So researchers bought some fast food and tested the DNA of the chicken meals.  Here are the typical results:

    A&W Chicken Grill Deluxe averaged 89.4 per cent chicken DNA
    McDonald’s Country Chicken – Grilled averaged 84.9 per cent chicken DNA
    Tim Hortons Chipotle Chicken Grilled Wrap averaged 86.5 per cent chicken DNA
    Wendy’s Grilled Chicken Sandwich averaged 88.5 per cent chicken DNA

And now for the big exception:

Subway’s results were such an outlier that the team decided to test them again, biopsying five new oven roasted chicken pieces, and five new orders of chicken strips.

Those results were averaged: the oven roasted chicken scored 53.6 per cent chicken DNA, and the chicken strips were found to have just 42.8 per cent chicken DNA.

So what the @#$% is taking the place of half the chicken in the chicken?

The majority of the remaining DNA? Soy.

Yummy.  But at least their sandwiches are low in fat.  And as we all know, that low-fat movement has done wonders for the nation’s health, especially among the younger generation …

More young people getting colorectal cancer

Obesity is on the rise among young people.  Diabetes is on the rise among young people.  And now there’s this startling development, as reported in The New York Times:

Cancers of the colon and rectum have been declining in older adults in recent decades and have always been considered rare in young people. But scientists are reporting a sharp rise in colorectal cancers in adults as young as their 20s and 30s, an ominous trend.

The vast majority of colorectal cancers are still found in older people, with nearly 90 percent of all cases diagnosed in people over 50. But a new study from the American Cancer Society that analyzed cancer incidence by birth year found that colorectal cancer rates, which had dropped steadily for people born between 1890 and 1950, have been increasing for every generation born since 1950. Experts aren’t sure why.

Well, maybe we can guess.  Let’s see … every generation born since 1950.  I was born in 1958.  By the time I was 20, we were all being told saturated fat and cholesterol will kill us, while grains will make us healthy.  Grain consumption rose sharply for the next 35 years or so and has only recently started declining.  During the same period, food manufacturers added more sugar to foods to hide the fact that many low-fat foods taste like cardboard unless you make them sweeter.

Most colorectal cancers are considered a disease of aging, so any increase in young adults, especially when rates of the disease are on the wane in older people, is both baffling and worrisome, experts say.

By the way, red meat consumption dropped rather dramatically during the same period when colon cancer rose sharply among young people.  Don’t the vegetrollians always tell us red meat causes colon cancer?

You can’t buy Kerrygold butter in Wisconsin

If I’ve said it once, I’ve said it at least twice:  when politicians rush in to “protect” the public from some supposed hazard, it’s rarely about protecting the public.  It’s almost always about some protecting some established business or industry.  Here’s an example from a Chicago Tribune article:

When Wisconsin resident Julie Rider shops for groceries, there’s one item she can’t legally buy at her local market — or at any stores in her state.

Because of a decades-old state law, Rider’s favorite butter — Kerrygold, imported from Ireland — isn’t allowed on Wisconsin store shelves.

The law, requiring butter sold in Wisconsin to be graded for taste, texture and color through a federal or state system, effectively bans butter produced outside the U.S., as well as many artisanal butters that also aren’t rated.

This means some residents of the Dairy State have to drive across the border into Illinois just to buy their favorite butter.

Whether Wisconsin’s law was intended as market protection for the state’s dairy industry or is simply a means to ensure quality, Rider, for one, thinks it’s “crazy.”

Oh, I’m sure the law was passed to protect the public after thousands of cheese-heads became violently ill as the result of eating imported butter.

People might not have noticed if butter weren’t making such a comeback.  But it is.

Though the rule has been on the books since the 1950s, it is churning new controversy at a time when butter consumption is on the rise in America as it’s increasingly thought to be healthier than margarine. Butter made from grass-fed cows, such as Kerrygold, is a staple in some diets and for the “bulletproof coffee” movement, where such butter is mixed with coffee and MCT oil for purported — but debated — weight-loss benefits.

A spokesman for the company that sells and markets Kerrygold in the U.S. and Canada, Evanston-based Ornua Foods North America, released a statement confirming it’s “currently working with the Wisconsin authorities on a solution.”

Well, thank goodness the government authorities are working on a solution.  Perhaps they’ll nickname it something like “If you like your butter, you can keep your butter.”

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Hey Fat Heads,

Happy New Year!

Thought I’d sneak into the Big Chair for a couple of quick items.

The big news is that the Fat Head Kids book is getting close enough that Tom sent a script to The Middle Son and The Youngest Son so they can start prepping to help with voice work for the DVD version. He included a preview copy of the book so they can relate to what they’ll be voice acting.

Naturally, I had to sneak a peek and I can say that it’s more than worth the wait. Just terrific.

In my completely unbiased opinion, of course.

Next, this isn’t in the breaking news category, but I thought my fellow Fat Heads might enjoy it. We’ve got a good-natured banter going with The Youngest Son’s fiancée about what grandson 2 will be eating as he starts the move from formula to people food. (This guy:)

I keep saying he’s going to be eating only eggs, chicken livers and steak (with some lard and bacon fat) before he’s one; future DIL threatens to feed him tofu.

Anyway, after being impressed with Jason Fung’s Obesity Code and his follow up book (with Jimmy Moore) The Complete Guide to Fasting, I got interested in fasting, especially after my annual Thanksgiving through New Year’s gluttony. I’ve done a couple of 24-hour fasts, a 36-hour last week, and am 36 hours into a two-day (maybe 60 hours) fast right now.

So last night, I was putting a coffee mug in the microwave, prompting the following:

DIL:   What’s that – are you having some tea?

Older Brother:   No, I’m having a cup of beef broth.

Youngest Son (to DIL):   See that? – even Dad’s water has meat in it!

Cheers!

The Older Brother

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