Bariatric Surgery: Bad To The Bone

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Bad news for the bariatric-surgery industry:  a Mayo clinic study released this week suggests that people who’ve undergone weight-loss surgery are more likely to break their bones.  Here’s the first paragraph from the wire story:

It isn’t just the thunder thighs that shrink after obesity surgery. Melting fat somehow thins bones, too. Doctors don’t yet know how likely patients’ bones are to thin enough to break in the years after surgery. But one of the first attempts to tell suggests they might have twice the average person’s risk, and be even more likely to break a hand or foot.

 

Given how aggressively the bariatric centers are promoting these procedures, I suspect they’ll put a good spin on this.  Pretty soon we’ll be seeing ads that read:

“The last time Mary Blarch broke her pelvis, she spent five miserable months in a size-24 cast.  But after shattering both legs in the year following her gastic bypass procedure, she’s practically swimming in her size-6 cast.  She only wishes there was more room for people to write their ‘get well’ messages on the plaster!”

I’m glad the study got some media play, but I have a bone to pick with the writer:  These people are not ending up with thin bones because they’re “melting fat.”  They’re ending up with thin bones because they had weight-loss surgery.  That’s a rather important distinction for a medical writer to make.

Here’s another fun paragraph from the article about the study:

A quarter of the 142 surgery recipients studied so far experienced at least one fracture in the following years, Mayo’s Dr. Elizabeth Haglind told the endocrinology meeting. Six years post-surgery, that group had twice the average risk. But in a puzzling finding, the surgery recipients had even more hand and foot fractures than their Minnesota neighbors, three times the risk.

It isn’t all that puzzling.  I don’t have a copy of the research paper, and the article doesn’t specify how many of the people studied were the victims of gastric bypass versus the lap-band, but I would guess gastric bypass is far more likely to produce brittle bones.  Here’s why:

The lap-band procedure squeezes your stomach down to a fraction of its former size – about the size of a golf ball. You lose weight because you are limited to tiny meals, which (if you’re following the recommended diet) consist almost entirely of proteins and non-starchy vegetables.  Yes, that would make it a low-carbohydrate diet.

Gastric bypass is much more radical.  The surgeon cuts apart your stomach and uses the top portion to make an itty-bitty stomach.  (They call it a “pouch”… isn’t that cute?)  The itty-bitty pouch is then connected directly to the middle of your small intestine, bypassing the evil duodenum.  And why is the duodenum evil?  Because that’s the part of your small intestine that aborbs fat.  The surgery centers that sell gastric bypass procedures even brag about this effect:

Gastric Bypass Surgery provides an excellent tool to limit the amount of food eaten and to change how food calories are absorbed.  Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.

Since people who have gastric bypass can’t absorb fats, they lose weight faster than people who have the lap-band procedure.  The gastric-bypass centers are quick to point this out in their literature.  Just one little problem:  you need fats.  Your hair, skin, nails, hormones and bones depend on fats, either directly or indirectly. 

As health writers like Sally Fallon and Nora Gedgaudas have pointed out in their books, many essential vitamins are fat-soluble, including A, B12, D, E and K.  If you’re not absorbing fat, you’re also not absorbing and using those vitamins — even if you’re filling your itty-bitty pouch with supplements. And if you can’t absorb those vitamins, you also can’t fully absorb the nutrients that depend on them, like calcium. Here are some quotes I found from studies that examined the effects of gastric bypass surgery:

  • The incidence of vitamin A deficiency was 69%, vitamin K deficiency 68%, and vitamin D deficiency 63% by the fourth year after surgery.
  • The incidence of hypocalcemia (low calcium levels) increased from 15% to 48% over the study period.
  • There is a progressive increase in the incidence and severity of hypovitaminemia (low vitamin levels) A, D, and K with time after biliopancreatic diversion and duodenal.
  • Dolan et al. reported vitamin A deficiency in 61% of patients following biliopancreatic diversion at 28-month follow-up. This was despite an 80% compliance rate with multivitamin supplementation. (Read that again: most patients took their vitamin supplements, but still became vitamin A deficient.)
  • Despite calcium and vitamin D supplementation after Roux-en-Y gastric bypass, Coates et al. found that within 3 to 9 months after surgery, patients have an increase in bone resorption associated with a decrease in bone mass.

So you end up losing weight, but also become vitamin deficient, and perhaps end up with brittle bones.  I’d rather be fat and know I’m able to roll on the floor with my rambunctious girls without snapping a femur.

But of course, you don’t have to become vitamin deficient to lose weight.  You can lose weight by cutting out sugar and starch, which don’t contain any nutrients we need – or to be more accurate, they don’t contain any nutrients we can’t get from the foods Mother Nature actually intended for humans to eat.

The lap-band procedure doesn’t block the internal absorption of fat, so it’s less likely to cause vitamin deficiency – and of course, the lap-band surgeons are quick to mention that advantage.  But as you may recall from a previous post, you’re still limited to ridiculously small portions.  I think it’s unlikely you can get all the nutrients you need from meals that could sit on a golf tee.

In fact, as I was wading through online research to write this post, I was reminded all over again of what an awful existence these procedures can produce.  Here are some explanations of the post-surgical effects – and keep in mind, I pulled these from sites that are actually selling the procedures.  Their explanations are in bullet points; my comments aren’t.

  • What is Symptomatic Dumping Syndrome? Dumping is caused by rapid passage of food from the pouch into the small intestine.  Before surgery, the stomach has a valve at the top and bottom, and serves as an acid-filled storage tank, breaking food intake down into small, component parts and passing it to the small bowel in increments.  After surgery, food passes directly into the small bowel, mixed only with saliva and amylase from the mouth, but no stomach acid. The small bowel responds by diluting what we eat through a process of ‘water recruitment’ into the bowel space. This is referred to as ‘early dumping.’  Suddenly, the heart will pound and beat rapidly; you may feel dizzy, and overwhelmingly tired.  The bowels may gurgle and churn, and will feel bloated and gassy.  This might be followed by loose stools and even vomiting.  It is not dangerous, but it can be frightening to the uneducated patient.

Yes, education is the key here.  When I was in college, I saw lots of educated people dumping and vomiting at parties, but they were never overly concerned.

  • Why is it sometimes necessary to vomit?  Your pouch and Roux limb, the two parts of the gastric bypass tool, work like a slow moving sink drain.  There is no stopper at the bottom of the sink, but the narrowness of the connection between the pouch and the Roux limb restricts the passage of food out of the pouch and into the Roux limb.  Sometimes if a food gets stuck and will not pass into the Roux limb, the only solution is to cough out the offending food to release it from the pouch. 

Coughing food out of your pouch … boy, that must make you popular at dinner parties. 

  • Why do some people complain of frothing after the surgery?

They actually gave one of those “it’s nothing to worry about” explanations, but I didn’t bother to copy it because 1) it was medical doublespeak, and 2) I was too busy laughing myself silly, picturing an obese, post-surgical woman frothing at the mouth … and her husband replaying the day’s events in his mind, trying to figure out what the heck he’d done wrong. 

  • What is Steatorrhea?  Steatorrhea is the result of fat malabsorption.  The hallmark of steatorrhea is the passage of pale, bulky, and malodorous stools. Such stools often float on top of the toilet water and are difficult to flush. Also, patients find floating oil droplets in the toilet following defecation.

So there you are, standing at the toilet, flushing and cursing and flushing and cursing and frothing at the mouth and risking a wrist fracture from all that yanking on the handle with your brittle bones, but your last meal insists on floating atop the water like a gang of pale, bulky, malodorous fishing bobbers. Sure, there are other options besides flushing, but they’re not pretty, even if you believe in composting.  And to make matters worse, there are oil droplets floating around the bobbers.  Best remember not to toss a burning cigarette butt into the bowl.

  • If a LAP Band patient nibbles on food all day, he or she can continue eating a high-calorie, high-fat diet without ever feeling full and never lose weight.

Uh, no.  If a lap-band patient nibbles on high-fat food, he or she will feel full.  If he or she nibbles on carbohydrates, he or she will spike his or her insulin and then he or she will feel hungry and he or she will nibble again … and again … and again.

  • Also note that hair loss is common – but don’t worry, it usually grows back within a year. 

Which gives you plenty of time to color-coordinate your smaller clothes with your new wigs.

  • If you are a regular coffee, tea, or soda drinker you should be aware that no caffeine is permitted for the first three months after surgery. 

So I’ll be nice and thin when I’m sent to prison for aggravated assault.  But I’ll also be bald, so maybe I’ll look badass enough to avoid any unwanted romances.

  • Considering whether to undergo Lap Band surgery requires serious thought. It should only be considered if morbid obesity is a major medical issue and nothing has worked. 

Really?  I thought you should only consider lap-band surgery if you think dieting sucks.

  • Remember, weight loss surgery is a tool!

So is the surgeon who performs it.

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Fried Food Is Tasteless: Let’s Thank The Guy From CSPI

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Michael Jacobson, The Guy From CSPI

Michael Jacobson, The Guy From CSPI

Last weekend my daughter’s dance school put on their annual recital.  As reward for all the hard work, we told her we’d take her anywhere she wanted for dinner and a dessert.  She chose Denny’s, where she had fried shrimp and a chocolate sundae.  I was feeling indulgent myself and opted for the chicken-fried steak, complete with fries.  I used to love chicken-fried steak, in all its crunchy, meaty, sausage-gravy-covered glory.

I don’t love it anymore.  In fact, I don’t love anything fried in a restaurant anymore.  My chicken-fried steak and fries somehow managed to be fried and tasteless at the same time.  It’s as if Denny’s perfected a method for frying food in distilled water.

The reason, of course, is that most restaurants have finally gotten rid of trans fats, which mimicked the taste and cooking properties of natural saturated fats like lard.  As we now know, trans fats are bad news.  They get taken up by the body and packed into the walls of our cells, which is one of the places saturated fats are supposed to go.  Unfortunately, trans fats don’t mimic the biological properties of saturated fats.  Instead of strengthening our cells, trans fats weaken them.  And instead of raising HDL like saturated fats do, trans fats bring it down.

And so the restaurants have finally bowed to both public and legislative pressure and gotten rid of them.  That’s the good news.  The bad news is that they’ve replaced trans fats – otherwise known as hydrogenated vegetable oils – with other vegetable oils that aren’t hydrogenated.

After my dining experience at Denny’s, I understand why the restaurants resisted switching to non-hydrogenated oils:  the taste (what little taste there is) pretty much sucks.  The restaurants weren’t trying to kill us with trans fats; they were trying to keep our business.  Killing us was merely collateral damage.

What’s annoying is that none of this was necessary.  Remember how irresistible McDonald’s fries were back when you were a wee tyke or tykess?  That’s because they were fried in tallow, a form of beef fat.  My grandmother used to fry chicken in lard.  I’ve never eaten chicken since that tasted so good.  Most people love the taste of natural animal fats, and with good reason:  Mother Nature wanted us to eat them.

But of course, McDonald’s dumped the beef fat years ago.  And good luck finding lard in any of your local stores, unless your town is blessed with a large immigrant population.  Frying in natural animal fats is a thing of the past – and the man we can thank for this dubious development is none other than that great consumer advocate, Michael Jacobson of the Center for Science in the Public Interest.  (If you’ve seen Fat Head, you know we immortalized him as an action hero, The Guy From CSPI.)

Jacobson is, always has been, and always will be convinced that saturated fat is a killer.  Any dish that contains saturated fat is guaranteed to send him scurrying off to hyperventilate in front the nearest camera, shortly after his worker bees blitz the media with press releases screaming, “Contains as much saturated fat as an entire stick of butter!”

(When I need a chuckle, I picture Jacobson being transported back in time to a buffalo hunt on the Great Plains, shaking his spindly arms at some Sioux warriors about to skin a fresh kill and screaming, “Don’t eat that!  It’s full of saturated fat!”  If they didn’t spear him, they’d probably mistake him for a scarecrow and worry that the corn fields were soon to follow.)

Aside from the manipulated studies produced by people like Ancel Keys, there is no scientific basis for Jacobson’s paranoia about saturated fat.  There have been several major studies in which researchers tried to reduce heart-disease rates by having the subjects restrict saturated fats.  Those studies were colossal failures.  In the Framingham study, people who ate the most saturated fat were leaner and had lower cholesterol, not higher. 

Without saturated fat in the diet, your body has a difficult time absorbing the vitamins and other nutrients from your food.  Your brain is made mostly of saturated fat and cholesterol, and without these essential fats, you are more likely to experience brain malfunctions, such as depression, or attention deficit disorder, or epilepsy.  Kids who suffer from epilepsy have reduced or even eliminated seizures entirely by going on ketogenic diets that include plenty of natural saturated fats.  Those are the scientific facts.

But of course, the Center for Science in the Public Interest isn’t interested in real science; they’re interested in pushing a vegetarian agenda.  The “Science” in their title is there purely for marketing purposes.  It’s designed to convince the media that their never-ending warnings are based on something resembling actual facts.  And unfortunately, many in the media fall for it. 

So do many people who view the media reports prompted by one of Jacobson’s hyperventilations.  At the Fat Head premiere party, a friend of mine – a well-read, thoughtful friend – told me he had no idea CSPI was a vegetarian group.  He assumed they were exactly what they claim to be:  a group of scientists and consumer advocates who are looking out for the best interests of the public.

So let’s review how Jacobson and CSPI looked out the public interest when it comes to fried food.

In the 1980s, CSPI went after restaurants like McDonald’s for frying in beef fat.  They sent out the usual press releases, and they held protests in front of restaurants.  The media bought it and dutifully showed up with their cameras and microphones.

Faced with the perception that they were serving the public deep-fried heart disease, the restaurants caved.  And what did they switch to after giving up beef fat and lard?  Why, trans fats, of course.  Jacobson and CSPI said they were perfectly safe.  After all, how could bunch of vegetarian nutcases not like the idea of chemically-altered soybean oil?  The soy industry also liked the idea, and they expressed their gratitude with generous donations to CSPI.

Dr. Mary Enig, a biochemist and one of the foremost experts on fats and oils, tried to warn CSPI they were making a huge mistake.  She sent them letters explaining that trans fats were unnatural and would displace saturated fats in the body, which needs them.

But CSPI would have none of it.  In their newsletters, they declared trans fats to be a safe alternative to “artery-clogging saturated fat!”  Then they launched similar campaigns to scare movie theaters into giving up popping popcorn in coconut oil, and to pressure companies like Keebler into giving up tropical oils for baking cookies and other desserts.  Once again, the natural saturated fats were replaced with hydrogenated vegetable oils.

Later, of course, reams of research concluded that trans fats could cause all the problems I mentioned earlier.  So CSPI promptly announced they’d made a grave mistake, took full responsibility for the countless heart attacks they’d caused, and disbanded.

Kidding!  Of course that didn’t happen.  After remaining quiet on the issue long enough for most reporters to forget CSPI’s role in promoting trans fats (roughly 15 minutes), CSPI jumped on the anti-trans-fat bandwagon.  They pushed for laws to ban them.  They sued restaurants for using them.  That’s right … they sued restaurants for doing exactly what CSPI had demanded some years earlier.  Even the IRS would be embarrassed by that kind of behavior. 

The result of CSPI’s campaign against saturated fat is the kind of tasteless fried food I ate at Denny’s. 

Vegetable oils that aren’t hydrogenated may not be as bad for you as the hydrogenated variety, but they’re not exactly good for you, either.  They’re certainly not part of your natural diet; early humans didn’t have the technology or the desire to squeeze a jug of oil out of rapeseeds and soybeans.  (They did squeeze the oil out of olives, and yes, olive oil is good for you.)  Many vegetable oils become rancid at room temperature, and they’re high in Omega-6 fats, which can cause inflammation.  If inflammation isn’t the actual cause of heart disease, it’s certainly an aggravating factor.

Meanwhile, tallow and lard – which are delicious, full of essential fatty acids, and raise your HDL – are still tagged with the “artery-clogging saturated fat!” label, perhaps for good.  Unless Gary Taubes is appointed head of the FDA, I don’t think the restaurants could ever switch back without raising a firestorm among the nutrition “experts.”

I realize that most fried foods aren’t good for you anyway, but not for the reason the experts think.  French fries are deep-fried potato starch.  Fried chicken (or chicken-fried steak) is coated with corn starch or flour.  I’m better off without the stuff.

And thanks to Michael Jacobson and CSPI, I won’t be tempted to order fried food again anytime soon.  Maybe I should send the guy a thank-you letter. 

But I want to smack him first.

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Meet The Fatheads: Tom Monahan

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Several people have mentioned in discussion groups that they can’t stop humming that “Sugar” song from Fat Head. Well, why should they? It’s catchy as all get-out. My daughter sang it for weeks after hearing it. (Although my daughter also eats bugs, so her taste isn’t always impeccable.)

Tom Monahan with some cute girls I know.

Tom Monahan with some cute girls I know.

Today I’d like to introduce the man responsible for that catchy tune and the rest of the music in Fat Head. This will be part of an occasional series of posts in which people who were influenced by the film tell their own stories. I know many of you who bought the film were already singing from the low-carb hymnal – and I love you all, believe me – but it was a real kick to hear from people who changed their diets after seeing it.

Tom Monahan, the film’s composer, was one of them. I met Tom in Chicago many years ago (we both had hair at the time) when he auditioned for a band I was trying to put together with a talented guitarist who was, as I realized later, a couple of cards shy of a full house. Tom called later to say he’d be happy to work with me, but the guitarist gave him a bad feeling – thus demonstrating his intuition.

We worked on some songs together, performed together now and then (mostly then) and became great friends. When I started working on Fat Head, I called and asked if he’d be interested in composing music. I knew this task would be challenging but not daunting for Tom, because at one time he was the composer for a Chicago children’s show titled “The Magic Door,” which won an Emmy.

Tom agreed and soon began sending me MP3 versions of various mood-music and transition-type compositions. At the time, I still planned on using pop songs to introduce some sections of the film. The section on blood sugar, for example, would’ve been introduced with a bit of “Sugar, Sugar” by the Archies.

I say would’ve because I was informed that licensing the songs I’d selected – and we’re talking about little snippets – would cost more than $300,000. After the smelling salts were administered, I told Tom about my troubles, and he got busy writing songs, including his own “Sugar” song and the opening “Fat Head” theme – which I must say, I love.

By the time Tom flew to L.A. and his compositions got the full treatment by a talented music producer named Martin Blasick, I was glad the pop songs were too expensive. The film is 100% original, and Tom’s theme music ties it all up in a neat little bow.

So, with my long-winded introduction out of the way, here is Tom’s story in his own words:

In 1972 I graduated high school at a strapping 5’ 8”, 135 pounds. My introduction to nutrition didn’t begin until the late ‘70s, with Linus Pauling’s megavitamin therapy. In theory, flooding the body with an array of nutrients would correct health imbalances, with vitamin leftovers excreted by the body in what some critics called “expensive urine.”

I was experimenting with all kinds of concoctions, such as vegetable juice, wheat bran and brewer’s yeast, all mixed into a thick, blended shake. The taste was medicinal, and there was enough fiber to make a king-sized quilt, but it didn’t matter; I was a starry-eyed baby boomer out to reinvent myself and discover the fountain of youth.

These elixirs left me feeling incredibly high, but what I didn’t realize at the time was that in addition to all of the dense nutrients, I was flooding my system with natural sugars. Afterwards, I’d crash into a bed of fuzzy thinking and eventually sleep it off.

My exploratory urges dwindled considerably when my friends believed that I was jaundiced, when in fact my skin had turned orange from all the carrot/beet/celery juice that I was guzzling. To counteract such an otherworldly appearance, I began fasting for days to clear away any hint of my saffron hue.

Tens years later, my father reluctantly revealed that he had volunteered as a military guinea pig for the Nevada atomic-bomb tests in the 1950s — six months before I was conceived. My dad now lay dying, and I was left to wonder whether I had somehow inherited damaged DNA due to indirect radioactive fallout.

To compound matters, I was exposing myself to powerful toxins by handling work-related industrial pesticides and solvents over a two-year period. These cumulative poisons took an unimaginable toll on my system. I eventually collapsed.

I was now 122 pounds, utterly exhausted, and unable to work. I experienced flu-like symptoms for eighteen months. Conventional doctors were baffled by my condition, and I felt hopeless. I had hit rock bottom.

A holistic MD later diagnosed me with Environmental Illness/ Chronic Fatigue Immune Dysfunction Syndrome. He prescribed a series of glandulars to restore my depleted endocrine system, and a macrobiotic diet to gently clean the toxins from my system.

Macrobiotics is an organic, low-protein/ high-complex-carbohydrate discipline that mainly consists of beans, whole grains, vegetables, nuts, seeds, and occasional fish. The theory is that the lack of saturated fat restores clogged arteries, similar to removing bacon grease from a kitchen sink drain.

At the time, such a metaphor made perfect sense to me, considering I was the kind of child who believed that fixing the television set meant that a qualified technician would put the smoke back in.

Magical thinking aside, it took about ten years to recover my basic health, but I still tired easily and was always hungry. After ballooning to 170 pounds, it slowly dawned on me that macrobiotics wasn’t working in the long run. Besides, I had been eating whole grains for years, only to learn that my cholesterol was now 245. How could this be? I was a vegetarian! I was eating almost no saturated fat!

Thus began another round of dietary investigation. In 2000, I came across Sally Fallon’s “Nourishing Traditions,” which describes the benefits of saturated fat and explains how the insulin response to grains and sugar raises cholesterol. I began experimenting with small amounts of meat and felt stronger every day, with newfound vigor.

Tom Naughton later asked me to compose the soundtrack for Fat Head. I was absolutely thrilled because music is my passion, and because Tom and I had both been vegetarians for years but independently came to the same conclusion: the current theories about fat and cholesterol were questionable at best.

But it wasn’t until finishing the soundtrack that I became fully committed to the high-fat/low-carb approach. Until then, I still believed I could get away with eating carbohydrates and sugar as long as I ate meat to slow down the process. Silly me.

The first day we were producing the music for the film, Tom, Martin Blasick and I took a lunch break at a nearby fast food restaurant. Everyone ordered cheeseburgers without the bun, but I was the only one who added fries and a soda to my order.

Two hours later I was exhausted. Not even an iced tea could revive me. Meanwhile, Tom and Martin were still going strong. “Why am I so sleepy?” I wondered aloud, to which Tom replied, “It’s the starches and sugar from the fries and the Coke. Your blood sugar is crashing.”

He went on to explain how the insulin response to all those carbohydrates was driving the available fuel into my fat cells for storage, even as my blood sugar was dropping. Now I finally got it. I made the commitment to drastically cut back on sugar and starch.

Over the next eight weeks, I lost 20 pounds. My energy levels rose. After years of feeling tired, I now feel strong enough to take a full load of college classes on the way to finishing my degree in theater, and I work out at the gym three days a week.

And I look forward to even greater creative challenges ahead.

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Tall Tales About Exercise

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I haven’t found NBA basketball worth watching since the Michael Jordan era, when I lived in Chicago and couldn’t help myself.  But last night, as sort of a “bye-bye to L.A.” experience, I decided to watch the Lakers in the finals, and the more I watched, the more I couldn’t help but notice something peculiar:  almost all the players are very tall – much taller than the average man.

This got me thinking back to my college days, when I last attended basketball games in person.  The college players were tall too, although not as tall as the Lakers.  Then I thought about my high school team.  As a bunch of white Catholic kids, they weren’t exactly human skyscrapers, but they were still some of the tallest guys in our school. 

So after carefully thinking through all the evidence, I came to the obvious conclusion:  playing basketball makes you tall.  And the longer you play, the taller you become.  Nothing else can explain why the players become taller as they move from high school, to college, to the pros.

Therefore, I’ve decided to add a few hours of rigorous basketball to my weekly workout regimen.  My goal is to grow to about 6 ft. 2 inches, which would make me as tall as my son – who did play high school basketball and thus outgrew me.  However, if Fat Head sells to the point that I can be sure I’ll be flying first class from now on, I may keep playing until I reach 6 ft. 5 inches.

There’s nothing wrong with my current height of 5 ft. 11 inches, you understand.  I certainly don’t feel vertically inadequate.  But I can see some definite advantages to being taller.  I’ve read, for example, that tall men tend to earn higher incomes, so after my basketball program does its magic, I’ll be able to raise my software-programming rates.

I’ve also read that tall men have an advantage in the dating market and are more likely to be happily married.  I’m already happily married, but I figure when I start packing on the extra inches, my wife may sense the growing competition and work on improving her already-sparkling personality.  (I would say she’ll work on becoming better-looking, but there’s really no room for improvement.)

If my plan sounds a bit ridiculous – which it is – keep in mind that it’s only slightly more ridiculous than the “exercise makes you lean” theory.  While researching Fat Head, I came across study after study that compared fat people to thin people and concluded that because the thin people moved more, it was the extra movement that made them thinner. 

And truth be told, this theory has been pounded into our consciousness for so many decades, I bought into it.  I quoted some of those studies in an early version of the film.  It was Dr. Mike Eades who warned me I was about to repeat the error made by the researchers themselves:  confusing an association with a cause. 

Yes, people who are active and bouncy tend to be thinner than people who aren’t.  But that doesn’t mean the lean people are lean because they’re active.  It’s just as likely – more likely, I believe – that they’re active because they’re lean.

This was one of the truly eye-opening revelations in Good Calories, Bad Calories, by Gary Taubes.  As Taubes explains, your body is constantly working to reach homeostasis, the point at which the internal environment is in balance.  Your blood sugar, for example, must be balanced, and so a whole series of biochemical processes interact to keep it within a narrow range.

Your body’s fuel supply also needs to stay in balance – which means maintaining exactly as much fat as you need.  Yes, you need your fat.  You may even need a lot of it, depending on your hormonal balance.

Your fat cells are not little bank accounts that only take deposits when you eat too much.  They’re more like rechargeable batteries.  When you eat, you charge them up with fatty acids … even if you’re skinny.  When you’re not eating and begin to run low on available energy, the fat cells release fatty acids to provide fuel for your muscles and organs.

If your fat cells don’t release fatty acids efficiently – that is, if they’ve become akin to weak batteries – your body will work to make bigger batteries.  You’ll feel hungrier and eat more.  Your metabolism will slow down.  You’ll produce less heat.  You’ll feel lethargic and lazy. 

Guess what?  People who feel lethargic don’t move as much – exactly what your body intended.  And this process will continue until you reach homeostasis, the point at which your slow-leak fat cells are big enough to provide the fuel your body needs when you’re not eating.

The opposite is also true.  As Taubes explains, people like Lance Armstrong (or my lean, bouncy son) have fat cells that are constantly releasing fatty acids.  With the body awash in fuel, there is a strong impulse to move.  Their bodies don’t want to store fat, and so they’re driven to burn it.  They’re active because they’re naturally lean.

So do I believe exercise is worthless for losing weight?  Nope.  If you work out and put on extra muscle, the bigger muscles will burn more fuel and raise your basal metabolism.  More importantly, a good, hard workout can increase your sensitivity to insulin, so you won’t need as much of the stuff to keep your blood sugar level.  Lower insulin means you’re more likely to burn fat and less likely to store it – which in turn means you’re more likely to have the impulse to move.  So exercise can lead to the desire to exercise.  I know it does for me.

But if your insulin is elevated and you don’t change your diet to bring it down, exercising will most likely just deplete your body of fuel – and your body will fight to hang onto those big batteries it needs by conserving fuel any way it can.  Taubes recounts stories of people who’ve trained for and run marathons without losing weight.

The bottom line is that I think the right type of exercise is great for your muscles and your overall health.  When I see people in their seventies or eighties clinging to a walker and inching down the sidewalk, it breaks my heart.  I’m determined to keep working out and make sure that doesn’t happen to me.  But without the right diet, I don’t expect exercise to keep my weight down. 

I also don’t expect it to make me any taller.  But I think the Lakers can live without me.

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The Alzheimer’s Project

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Last week my wife and I finished watching “The Alzheimer’s Project,” a four-part series on HBO.  If you haven’t seen it, I recommend it; the episodes are informative and often touching.  You may find yourself moved to tears.

I certainly was, but that’s mostly because I was thinking about my dad, who was diagnosed with Alzheimer’s a couple of years ago and has declined markedly in the past six months.  I always expected to lose my father someday, but not like this.  I thought he’d be here one day and gone the next.  I would say goodbye, grieve for awhile, and miss him forever.  Instead, we lose a little bit of him day by day.

For most of my life, my image of my dad was largely defined by his high intelligence and quick wit.  He left a comfortable corporate job in his mid-30s to buy his own business and did well.  He devoured books and magazines and remembered everything he read.  When we played Trivial Pursuit, he’d run the table in about a half hour, then the rest of us would play on as if he hadn’t been there.  Some friends of his who saw my standup comedy act commented that they saw a lot his style of humor in mine, and they were right.  I tell stories on stage, and my dad was always a gifted story-teller. 

In retrospect, we realize something began going awry in his brain at least a few years before the official diagnosis.  He stopped reading and spent hours vegetating in front of the TV.  His once-competent golf game went south.  He began missing stop signs and making wrong turns in the neighborhood were he’d lived for more than 30 years.  But most of the time, he still seemed like himself.

Nowadays, he can’t follow a normal conversation. He rarely knows what day it is.  He tries to put his legs into the sleeves of his shirt when he’s dressing.  When my parents have friends over for dinner, he’ll tell my mom he’s tired and wants to go home.  In recent weeks, he’s had to ask both my mom and my sister who they are.  I haven’t seen him since the holiday season, and I know the next time I go home to visit, there’s a good chance he won’t know who I am.

I’ve read quite a bit about Alzheimer’s in the past year, and I know now that my dad was a walking bundle of risk factors.  His mother died of the disease, although she was in her mid-eighties, not early seventies.  He took Lipitor for 20 years.  Despite being touted as wonder drug that may even help with Alzheimer’s, the truth is that memory problems are a known side-effect of statins.  Dr. Duane Graveline, a former NASA astronaut, suffered bouts of extreme confusion and memory loss until he identified Lipitor as the culprit and stopped taking it.

(And by the way, Dad still ended up with stents put in his arteries, which were 98 percent blocked.  So much for the wonders of statins.)

Dad was also a heavy smoker until he quit at age 58 – and then, like many people who give up nicotine, he developed a fondness for sweets and starches.  He gained a lot of weight.  He suffered from sleep apnea.  He showed all the signs of someone developing insulin resistance.

Which brings me back to The Alzheimer’s Project.  In one episode, they named insulin resistance as a major risk factor.  Diabetics are four times more likely to develop the disease, and people who are insulin-resistant are at three times the usual risk.  Many doctors are now referring to Alzheimer’s as Type III Diabetes.

I was pleased at that point.  But then some goofy doctor cited a study which demonstrated that people who consume a diet high in sugar and saturated fat produce more insulin than those who consume a diet low in sugar and saturated fat.  I nearly jumped off out of my chair, yelling, “What the @#$% does saturated fat have to do with insulin?!  Fat is the only macronutrient that doesn’t raise insulin!”

This is akin to comparing people who consume a lot of whiskey and carrots to those who consume almost no whiskey and very few carrots.  Turns out the key to sobriety is a low-whiskey, low-carrot diet.  (Don’t order the side of carrots if you’re driving yourself home.)

Meanwhile, as my wife and I watched the scenes that showed Alzheimer’s patients and their families struggling at home, we couldn’t help but notice their meals were a parade of mashed potatoes, pies, cookies, sodas, and other carbohydrates.  This proves nothing, of course; you could step into most American kitchens and find those foods on the table.  But it certainly adds weight to the theory that Alzheimer’s may be a form of diabetes.

Some months ago, we watched another documentary about a woman’s personal struggles dealing with her mother’s Alzheimer’s. She noted that rates of Alzheimer’s are increasing, and since she grew up in a town polluted with industrial waste, she guessed that pollutants may be largely to blame.

Perhaps so.  But I think it’s more likely that the rise in Alzheimer’s is being driven by the same factor that’s driving the rise in obesity and Type II diabetes:  high-carbohydrate diets.  Nature simply didn’t intend for human beings to rely on high levels of insulin to smack their blood sugar down several times per day. 

The last episode, which was presented in two parts, featured some brilliant and dedicated researchers who are working to develop drugs to stop the disease.  They believe they’re close. That’s good news, but if Alzheimer’s truly is Type III diabetes, then prevention is (as always) the best medicine.  That means ignoring the stupid advice we’ve been fed by the USDA , the FDA, and countless other nutrition “experts,” and getting off the sugar and the starch.

I just wish I could go back in time and warn my dad.  I’d also like to tell him I love him a few more times without having to explain who I am.

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Dietary Confusion at MSNBC

      28 Comments on Dietary Confusion at MSNBC

I know I’ve made fun of nutritionists and health writers in the past, but I have to admit most of them possess an unusual skill: they can listen to a true-life story about weight loss and hear exactly what they want to hear, instead of what actually happened.

That skill became apparent after I read this story on the MSNBC web site and watched the accompanying video clip from The Today Show. Before we get into the details, let me summarize the how the story was covered:

“Today we’re talking to Cindy Dominick, who lost 130 pounds and went from a size 24 to a size 6. Cindy, how did you lose such an amazing amount of weight?”

“I walked a lot and cut all the sugar and starch out of my diet.”

“Well, there you have it, ladies and gentlemen … proof once again that a low-calorie diet and exercise will make you thin!”

Visit msnbc.com for Breaking News, World News, and News about the Economy

Okay, it wasn’t quite that bad. Cindy Dominick didn’t state directly that she’d given up sugar and starch, but it’s pretty obvious if 1) you listen to her describe her new diet and 2) you have a functioning brain. But as usual, whoever wrote the story managed to pound a round peg into a square hole and blame fatty foods for causing obesity. Take a look at this quote:

At 285 pounds, Cindy was certainly aware of her size, but felt hopeless about controlling her eating habits. She never felt satisfied by three meals and she’d often catch herself snacking on fatty fast food like fried chicken, McDonald’s fries or take-out pizza. She’d then top it off with a king-size Snickers bar.

Are those fatty foods? Yup. But they’re also loaded with refined carbohydrates.

If you eat a 12-inch pizza (which isn’t difficult for a fat person; I’ve done it many times) you can easily consume 200 grams of starch. A large order of fries delivers 25 grams of fat, but more than 60 grams of carbohydrates. Fried chicken isn’t particularly starchy, but if you snarf down three pieces of KFC extra crispy, you can still end up consuming 50 grams of starch from the batter.

And I found this part of the quote rather illuminating:  She never felt satisfied by three meals …

I can assure you from both personal experience and from the research I read while producing Fat Head that anyone who isn’t satisfied with three meals is almost certainly consuming a lot of carbohydrates. The insulin spike that results from a high-carb meal causes your body to store calories, either as glycogen or fat. With the calories locked in storage, you soon run out of fuel and feel hungry again.

This doesn’t happen with meals that are mostly protein and fat. Or as Dr. Mike Eades put it during our first interview, “Nobody ever binges on steak. Nobody ever binges on eggs.”

This quote was also interesting:

Soon she was taking medications for blood pressure, asthma, cholesterol and acid reflux. Tired from being overmedicated – and concerned after her home state had been named the fattest in the nation – Cindy put on her sneakers and started walking.

Let’s see … high blood pressure, asthma and acid reflux.   What could possibly cause those conditions?

Acid reflux can have a number of causes, including food allergies, but sugar and starch will do the trick for a lot of people. In fact, starch alone can cause reflux. When I was a starch-eating vegetarian, I didn’t consume sugar at all (I at least knew that was bad for me), but I still had acid reflux now and then. I also had asthma, which disappeared – along with the reflux – when I cut back on starch. And chronically high insulin is known to cause chronically high blood pressure, along with a host of other horrors.

To her credit, Joy Bauer of the Joy Fit Club pointed out the high amount of sugar Cindy Dominick consumed when she was 130 pounds heavier. But of course, she also had to bring out the butter sticks to demonstrate the high fat content.

Fat doesn’t make you hungry. Fat makes you feel full – unless you mix it with carbohydrates, which causes the fat to be stored instead of burned for fuel. 

(I always wonder what they do with the butter props after they tape a segment like this. Since the hosts seem to think butter is the nutritional equivalent of a loaded gun, I’m pretty sure they don’t take it home. One of the kids could find it and suffer a tragic butter incident – like taking a bite and realizing it’s delicious.)

Fortunately, Cindy Dominick herself provided a clue to the real cause of her admirable weight loss when she described her current diet as “grilled and green.” Unless she’s grilling bread and potatoes, that means she’s living on a low-carb diet. Her insulin levels have surely plummeted since the time when she was filling up on pizza and French fries, so when she takes those long walks, her body can burn fat for fuel.

Too bad nobody at MSNBC or The Today Show managed to figure that out. The readers and viewers might’ve learned something useful.

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