Friday, November 23, 2007

'Dogma Instead Of Data' Low-Fat Diet Recommendation Dogging Doctors

Pick a health ailment, any old one will do. Now think about what your family doctor would tell you about it in terms of your diet in order to help alleviate the symptoms of that condition. Whether it's diabetes, heart disease, high cholesterol, name it, the answer is always the same--EAT A LOW-FAT DIET!

Doesn't that just frustrate the heck out of you? Without any real evidence pointing to WHY the low-fat lie which has been such a miserable failure is so strongly recommended, doctors unfortunately take on a mob mentality and just do what everyone else in their profession does. They dutifully write out those prescriptions for Lipitor, promote eating grains and sugar to diabetics as long as you are taking your medicines and insulin, urge hearts patients to engage in hours upon hours of exercise which only make them hungrier, and then the granddaddy of them all--EAT A LOW-FAT DIET! UGH!!!

But is the low-fat diet recommendation actually based on any consequential long-term scientific data that has been proven to be highly effective for managing disease? Or has this dietary dogma been allowed to run rampant for decades without the necessary checks and balances that come from the results of actual data from real people who have actually survived living that way?

More and more people are beginning to see through this charade thanks in part to the September 2007 release of the book Good Calories, Bad Calories by Gary Taubes. But we're probably still at least a generation away from the practicality of overcoming this "dogma instead of data" mode of thinking we are currently in as you will see from the following e-mail I received from a concerned reader.

Here's what she wrote:

Hi Jimmy,

I've been a lurker for many years and I'm now signed up at your forum page. I did a quick search on Dr. Eades archives but couldn't find anything on this subject.

I have a very close friend who for over a year has had 3 tests come back with her Liver Enzymes being very high. She is only slightly overweight, but doesn't really follow a decent diet. However, her cholesterol numbers were all good.

She is not a heavy drinker, only occasionally, and doesn't take a lot of medications (in fact, she hardly ever takes ibuprofen or Tylenol). The tests they ran for hepatitis came back negative.

My concern and the reason I am e-mailing you is that they tell her the only way to solve the high Liver Enzyme problem is to eat a low fat diet--which of course gets my hackles up immediately!

Are there any studies you can point me to, or articles that I could print out and give her before she starts on this path and ends up wrecking the good cholesterol she already has? Thanks a bunch.

Although I have blogged a couple of times about the subject of a "fatty liver" this year with Dr. David Ludwig predicting it will be the next major health crisis and that this condition is made worse by a low-fat diet, there are some serious questions about what to do as my reader shared in her e-mail. This calls for some backup.

Since I am not a doctor, I decided to pose this reader's e-mail to a low-carb one who I personally know and trust--Dr. Mary C. Vernon from Lawrence, Kansas. I love the way Dr. Vernon looks at all the possibilities based on what she has seen in her own patients and then shares her thoughts in language that anyone can easily understand.

Here was her response:

Liver enzyme elevation, in my experience, can, of course be due to infections (Hepatitus C, etc.), drugs (alcohol, acetaminophen) and abnormal glucose metabolism (high insulin levels). In my simplistic brain, I think this is because the high levels of insulin cause the liver to make fat, but block the liver from moving the fat out as fast as it is made.

It is still important to consider all the other causes. Even though carbohydrate restriction causes almost miraculous improvement in many patients, one would not want to leave a treatable infection untreated. If the triglycerides are elevated or the HDL depressed--and the GGT is not elevated--then this is the picture most likely to respond to carbohydrate restriction.

Of course obvious glucose abnormalities such as Type 2 diabetes would be a clue, too. Dr. Eric Westman from Duke University did a study showing liver biopsy documented improvement in "fatty liver" after CHO restriction.

Finally, I don't really know what to say regarding the low-fat recommendation. Doctors (with the exception of a few renegades like myself) do what they are told and they don't actually look at the evidence behind the recommendation. This is a fine system if the recommendations are actually valid science and not just dogma.

However, when the recommendations are "faith based" rather than grounded in science--or as I say "dogma instead of data"--then you have the situation in which we find ourselves in today.

We truly need more people like Dr. Mary C. Vernon, the current President of the American Society of Bariatric Physicians (ASBP), who are willing to buck the trend and choose to look at the data rather than adhering to the dogma as 99.99% of the doctors in the United States have chosen to do. We could blame it on them for not knowing any better, but they are merely doing what they've been taught over the years. The Taubes book can help educate them, but we need examples like Dr. Vernon to continue to SHOW what can be done when low-fat is NOT the answer to everything.

What can be done to change the hearts and minds of those medical professionals who care about their patients but don't know about the amazing weight and health benefits of livin' la vida low-carb? Will we EVER begin to see even an incremental change in their philosophy in light of decades upon decades of dismal failure with the low-fat diet? Share what YOU think should be done to turn the tide so that doctors and patients will at least have a choice between a low-fat or a low-carb nutritional approach.

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Blogger shortandsweet said...

Funny, I've never had a doctor tell me to go on a low-fat diet or, for that matter, any other kind of diet. They just want to throw medication at me. How sad is that?

11/26/2007 6:25 PM  

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