The Physical

“I don’t have time for this. I have other patients to see.” Said my doctor, clearly indicating that I had used up all my allocated time for my yearly physical – or had finally pushed enough of his buttons. One or the other. It was awfully late and I thought I was his last patient. Perhaps it was true that he had other patients to see, or maybe it would have been more truthful for him to say: “I’ve had enough of arguing with you. I’m hungry and tired and want to go home and see my wife and kids.”

Either way I wasn’t offended. I am an exasperating patient. I am exasperating human in general, always questioning the obvious, asking questions that generate cow-stares or mild shock from those within earshot, or saying what I believe to be the unvarnished truth when it might be more prudent to just shut the fuck up.

In this particular instance of exasperating another human being, it was because my doctor, assessing my spectacular weight gain of 40 pounds since my last visit and a crappy total cholesterol count in the 260s, wanted to put me on statins – cholesterol-lowering drugs.

He showed me a worksheet from the American Heart Association that, when my crappy blood work numbers were plugged in, said I had a 14% chance of a heart attack in the next 5 years. He had done his homework probably because he knew I was a hard sell. We had the ‘statin talk’ last year when I was about 207 pounds and my total cholesterol was only a little elevated. I told him ‘no’ then.

And 40 pounds heavier and with really shitty blood work – the worst ever, I told him ‘no’ again.

I told him: “I have to be honest with you: I’m not a big fan of statins. They have not been shown to reduce all-cause mortality in patients like me and they also have a curious side effect, little discussed, of increasing the risk of violent death and suicide.”

My doc is a chill guy. I like him, though we don’t agree on a lot of things. I’ve mentioned this to people and they say: “Why don’t you change doctors?”

“Why? I’m not looking for somebody to always agree with me.” He’s smart and has a good 15 years of experience as a clinician. I also think he cares. He took the time to prep for me coming in by running that American Heart Association risk assessment. I think that counts as ‘going the extra mile’. He genuinely thought that he had the evidence to convince me – a seemingly rational and  medically knowledgeable layperson – to comply with his recommendation.

And I exasperated him by still saying ‘no’.

So I suppose I like him because, with nearly every relationship I have, there is a certain aspect to it where the other person has to put up with me.

People in their professional roles sometime turn into caricatures – and I suppose doctors are probably more guilty of this than most professions. In a line of business where on any given day your job might be to tell a seemingly young and healthy parent who came in with what they thought to be some minor ill that they need to ‘get their affairs in order’ because they are going to die soon, I can’t judge them harshly for perhaps putting up a wall of sorts between their patients and themselves.

But I am fascinated with these walls we put up as part of our daily interactions – and I love to break through them. Being exasperating frequently causes people’s walls to unexpectedly crumble – and what’s behind them is usually interesting.

So when I mentioned the statin research showing no benefit in all-cause mortality for patients without active cardiac vascular disease – and the crack about the increased risk of suicide and violent death, my doc’s usual chill turned less chill. He seemed slightly taken aback by the all-cause mortality, violent death and suicide bit and said with reserved force: “I challenge you to produce the evidence on these.”

I could easily find these mentioned in respected journals like the Oxford University Press, Pubmed, and the Lancet sitting in my car on my smart phone before leaving the parking lot of his office. I’ll be printing out whatever isn’t paywalled before my next visit.

Here’s one link: http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/

It says – and backs it up with a boatload of legitimate citations – that after 5 years of statin use in patients without known cardiac vascular disease:

  • None were helped (life saved)
  • 1 in 104 were helped (preventing heart attack)
  • 1 in 154 were helped (preventing stroke)
  • 1 in 50 were harmed (develop diabetes)
  • 1 in 10 were harmed (muscle damage)

Here’s another: http://qjmed.oxfordjournals.org/content/97/4/229 – you might have heard of Oxford, it is the world’s second oldest university, having been around since 1167. 16 Nobel prizes in medicine were awarded to alumni. It’s not a citation from some jackass with a blog and an axe to grind.

The study was small and warrants further investigation, surely, but a few people put on statins got really grumpy afterward. The link notes:

Manifestations of severe irritability included homicidal impulses, threats to others, road rage, generation of fear in family members, and damage to property.

Now – don’t get me wrong – statins have their place. In people with CVD it is a lifesaver (http://www.thennt.com/nnt/statins-for-heart-disease-prevention-with-known-heart-disease/). However, I come from a family with no predisposition toward heart disease even though my father’s side of my family ate and drank with abandon and all had potbellies and ruddy faces from all the beer they drank. A good part of my heredity ate whatever the hell they wanted and lived well past 80 – with 80 being the point where the dodginess from the family predisposition toward Alzheimer’s began to take full effect.

I don’t have known heart disease, nor do I have diabetes though my brother, sister, father, and mother all had it – with my siblings getting it way before the age I currently am. I don’t have a family history of CVD. I see nothing in my medical history nor my heredity that makes me a good candidate for statins and have to put up with the potential to develop diabetes, the potential for muscle damage, or the potential for negative psychological effects.

Before the ‘statin talk’ I had already parried with him on diet. As I sat in my underwear, an unpleasant sight except perhaps to a clinician who has trained themselves to be detached and doesn’t really give a shit as a protection mechanism from going insane, he mentioned in what in retrospect was carefully chosen language that “I was a much larger patient” than when he last saw me – and he hoped I had a plan.

“Yeah. My plan is to go on a low carb diet.” I said.

“Do you mean below 100 grams of carbs or below 50 grams?” He asked.

“Oh, I want to do a ketogenic diet. I’ve been on one on and off for a decade and I find it works quite well for me. It even seems to make me calmer.”

“What is recommended is a calorie-restricted diets with legumes, whole grains, and lean meat, along with vigorous exercise most days of the week.”

“Well, a ketogenic diet has worked for me in the past.”

His tone changed. He was going into his ‘learned clinician schtick’. It became more patronizing. “Well you know, a ketogenic diet puts your body into a mode similar to starving. You body can’t live without glucose. What is most important is that a diet be sustainable – and a low carb diet isn’t sustainable.”

OK – a decade of sustained weight loss shows it isn’t ‘sustainable’ – he’s right – I gained weight after a decade. Got it.

I did counter on the glucose thing, though: “Um…but your body can create the glucose it needs from a moderate protein diet and converts the protein into glucose through gluconeogenesis – right?”

He didn’t say anything for a bit – frankly, I don’t recall a direct response at all. Perhaps he had busied himself with the next part of the examination – the part that included the snap of a latex glove and ‘bend over’.

Given the asymmetry of the situation – he fully clothed and I in my skivvies – I wasn’t about to tell him that my lack of exercise is almost a badge of honor for me. I follow the advice of a quote I once read: ‘Whenever I get the urge to exercise, I lie down until the feeling passes.’ I have a sneaking suspicion that the relentless advocation of ‘exercise for everyone’ is not so much for the health of individuals but rather the health of the economy: every gym membership, every Thighmaster, every pair of running shoes raises the GDP – and so do the attendant sports injuries: muscle pulls and torn ligaments provide physical therapists gainful employment; injections of steroids provide income to doctors as well as relief to the patients who have exercised their way to worn out joints, and finally the people who thrive on a steady stream of former exercise enthusiasts who, instead of choosing the next pair of running shoes to buy, now have a choice between a hip replacement or a walker and constant pain.

I also feel that above a given weight, it is smart to start losing weight without the exercise (it can be done – I did it) – and with an increasingly lighter body comes more energy and the freedom of movement that can make you *want* to exercise.

And I haven’t even begun with my feelings about what constitutes ‘healthy eating’. If my differences with the standard accepted notions on exercise were a flaming match head, my differences on nutrition from most people were a nuclear bomb.

As I left I mentioned he should check out the book ‘The Big Fat Suprise‘ – a masterfully written work that clearly explains just how we ended up vilifying fat as a nutrient because of bad science, big egos, and politics. He just snorted. It was only a:

  • A New York Times bestseller
  • Named one of The Economist’s Books of the Year 2014
  • Named one of The Wall Street Journal’s Top Ten Best Nonfiction Books of 2014
  • Kirkus Reviews Best Nonfiction Books of 2014
  • Forbes’s Most Memorable Healthcare Book of 2014
  • Named a Best Food Book of 2014 by Mother Jones
  • Named one of Library Journal’s Best Books of 2014

Kinda what I expected. 

For those of you unfamiliar with my backstory, in 2003 I lost 80 pounds on a low carb diet. Unlike most people who would have reveled in their success, bought new clothes and left it at that, I needed to know why. How could I eat like I did and lose weight? I had only read the Atkins book, and learned about ketosis: a chemical transformation to your body that allows you to run your body on ketones – the product of burning fat – instead of glucose – which comes from sugars and starches and is what the vast majority of human beings run on these days. In fact, running your body on ketones is so rare that one way of measuring your ketones to track your progress – urine strips – are actually manufactured for people with severe diabetes to manage a severe side effect called ‘ketoacidosis’.

Being slightly obsessive – or maybe a tad more than ‘slight’ – I spent the next 10 years reading books, research, blogs, and articles and all aspects of diet nutrition, the history of diets and dieting, how diet has changed over the centuries, the psychology and sociology of food and eating, as well as a myriad of odd little detours into admittedly wacky material produced by people with dubious credibility as well as my own hare-brained ideas.

All that obsession spilled out into a blog on low carb which I started on a whim and then wrote and published over 500 articles over 7 years. I sort of abandoned writing on low carb and shuttered the blog at the end of 2014 for reasons not entirely clear to me. Perhaps I had grown tired of it all. Perhaps I had said all that I had to say on the subject.

Perhaps I was just paying lip-service to my low carb lifestyle and writing about it – as I gained weight – seemed disingenuous.

Perhaps I needed to regain enough weight to give a shit again.

Who Is This Guy?

IMG_2452

After a newfound commitment to begin again, and off to a great start in week one, things slowly drifted back to the habits that helped get me fat again and the passionate indifference returned.

I’m now back to pretty much where I started.

Iv’e spent some time reading some of my old posts – which I typically forget moments after writing and have to ask: who IS this guy? He seems more eloquent than I. He seems more curious, more committed, and more energetic.

He *is* younger than me – and thinner. I don’t think that time spent on the right-hand side of the big five-zero has been kind to him. He can’t claim any bad luck – actually the Universe has been quite generous to him in comparison to many of his age. Yes – there have been the sort of things one starts to expect as the car passes the 50,000 mile mark. Parts start to wear.

My eyesight isn’t what it once was and while wearing readers for almost a decade, it seems I need them now more than ever. I also have Uveitis in one eye – a condition that makes the vision quite blurry in that eye – and is treated with an injection – INTO THE EYEBALL.

Did that make you cringe? It really isn’t as awful procedure as you’d imagine, but it does make your eye blood red for a while.

And the 12-year-old in me get a kick by seeing the faces of the people who ask why my eye looks like that and I tell them it’s because I got an injection in it.

An appendix got removed. It’s wasn’t a big deal except that it was a milestone of sorts: my first surgery. Yet more proof that the Universe has been kind: how many people get cut open for a myriad of reasons well before the half-century mark?

Still – despite my good fortune in many aspects of my life, something seems changed. I’m different than the guy who wrote all these posts.

First, I’ve become somewhat tired of the science aspect of a lot of nutrition. Perhaps it’s that I know enough – or at least I think I do.

I think that it was the Buddha that tried to teach his students that his teachings didn’t need to be worshipped, made sacred, or endlessly studied but were only a tool meant to be used to accomplish a goal and discarded. He described it as a boat to cross a deep river. Even though it was valuable to make the crossing, once the river was crossed there was no need to carry the damn boat all over creation – it could be left on the shore while the journey continued unburdened by it.

In Zen Buddhism there is a state where an adherent is said to ‘stink of Zen’. It means they are going overboard. The tool has become more important than its purpose. The study has become more important than its application.

Zen has little tolerance for righteousness or for excessive knowledge. It’s about the practice.

Perhaps I know enough and it’s time to get my nose out of the books and practice more.

Second, which might be the bigger problem, is that I’ve become bored with low carb eating – and this extends from the fact that I’ve become tired of low carb cooking. As my enjoyment of cooking has waned, low carb eating by necessity becomes less varied, and perhaps this is what is derailing me.

Third, perhaps the gain in weight, combined with age, and combined with the fact I no longer drink 3 pots of coffee a day, contribute to a lack of energy. I used to happily get up at 4am, drink a pot of coffee, write blog posts, maintain a little notebook of goals and to-dos, then leave for work, put in my time while putting away another 2 pots of coffee, and come home and cook and do other chores. Now I get up between 5 and 6, have a cup of coffee while staring into space, then go to work where I have maybe 3 or 4 cups.

The decline in coffee drinking was not intentional – not something I wanted to necessarily do – it just happened. Perhaps being a caffeinated speed-freak was good for me, but it’s not me anymore.

Fourth, perhaps my long-documented love of sloth – and the ability to lose weight without it – has to come to an end. I don’t know where I read it, but the case was made that, while this nonsense of burning calories talked about as if it is a financial transaction: “If I run for 30 minutes I will burn 200 calories” is a simplistic explanation, wrong, and yet enshrined as a myth so strong that every treadmill purports to tell the user down to the calorie just how much they’ve ‘burned’, it was said that there is *something* more subtle going on with exercise and weight. It isn’t well understood – but there’s a connection.

I can buy that.

After years of reading all sorts of research on these topics, I’m more comfortable with the people who know that ‘I dunno’ is not an admission of stupidity but one of honesty.

A good friend is moving and giving away their treadmill. I’m going to try to get it. Maybe it will jumpstart some better habits.

Maybe my repeated failures shows I’m not ready for a full-blown low carb diet just yet. I’ve done a hard-core program before with great result – and I can do it now, too – for about a week. Then I crumple like a cheap suit.

Maybe I’m not ready for a diet just yet, but instead in need of a ‘pre-diet rehabilitation’. Maybe I should start small, make small wins where I can, and proceed slowly in the direction of the headwinds of the right direction than to think I’m going to do it in a dash.

After thinking this, I bought a salad – just vegetables – and bought that home. My wife asked if this was the start of a new beginning. I told her: “I’m not being that ambitious. I’m just thinking that ‘maybe a salad now and than wouldn’t kill me'”.

Her birthday is soon and I’m thinking of giving her a gift: I abstain from alcohol until I’m under 200 pounds.

The dynamics are different here: promising yourself is one thing – but promising the spouse you love? That’s another.

The occasional salad and the abstention from alcohol are not going to result in an almost 60 pound weight loss – but they might not hurt.

I have a quote on the recent change in dietary guidelines that has announced that all the dietary cholesterol we were supposed to be worried about? Nah – they were wrong. “It isn’t a nutrient of concern.” Apologies to all those egg lovers frightened into avoiding a food they loved by science that has now been dismissed.

One section really struck me of the article on the topic in the Washington Post (emphasis mine):

“These reversals in the field do make us wonder and scratch our heads,” said David Allison, a public health professor at the University of Alabama at Birmingham. “But in science, change is normal and expected.”

When our view of the cosmos shifted from Ptolemy to Copernicus to Newton and Einstein, Allison said, “the reaction was not to say, ‘Oh my gosh, something is wrong with physics!’ We say, ‘Oh my gosh, isn’t this cool?’ ”

Allison said the problem in nutrition stems from the arrogance that sometimes accompanies dietary advice. A little humility could go a long way.

“Where nutrition has some trouble,” he said, “is all the confidence and vitriol and moralism that goes along with our recommendations.”

Perhaps professor Allison’s admonition to his colleagues might apply to those of us trying to lose weight as well. More humility, less moralism, less hubris about progress  – those resolutions the emptily echo because you know you and know it ain’t gonna play out like that. Patience and tolerance for ourselves while gradually moving toward a better way of eating – without worrying about the scale as much as how we feel might do a world of good before taking the plunge into a more serious diet.

For me that means trying to score me a treadmill and maybe replacing a few meals a week with a salad.

 

 

 

 

Can You Be Allergic to Red Meat?

There’s an old saying in journalism: if a headline is stated as a question, the answer is ‘no’.

This might be an exception.

I stumbled across this article in the New Yorker – Can Ticks Make You Allergic to Red Meat? – and figured that while the New Yorker is a perfectly cromulent publication, it isn’t where I would go for science news. So while intrigued, at first I dismissed it as bad science. There’s a lot of it (you’ll find plenty on my own blog).

The gist of the story was that when these ticks bite you, they excrete a substance found in red meat into your bloodstream that your body can develop an immune response to. This results in getting hives and even a tightening throat similar to anaphylactic shock symptoms some unfortunate people get from peanuts or bee stings.

Hoping the editors were asleep at the switch, I began to Google this. I had never heard of this and figured this must be some urban legend.

I wish.

WebMD is certainly a better place to find health information and I found it mentioned there.

I also found it mentioned on Wikipedia: http://en.wikipedia.org/wiki/Amblyomma_americanum#Meat_allergy

Don’t trust either of them? You can also find it here: http://acaai.org/allergies/types/food-allergies/types-food-allergy/meat-allergy

Being in New Jersey, I selfishly thought this might be confined to Texas – the poor bastards – being it’s called the ‘Lone Star Tick’.

I was wrong – here’s a map of where the ‘Lone Star’ tick can be found.

Lone-star-tick-map-cdcSeems to me to be a very misnamed creature.

I happened to tell this to my 8-year-old daughter and her response was: “Aauugh! That would mean I couldn’t eat bacon!”

I did mention to her that it was an allergy from ‘mammalian non-primate meat’ only, so monkey-meat bacon would be just fine.

She didn’t even grace my nonsense with an answer.

The good news is this particular tick isn’t likely to carry Lyme Disease – just a bushel-basket full of other diseases to fuck you up.

Yet another reason for us to stay inside our hermitically-sealed, climate-controlled houses as far away from nature as possible.

Want ‘nature’? Find a documentary on Netflix!

 

Week 1 Back on Low Carb: Not Exactly, But Sort Of

Here’s a day-by-day summary of my first week back:

Monday, March 23, 2015 – 257.8

That moment in a soon-to-be-dieter occurs: shuffle to the scale, get on, look at the number – and it hits. A flabby fist shakes at the heavens in defiance: “Damn you! I’m going to lose this weight starting NOW!” The act feels good: I know, I’ve done it for a year and a half. My wife calls it ‘The Tomorrow Diet’ because I would usually cave soon after my defying the Universe and my weight in it and resolve to try again – tomorrow.

This time, however, I managed to muddle through the day. I had done some prep the night before. Not exactly knowing I was going to plunge into a diet the next day, I had made some pork belly and eggs and created cup-sized portions for lunch the following week. I hadn’t lost my instinct to do these sorts of things – I just ate like crap alongside these behaviors.

I decided to skip the pork belly and just brought Fage Greek yogurt and butter to work. I put butter in my coffee and ate the Fage with the zero-calorie EZ-Sweetz. I decided at the outset that artificial sweeteners, which I have tried to do without on other attempts, would be A-OK – I lost 80 pounds guzzling them down my initial go at this in 2003. I wasn’t going to worry about them now.

I also bought some of that MiO ‘water enhancer’ – the ‘energy’ type that contains caffeine. That does help me get more water into my system – and the caffeine did help replace some of the coffee as my stomach had not been feeling good as of late and I cut beck.

Once out of work I passed through the gauntlet of stores and the fast-food restaurants with some concern – but I didn’t stop.

At home after work I had the pork belly and egg – swimming in pork fat and kicked up a notch with Tabasco sauce. Good stuff.

I then screwed up a bit, having two dinner rolls the size of a baby’s fist with butter, then mozzarella and tomato. Rumor has it a bit of chocolate cookie was also consumed.

Not a picture-perfect start, but way better than I had been doing.

Cals: 1,832
Fat: 146 (72%)
Carbs: 62g (14%)
Protein: 68.4g (15%)

Tuesday, March 24, 2015 – 255.4

Weight down a bit. Meh. I got my work cut out for me. A little more in the groove, I added a can of tuna to the day’s routine above, and had the pork belly for dinner again. I also had an avocado and 2 ounces of American cheese.

Cals: 1,506
Fat: 120 (70%)
Carbs: 30g (8%)
Protein: 86g (22%)

Wednesday, March 25, 2015 – 251.8

Screw the weight loss – I was feeling a lot better already. My Tums usage had plunged and I didn’t hit the snooze button a dozen times before dragging myself from bed. My energy was returning. I was also beginning to feel some of that weirdness that comes from going into a ketogenic state. Headache, though mild. A slight dizzy feeling. All manageable – and familiar.

I got derailed by an afternoon hunger that just wouldn’t quit. I had my yogurt but then tucked into to way too many macadamia nuts, then a can of sardines kept for emergencies, then another yogurt. Lastly, I had 2 squares of the Lindt dark chocolate with butter between them like a sandwich. This was way better than I expected – the butter adding the creaminess the brittle but tasty hard chocolate was in short supply of. I’d have to remember that trick.

It didn’t stop there, though. Home was some fresh-made potato salad and steak. I could have left the potato salad alone, but that didn’t happen. Four large slices of pepper jack cheese an a few slices of low carb bread also helped to put me way over the top. It wasn’t worth counting – or I was too mortified to try.

Thursday, March 26, 2015 – 254.2

Despite the excess eats and the weight gain, I was feeling way better and sleeping better. A bad day here and there wasn’t the problem – it was too many of them in a row. I switched things up a bit and brought the pork belly concoction at work, though something that oily is almost like handling nuclear waste in an office – and I’m glad no one asked me what I was eating.

I was a bit hyper as well. Caffeine has a stronger effect on me when I go low carb and it showed. I apologized in a meeting and blamed the coffee for my over-exuberence.

I was hungry on the way home and had a number of fast-food fantasies as well as internal negotiation (‘If I get the double cheeseburger and throw away the bun…’) but I resisted.

At home I had almost a third of a head of lettuce with 3 ounces of cheese, then a bit later caved for some of the potato salad. I also had some of the leftover kilebasa and hard-boiled egg mixed with mayo on a slice of low carb bread.

Not a perfect day – but not a bad one, either. I was off to shaky start, but trending in the right direction at least.

I decided not to count just because whatever measurement I came up with would be wrong – and counting all the time, well, sucks.

Friday, March 27, 2015 – 252.4

Another uneventful day at work. Had a Greek yogurt and that’s it. I do drink maybe 4 cups of coffee, and a 16 oz glass of water with the MiO energy stuff squirted in – one with 2 tablespoons of psyllium husk, the other without.

Psyllium husks, typically used for constipation, were a staple of my first time on low carb. This is what Metamucil is made out of. Here’s the thing, however: it might have other benefits. I’ve read that it can act as a prebiotic, and while no one is really sure, it might – just might – have had a hand in my initial weight loss.

As this is a possibility, I’ve added it back in.

For dinner I bought hot Italian sausages and cooked them with 4 onions and olive oil until the onions were nicely carmelized and the sausages cooked. The entire family pounced on them and I ate their leftovers – the sausage and onions along with boiled potatoes.

I also had a few glasses of red wine and one large sugar cookie.

Saturday, March 28, 2015 – 250.4

A quick review of the past weeks shows what I’d call a pretty poor performance at doing low carb. Despite that, however, I’ve shaved off over 7 pounds. I’d argue that it’s water weight mostly, and nothing to crow about, but two things jump right out:

  1. I have certainly stopped the upward trend of weight gain – at least in the past 5 days
  2. I have lost what most people would consider a considerable amount of weight in a short amount of time

I also feel better in general.

But what have I done right, exactly? Right now I think it’s little more than:

  • Keeping clear of takeout food – burger, pizza, and sandwiches at lunch
  • A level of accountability about what I eat
  • A lower carb level

Even though I’m not keeping my overall calorie intake to what’s considered an ideal level for me – and my carb levels are too high for generating ketones, it’s apparently been enough to start a course change.

In a way I’ve failed, however: I expected to be in a full-out ketogenic state. Perhaps this is a better way to start, though: easing into it.

As far as the day went, weekends can always be a problem because being home makes me much more able to grab a snack when I like. It’s far too easy to eat as a cure for boredom and I don’t consider any attempt to navigate a diet to be successful until I’ve run the gauntlet of a weekend.

By my reckoning, I ate too much. After coffee and cream in the AM, as well as an extra-large Dunkin Donuts coffee with cream, I came home and had another serving of the pork belly and egg I had made earlier in the week. Not content – though I should have been – I followed that up with some kilebasa in mayo on a piece of low carb bread.

Late in the afternoon I had a few ounce of American cheese, as well as some egg salad on another slice of the LC bread. A bit later, cleaning up, I found a jar of Tapenade misplaced in the wrong cupboard. What is one to do with a misplaced item?

Eat some, of course.

I had it with some pork rinds.

It was some time after this that the family decided to go out for dinner. I hadn’t planned for this, but I was also easing in to the diet and we really needed some time together as a family because, as of late we’ve all been too busy in our own stuff to spend much time together.

I’d survive.

We decided to go to a new restaurant, Seasons52. I wrote a review for the place that you can find here if you’re interested. I had a bit of flatbread with lobster, mozzarella, and diced peppers, and for the main course had a cut of roast salmon on a cedar plank with a creamy mustard sauce and the root vegetables potatoes and carrots. I skipped dessert but did have a taste of my wife and daughter’s. It wasn’t part of my diet plan, but it wasn’t an outrageous cheat, either.

Sunday, March 29, 2015 – 252.0

A minor uptick in the weight is nothing to worry about – I drank a LOT of water the night before and whatever triggered this usually like to retain some of it for a while. What I continue to notice are the things that have nothing to do with the scale that are changing. I woke up rested at 6am. This sort of thing had stopped happening a while ago. It’s coming back. My upset stomach, the unquenchable fire in the belly each time I eat, has disappeared. The feeling in my throat where it felt like I couldn’t eat when I haven’t eaten for a while has also gone.

I haven’t gone hungry, shed a few pounds, and have more energy – changing bad habits can be difficult and are fraught with booby-traps that catch you unawares – see ‘ironic rebound‘ – but so far it’s been a gentle and positive easing into a better routine.

I didn’t eat much – not particularly hungry – but did have a bit much wine in the evening as a sort of ‘goodbye’ as wine drinking has never been compatible with weight loss with me.

The combo of which knocked me flat.

Monday, March 30, 2015 – 252.6

So even off to a crappy start I lost 5.2 pounds for the week.

Let’s see if week 2 gets any better as I’ve ‘acclimated’ myself (somewhat) to a new routine.

What Does Gaining 50 Pounds Feel Like?

It might be worthwhile at this point to spend some time detailing how it feels to gain 50 pounds. It can be summarized as ‘it sucks!’ but beneath that lies a litany of things that ought to be detailed in case I forget.

My newfound shortness of breath. Wearing a 50-pound bodysuit every day makes me winded easily. My disdain for exercise doesn’t help here, but I’ve certainly noticed that climbing a flight of stairs can leave me winded to a point where I need a minute or two to catch my breath. Just the normal exertions in life – like rummaging through a low cabinet for some cooking gizmo – can do it.

A rekindled relationship with massive amounts of Tums. If you follow the stock market and see the stock of the company that makes Tums go up unexpectedly – that’s me. It seems nearly *any* carb-laden food that ‘normals’ regularly eat quickly turns into a fire-bomb in the pit of my stomach soon after. Only a handful of Tums can extinguish this.

The resurfacing of GERD symptoms. Waking at night choking. Coughing, sometimes for a good part of the day. It’s connected.

The lack of accessibility to body parts. My feet seem further away and putting on socks has become bit of a challenge. This ain’t cool. I don’t like to think of myself as handicapped nor incapacitated, but being close to not being able to get my own damn socks on is one of those things that is really pissing me off. I wrote a review of mobility scooters as snark – it’s beginning to seem my fate if the current trend keeps up.

The snoring. Apparently quite loud according to innocent bystanders. Might involve sleep apnea, which at the worst isn’t good for your health long-term – oxygen being somewhat important to we humans – but it also ensures a crappy sleep, which is going to contribute to…

The total lack of energy. While there are bursts of energy here and there, the default state is ‘tired’. I wasn’t exactly a ball of energy to begin with given my love of sloth, but I could rise to the occasion when needed. Now I am more or less exhausted by the time I *get* to work, revived by coffee, then go home completely spent. I’m pretty much worthless in the evenings – a pile of protoplasm in sweatpants with butt affixed firmly to couch until I drag said butt to bed.

Joint pain. Especially my knees. I’ve known a number of people who’ve had their joints sawed out and replace with spiffy titanium substitutes, but I’m the kind of guy who’d like to make due with the knee joints I was born with. This dovetails nicely with my plan to use this as an excuse to not exercise until I’ve done some serious debulking, but this is a topic for another post.

My diminishing wardrobe. My clothing choices are becoming less and less, and the few items that still fit are comically tight. The button of my khakis is about to come off so I need to get out the sewing kit – and I’ve become more fond of the riveting used in jeans as it can better hold back the boatload of blubber attempting to burst from its constriction within garments to small. I haven’t even gone into how uncomfortable I feel in my clothes.

My crappy blood work. Bad cholesterol high. Triglycerides high. Blood sugar elevated. A doctor warning of a 17% potential for a heart attack within 5 years and pushing statins. My blood work was always pretty good when I kept the carbs to a minimum and swam in fat.

People telling me I’m not fat. I’m not sensitive about my weight. I’ve gotten fat – and I’ll come right out and say it. When I hear people say: “Oh, you’re not fat.” despite the evidence in front of them as well as my forthright admission, I translate this to: “Oh. My. God. You’re. Fat. You’re so fat my prefrontal cortex has shut down and I’m sputtering lies because I don’t know how to deal with how fat you are.”

All of this I attribute to eating like a ‘normal’: don’t get all hung up on this ‘carb’ thing – just eat what you like in moderation and you’ll be fine.

Plenty of people pull this off. I can’t. I have to accept this.

Cancer, Warburg, Seyfried, and EXTREME Low Carb Diets

I’ve made mention of a peculiar use for low carb diets other than for weight loss. You might have heard that low carb is successfully used in children for epilepsy (check out The Charlie Foundation for more info on that), but you might not have known that nascent research is being done independently and somewhat outside the normal protocols to determine if a very – and I mean VERY – low carb diet *might* work as a treatment for cancer.

Now let’s stop here for an important warning: if you have cancer, this most likely *isn’t* something for you. First off, for many cancers, traditional treatments do, in fact, work if treated early. It also isn’t a treatment that you can try on your own along with a standard course of treatment. Many of them are incompatible with a low carb diet. It also has only been tested in mouse models – and for only certain types of cancers. You’d need professional guidance if you wanted to see if this was right for you.

There’s also this: the theory as to why it might work contradicts decades of research.

Hear a quacking sound? Cancer has been called the ‘Emperor of all maladies‘ and had attracted charlatans willing to turn a profit on other people’s tragedy, peddling false hope and leaving their families penniless. This one is somewhat different, however, and we’ll get to that in a moment, but first you must meet Otto Warburg, but to meet Mr. Warburg we need to go back 90 years and also revisit out high school biology class for a little refresher. I promise I won’t get too ‘sciencey’ and I apologize beforehand to those readers who know this stuff way better than I ever will. Forgive me my simplistic explanations – but please call me out if I state something patently incorrect. I don’t want to misinform.

Most of the cells that make up this container we call you and I contain mitochondria. There’s a hundred fascinating things about these parts of the cell – you can only get them from your mother, for instance, and they have their very own DNA that is completely different from yours – but lets focus on the what they do for you. Mitochondria are considered the ‘powerplants’ of your cells and create the energy the cell needs to survive. They do a bunch of other things, but one of the important parts for our discussion is the energy production.

Otto Warburg was a researcher who, in 1924, noticed that the mitochondria in cancer cells didn’t properly respire – as in ‘breathe’. Yes – cells breathe, which is why *we* breathe – to get the oxygen the cells need to properly respire.

But cancer cells didn’t respire properly – instead, it appeared that they took a different approach that only allowed them to feed only on glucose.

Now, just because a cancer cell’s eating habits are different doesn’t quite explain why they’re cancer cells (at least that I know), but it does point out a cancer cell’s Achille’s heel: they’re sugar addicts.

As sometimes happens in science, some guys in lab coats scratched their beards, mumbled something about this being ‘interesting’ – and then it was mostly forgotten except perhaps as trivia while science marched forward with cancer treatments using surgery, chemotherapy, and radiation.

Cancer treatments did get better, but now we’ve reached a point where new treatments might only add months to a patient’s life.

Then along comes Thomas Seyfried who writes a textbook named Cancer as a Metabolic Disease which challenges many of the standard notions about the treatment of cancer and recommends an extremely low carb diet instead of chemo – and gets himself into a mess of trouble – at least from a career standpoint.

Dr. Seyfried is a legitimate researcher who comes out with a book that overturns 50 years of thinking on cancer. This is going to attract two things: crackpots and the label of ‘quack’ from his peers.

I simply do not have the skill-set to judge his work as I am not an oncologist, but he had laid out a legitimate attempt to create a new way of thinking about and treating cancer and no one can deny that a low carb diet might be a heckuva lot better treatment for cancer – if it works – than chemo and radiation. Simply put: normal brain cells can live on ketones – cancer cells can’t, so a super-duper low carb ketogenic diet starves the cancer cells while normal cells survive.

Here’s Thomas Seyfried discussing his theory. Pretty sciency, though it allows you to gauge the man:

He doesn’t come off as a quack – more frustrated than anything.

His last answer in the Q&A is his most damning: if the standard of care raises blood glucose, then it leads to the ‘demise of the patient’.

“Oh.” Says the oncology community. “We’ve been doing this all wrong for 50 years? My bad – let’s fix that right away.”

You can see how his theory is a ‘turd in a punchbowl’ for anyone in the medical community invested in the current standard of care.

Here’s an example from one of his naysayers. It’s a well-reasoned criticism and well worth slogging through to help to begin to understand the point of view of the medical community.

How *I* got exposed to this was because a friend’s relative was diagnosed with a glioblastoma – a type of brain cancer that is pretty much a death sentence. I was reminded of the article I had read about a woman who was treating her brain tumor with a ketogenic diet and was even keeping a blog about it. I provided the link and my friend and their family, after a lot of research, decided on a doctor-supervised ketogenic diet.

It’s too soon to tell at this point if this was the right approach, but given what I’ve read about glioblastomas, there’s not much to lose.

Doing my own research I came across a website that offered a complete diet book for cancer patients trying a ketogenic diet, bought a copy and read it from cover to cover.

book-cover-med

I’ve read plenty of other books on ketogenic diets, but this one comes not from the weight loss community but out of the childhood epilepsy community where the stakes are higher. We’re not talking about fitting in that cute little dress but preventing debilitating seizures in small children – or not dying from cancer.

This is the most extreme low carb diet I’ve ever seen – because most diets try to make it comfortable for the patient. While this book bends over backwards to do the same, its primary goal is to manage a threatening disease.

I thought it would be interesting to try this approach – what the heck – and did it for a few weeks over the summer.

Even though I am an old hand at ketosis, this was hard. I felt like passing out one hot summer day walking a nearby downtown, which I summed up to dehydration: you don’t store *any* water weight on this diet so it probably made dehydration a huge possibility. I felt much better after a bottle of water and a salad.

I didn’t keep up with it but I consider the book an excellent reference for anyone interested in what an ‘extreme’ low carb diet looks like. I have to admit that my own diet is in tatters as I write this but if/when I get up the gumption to start again I am going to use this book as a guide – perhaps not going as ‘full-on’ as a cancer patient might, but rather as a target I can afford to miss, given that even coming near to this protocol will still be a very adequate ketogenic diet.

An Introduction – Day 1

Joseph Merrick 'aka' The elephant Man
Joseph Merrick ‘aka’ The Elephant Man

Let’s start slow here, OK?

Once upon a time a guy went on a low carb diet and lost 80 pounds, bringing his decidedly pudgy exterior down to a perfectly fine 185. Of course, weight never stays off unless you are a total maniac about your diet – and this guy wasn’t – he was pretty awful at low carb, though some points should be given for some amusing hare-brained experiments along the way.

The weight loss stayed for about three years but the onset of middle age – and perhaps a well-honed laziness crafted into a fine art- caused the weight to creep back on. It was manageable for many years and a diligent return to a hard-core low carb diet each time things got out of hand always got it back down, though later years the weight tended to stay in the low 200s.

Then a decade passed. a WHOLE FREAKIN’ DECADE on a low carb diet. That’s a lot of time on a diet that makes one a bit of an oddball. Despite a lot of evidence that a low carb diet is helpful and safe for a lot of folks – and personal experience showed that it worked for this particular schmuck, he kinda drifted away from it.

There were some valid reasons for this drifting away. Some less so. Regardless, this guy went from someone who struggled with following a low carb diet pretty much every day – even if he failed miserably – to someone who wasn’t even trying anymore – and that gradual drift happened oh-so unconsciously, until the man awoke to find that perhaps he didn’t know how exactly to do a low carb diet anymore. Perhaps they didn’t work for him anymore and what once worked no longer would. perhaps the person he was 10 years ago when he lost the weight was gone and the person he was now couldn’t do what he had done then.

Perhaps he just didn’t want to be on a diet forever anymore.

This was all well and good, but a very real problem existed: he was getting fat again. He was outgrowing the fat clothes he bought.

Breathing in his clothes might become a problem. Buttons might begin to pop.

It was fun to eat Italian deli sandwiches. Bread is an awesome thing. So was pasta. But it seemed there was no way to dance on the knife-edge of having some without having too much. His appetite went out of control and a taste always became more than a taste.

Joseph Merrick, known as ‘The Elephant Man’ was a normal human stuck inside a deformed body. The story that I had heard was, because of his deformity, he had always slept upright.

But one time he wanted to sleep like a regular human being – lying down. His simple desire to be like other humans is supposedly what did him in: due to his deformities, lying down choked him to death in his sleep.

Perhaps there’s a lesson there the man needed to accept.

So with only that thought as a start, the man, with little of that wide-eyed optimism most dieters have when starting a sparkly new diet, just said: “Here we go again.”

My Next Approach to Low Carb

Perhaps taking a vacation from blogging – and low carb – after a decade of thinking about the diet *every damn day* was a good thing.

As mentioned previously, I gained weight toward the end of last year and no matter how much effort I put into low carb – even going so far as to go on an extreme low carb diet  used by some cancer patients along with calorie-restriction, my weight didn’t want to move much outside of a 220-225 range.

I then just gave permission to myself to forget about low carb and blogging for a while. I ate what I wanted, when I wanted. Now doing a low carb diet for a decade certainly changes your habits quite a bit so the ‘eating what I wanted’ still had a lot of aspects of a low carb diet. While I stopped monitoring and measuring things, I did form a routine of sorts that, while it did not lead to weight loss, did not lead to weight gain, either.

This routine left me way more relaxed about eating and removed a lot of the obsessiveness about food. After all these years, removing this yoke was a revelation.

I realized that for a decade, there was an extra family member besides myself, my wife, and my two daughters: my diet.

Like every other family member, this apparition had wants and needs and was part of many conversations. Every family member needed to make room in their lives for this apparition and put up with its peculiarities.

And now I saw clearly what a burden this family member had become.

It’s presence in a household of foodies that all enjoy good food and enjoy the ritual of enjoying good food together led to a distancing between us. Everybody seemed to eat on their own schedules and there was no such thing as a ‘family meal’ at home except on the rarest of occasions or when entertaining.

This summer I consciously began to form a new ritual of a family meal. Sometimes it was my wife who would cook. Sometimes it was me. Sometimes it was my older daughter. Sometimes everybody pitched in. Whatever the result, and no matter the carb count, we all sat down, held hands, said a prayer of gratitude to whatever-the-hell allowed us to have the great fortune to be together at the moment, with a roof over our heads, sitting around a table sharing a meal of good food together. The incessant TV in the background, mumbling and laughing and crying and screaming at random times, got turned off. The iPhones, and iPods got put away, and we all leisurely spent some quiet time eating and talking and enjoying the moment, the food, and the company of each other.

It was unexpected to see that such a simple thing as a common meal held so much power. I suppose it is a ritual etched in our DNA: the communal meal, another day without starvation, another victory against the misfortunes of life that permitted at least one more celebration of life and of food together as a family. So many of us lack one or the other – or both. The kids are getting bigger and this brief window of time where we will all be able to sit and talk and eat will quickly pass.

Low carb, the extra family member, helped prevent this from occurring. It wasn’t the sole reason, but it was a part of it.

This summer we also put a major dent in the family finances and went to France. While my bank account will need to endure a long convalescence to recover, it was a transforming experience for me.

It was a life-long dream of my wife to travel there. I am a reluctant traveler: I like having traveled but do not like traveling. for years I made excuses and we would go places less expensive and easier to get to – and my wife accepted these consolation prizes in place of the Grand Prize she had always held on to.

When she announced that she had found insanely-cheap plane tickets due to a combination of luck, mileage points from some business travel, a credit from the airline that was expiring in October, and other savvy-traveller tricks she pulled out of her bag, I decided that now was the time for her to have her dream – and I would do my best to suppress my bundle of anxieties about traveling and let her have her experience – and allow myself to fully enjoy it as well, because if I brought my anxieties along (another family member), they would reduce my wife’s enjoyment of the trip.

I couldn’t entirely dismiss my traveler’s anxiety, of course – we can’t simply turn off our anxiety. Instead, I prepared and did a bunch of things to reduce it. I am sometimes considered negative because whenever I am involved in a project I think of all the things that can go wrong at the outset. People take this as negativity but I see it as a necessary preparation to prevent things from going wrong. 

I like my optimism to be reality-based, so I worried to myself about things like keeping the house safe during our trip, reading about problems American tourists have in France so I could avoid these, while my wife read the travel books and thought about where we would go and what we would see.

I learned that pickpockets are a big problem in France, for example, and got myself a travel wallet that hangs around the neck. I also jury-rigged a little device with my iPhone and a gizmo to find your keys and had my younger daughter wear this around her neck. The crowds of tourists in Paris can be a crush in August as I read, and this gizmo would go off if she strayed too far from me.

I was also anxious about the tales of French rudeness to American travelers and wanted to know why. I started from the proposition that it wasn’t them – it was something about us that galled the Gauls, so I talked to a person that taught courses in intercultural relations for business people and was recommended two books on how the French think. After all, we were going to be guests there – the least we could do is be well-mannered guests and not do the international equivalent of sticking our napkins in our shirt collars and picking our teeth at the table with the steak knife.

I could not be more amazed at what I learned. The French are a people with a very different worldview than Americans. They are proud of their country, their government (though they are almost always protesting something or other), and their culture. When in public they tend to be more formal in their interactions with other people because for them it is a sign of respect. They also believe in projecting an image of being ‘well put together’. It’s not that you need to dress formally, but walking around in shorts wearing a T-shirt that says ‘I’m with stupid’ or some other typical American casual dress projects to them that you don’t have respect for yourself.

I left my shorts home and dressed ‘business casual’ for the most part, which meant that you might not have been able to tell we were tourists from a block away.

They also always greet people with a formal ‘Bonjour, Madam’ or ‘Bonjour Monsieur’, and expect a ‘Merci, au revoir’ when leaving their presence after an interaction. Again, to them it shows a respect for the individual. I see nothing wrong in that. We Americans once also had this same sense of formality but seemed to abandon it a number of decades ago when we embraced an casual ‘Hey-buddy!-anything-goes-wear-sweatpants-to-church’ informality that didn’t expect such niceties to be the standard.

You could argue that their way is a bit stuffy – but that wasn’t the point.

I didn’t want to change France – I wanted to see if France might change me. Perhaps there would be lessons learned here that might make an understanding of the culture I was about to immerse myself in make the trip more than just seeing sights and taking pictures in front of monuments as a sort of trophy to show off on FaceBook.

I think it did change me. It went way beyond a ‘vacation’.

Paris was a breathtaking experience The grandeur of the place, the almost seamless mix of ancient and modern, great works of art and architecture a part of any glance in any direction, with charming little bistros, brasseries and cafes on every street seemed surreal, perplexing – and unnecessarily expensive to a practical mind. So many things useless except to look at in awe in every direction. No sane US citizen would put up with the taxation necessary to erect and maintain such uselessness which is why we’re a nation that has left behind marble and gilt for Tyvek and vinyl siding.

This left me obsessing over the question: “What kind of people would create a city like this?”

Thankfully I had my two books on France and the French that answered a lot of questions. I read these in my free time back at the hotel. I certainly did not turn into a French cultural expert overnight, but some of the insights at least began to explain some of what I saw.

At one point in the trip I stopped taking pictures. I realized that you can’t fit Paris into a rectangle. Go to the Louvre and stand in the center courtyard and try to take a picture. Compare it to what you see standing there. Nope – doesn’t cut it.

Throughout our trip, almost every French person we dealt with was friendly and gracious. We met many who spoke perfectly acceptable English and patiently put up with our horrible French. I suppose it came down to: treat people as you would like to be treated. It also might have been because it is said that everyone goes on vacation in Paris in August and the city is left to those who remain behind – and to tourists.

Perhaps we might have encountered more grumpiness in September when the Parisians return to take their city back from the tourists – I don’t know.

We also ate their food. Funny: I was asked that question twice. “Are you going to eat their food?” That would be like asking me if I was planning on breathing their air.

The first memorable meal was some duck cooked rare in a raspberry reduction with mashed potatoes. No vegetable side. Each flavor and texture complemented the other. We didn’t eat at any fancy places – just some of the many bistros that don’t get listed in travel books – yet all the food was prepared with such concern for the ingredients that each meal, no matter how humble, was like the random art found around every corner in Paris: unexpected and pleasurable.

To keep costs down we found a French grocery store across the street from our hotel in Paris and ate some meals of fresh baguette, foie gras, sausage, and cheese in the hotel room.

Over the weekend we spent there we left Paris and went to Amboise, a town of about 10,000 people less than 2 hours by train outside of Paris. The centerpiece of the town was a castle-fortress and not too far from there, a short walk down a cobblestone street, was Leonardo Da Vinci’s home for the last few years of his life.

This was wine country and we just happened to arrive during a wine-tasting festival with a downtown marketplace with the most amazing foods and local crafts. Very little in the way of tourist trinkets of the Eiffel Tower made in China – this market was for the locals. The wife and I tasted wines while the kids took a nap back at the hotel (a 5-minute walk from the center of town where the festival was held). We bought some brioche and other foods from the market and a little sweetshop across from the open air market and the next day a much larger weekend market filled a parking lot a 10-minute walk from the hotel. Farmers from miles around brought their fresh-from-the-farm goods and there were many booths cooking fresh food. We bought a huge container of paella from one vendor and bread and foie gras from another and had a picnic on the banks of the Loire river just steps from the hotel.

The way the French eat has always intrigued me. I don’t recall seeing a single fat French person. They ranged from rail-thin to plump, but no one was obese in my estimation. How could they eat like this? Yeah – they eat a lot of fat – but they love their bread and their sweets as well.

The answer was in one of the books I was reading and had to do with part of the main reasons why Americans think the French rude and they think we are rude: a difference in what is considered ‘public’ and what is considered ‘private’. This was a fascinating read. The French consider money to be vulgar and tend not to discuss it in public, don’t want to be asked ‘what do you do?’ in conversation, consider a stranger asking their name to be rude, and if they were to invite you to their home would most likely NOT ‘show you around the house’ or want you to peruse their bookshelf unless invited to do so.

And unlike Americans, they consider eating to be part of the public sphere. Eating is a social activity in France. Meals are meant to be lingered over, preferably with friends and family, and no self-respecting French restaurant would ask you to leave even if you only bought a single espresso and were still hanging out 4 hours later.

Americans, on the other hand, consider most eating to be a private activity: hence we snack, and they – for the most part – don’t.

This brought me back to the ‘family meal’ that I had begun to enforce a month before we left. My seemingly retro notion of a family meal in our house was enshrined in their culture. They lingered over their food and this gave them time to digest and feel fuller on less. They simply ate less of high quality food because it was all they needed and they never ate mindlessly like so many Americans do – hypnotized by the TV with a bag of chips on their laps vanishing bit by bit without being noticed.

Not realizing it, I had hit on something that I thought would derail my diet but now I was thinking might become the center point for it.

The funny thing about the family meal was that I found myself not picking much afterward. There was little ‘raiding the fridge’ after eating whatever meal I had when I came home. We ate later than usual, ate slowly, and ate with a mindfulness – discussing the food itself, it’s preparation, how the different ingredients went together. We discussed future meals – and what we tried that wasn’t liked (while peas were a comfort food for me, neither my wife nor kids like them).

There were also complaints from the family when we couldn’t follow the ritual. It seems it wasn’t something the rest of the family just ‘went along with’ – it was valued by them – despite the prohibition on electronics and the TV.

Perhaps ‘meals’ are more important than ‘eating’. Perhaps ‘dining’ is more valuable that ‘3 squares a day’. So where my head is at present is as follows:

My Low Carb Diet must become invisible

I’ve concluded that talking about diets – especially at a meal with others – is vulgar – akin to talking on the cel phone at a movie theater. It detracts from the enjoyment of others in your company. Discussions about food at meals should only be ones that discuss it as a means to pleasure. Discussing how well the peas and onions complement each other is perfectly acceptable – the carb count, or the discussion about any chemical in any ingredient being shown in studies to do X – is not. Certainly, there is a time and a place for such discussions – like here – but at the table, with dinner companions, conversations about calories, nutrients, and the long-term ill-effects of a particular food is not one of them. I’m going treat any food placed in front of me as I would a guest and not be rude nor denigrating to its presence. Like someone at a party I don’t particularly like, I can avoid them yet still be gracious.

Now, this does present a tricky problem: eating with companions or with family and friends means dealing with what dieters call ‘food pushers’ who might ‘derail your diet’. I’m beginning to think that this sort of thinking might be a misstep. Looking at food from a cultural and communal standpoint, offering food to people is one of the grand gestures of friendliness and kindness that one human being can give to another. In a world that has arisen from one where starving was a very real possibility every day, this gesture is the utmost hospitality – and we dieters reject it. Instead of embracing our humanity we bring science to the table and tear up the social contract that has been built up over thousands of years across almost every culture on Earth.

The diet problem is still there, of course: anyone reading this has probably concluded that they need to control their diet and that certain food should be avoided. I’m beginning to think though that perhaps, once at the table in a social situation, we might be better off focusing on the metered enjoyment of the food we are presented with rather than reciting our list of prohibitions to a table that is more interested in enjoying a meal rather than hearing about your ‘diet’. Again, taking the mindset that the food itself is a guest of sorts, and imagining it as a person you would rather avoid that you bump into at a party, you would probably NOT bring up your list of grievances with them in a public setting, though you might limit your time with them. Do the same with food.

Your diet isn’t ‘blown’ if you participate with smaller portions. At a restaurant you can ask for a double portion of vegetables instead of the side of mashed potatoes. You can still avoid sugary drinks and skip the bread brought to the table. These will be almost invisible to your companions. At a family meal or a when entertaining friends, certain items can be safely avoided – like chips placed on a table before a meal. At the actual meal, where there is some social expectation of participation in the various dishes, taking a small portion and allowing yourself to enjoy it might be more sane and more in the spirit of things than to express your prohibitions.

Either become a monk to your diet or accept the fact that there will be times when the best course of action is the practice of a concealed metering of eating what is being graciously offered.

One meal does not ruin a diet: it’s a series of meals that does that to you. Allow yourself the pleasure of food with family and friends, participate in the bounty we’ve been given, and work to develop the ability to participate fully while watching your diet as much as possible without others noticing you doing so.

Make eating a communal event as much as possible.

A diet is in some ways chasing after wind: “When I get to be my goal weight I will be happy.”

It doesn’t work that way.

Goals are great, but I assure you – you won’t be continually ‘blissed out’ when you attain that magic number on the scale. I’m not saying you won’t be filled with a sense of accomplishment, better physical health if done right, and a host of positive emotions – it’s just that these will fade into the background of your life after a time. Studies have shown that people who win the lottery, within a few years, return to more or less the same level of happiness they had when they weren’t rich. We adapt to our situations – good and bad – and while being thin might bring you all sorts of things you don’t have now, we humans have a tendency to take things for granted after a while.

Make sure you don’t postpone your happiness entirely until a certain number on the scale appears. We don’t know how much time we have left. Our expiration dates can’t be found on any label attached to us. Enjoying a meal with others when possible, when done the right way – focusing on the food with other people who know how to truly experience the pleasures of food – will bring greater happiness to every day of your life.

Should death tap you on the shoulder and tell you you’ve got only a few more moments, I guarantee you: your diet will be the last thing on your mind. Don’t give up the pleasure of good food with good company because of a ‘diet’.

Again, your brow might be furrowing as to how you follow this advice and still lose weight. It seems easier from one perspective to set a goal, sacrifice for it for a certain time, and achieve it. That’s how Americans do it.

That might work for things like passing a test or building a business, but we don’t ‘own’ or bodies in the same way as we might own a car that we’re restoring or own a business or have responsibilities to a job that we can work to excel at. Our bodies allow us to inhabit them, but they breathe on their own, the blood flows without our consent, our hearts beat to the rhythm they choose.

One thing we pretty much know about our bodies is that they are resistant to weight loss once the weight is gained. Respect this and embrace the notion of slow and gradual weight loss. I know this goes against every notion in a time-bound, deadline-obsessed culture, but your body doesn’t exist in that artificial world that lies outside of it.

So accepting this and making eating a communal event as much as can be managed involves cultivating a pleasure in good food shared with others. The secret to the power of this in an attempt to lose weight is eliminating the notion that eating alone on the couch in front of the TV is acceptable. You are replacing one with the other. Public eating is conscious eating, and conscious eating never ends up with an entire pint of Haagen-Daz disappearing while watching ‘The Biggest Loser’ along with a bag of chips now empty without you not quite remembering how it happened. Communal eating is also conscious eating with little effort. Instead of meditating on each bite of your meal alone, doing it with others occurs in an atmosphere that makes it more effortless.

Of course, if you are coming off of years of binge-eating, there’s work to be done here in terms of portion control and selectivity. Work on that rather than pursuing the goal of ‘hermit dieter’.

When eating alone, make it monotonous

You won’t be able to make every meal a communal one if you are anything like most of the people I know. In a culture obsessed with busyness, schedules conflict, things pop up, and families are separated by work, school, and separate activities. What to do then?

Well, what I am attempting to do is pursue the notion that these meals are unimportant in the grand scheme of things. I don’t want to have to think about my lunch at work, which is usually alone because ‘lunchtime’ is not a certain hour in my business and tends to be the time one can squeeze in between meetings and phone calls and can land anywhere between 11am and 3pm.

What I’ve been doing is enforcing a very small and rigid set of food choices that allow me to not think about preparing a lunch. As I work in an office, I have this luxury, so this is not in any way a recommendation, just an example of what I’m doing.

I’ve narrowed down my daily eating to the following items:

  1. Coffee
  2. coconut oil
  3. Lindt 80% dark chocolate
  4. Macadamia nuts
  5. eggs
  6. Chicken broth

Now, my particular constitution allows me to go long periods without eating with no ill-effect. Perhaps I’ve been in ketosis so many times that my body finds it easy to pull from my fat stores and run on ketones to keep me humming when I haven’t eaten in more than a dozen hours. Maybe my body is like a hybrid car than can run happily on gasoline or propane. So again, this is not a recommendation – it’s just what I do.

My breakfast is always coffee and cream, providing me with a little ‘get-up-and-go’ with between 100 and 200 calories of pure fat.

Around 6 hours later, a half cup of coffee with either 2 squares of dark chocolate or coconut oil melted in it is my next feeding – another 100 to 200 calories of mostly fat.

A few times a week, anywhere from the noontime coffee break all the way to almost before I leave work, I might have a cup of chicken broth with two raw eggs broken in it and nuked for 3 minutes. Or maybe a 20 or so macadamia nuts, totaling somewhere between 200 and maybe 350 calories.

So for 12 hours of my waking day, my input is almost zero carbs, mostly fat, maybe some protein from the eggs, and a calorie intake of anywhere between 200 calories and 750 calories.

Given I’ve eaten almost no carbs, this leaves room for the family meal in the evening. While at present I’m eating anything, my intention moving forward is to continue the ritual – except to artfully cut back on the carbs. Pasta and meatballs with Italian bread? I can have a taste of the Pasta and the bread with butter, and have mostly meatballs. Pork belly with gravy, vegetable and mashed potatoes? Same thing: a taste of the potatoes and vegetable if it’s high-carb, and focus on the pork belly and gravy.

The room that I’ve left in my daily food intake for a family meal allows some decidedly un-low carb foods in small portions to enjoy while also allowing me to keep both calories and carbs within limits that still mean I’m on a ‘low carb diet’ without the appearance of being on one.

 The one prohibition

If there’s one thing I have learned in my decade of low carb, it’s that without exception, no weight loss occurs if I drink alcohol. So in an effort to make the notion of social eating work as part of a weight loss strategy, I am going to sacrifice the conviviality of social drinking. I was never much of a barfly anyway, and most of my drinking was drinks after work at home – nothing that added much to the joy of life as much as calmed the nerves after a hectic day. For many months now I’ve been adapting to not exciting my nerves unduly in the first place – the 3 pots of coffee I once drank is down to a cup and a half, so a less jangled nervous system should be able to forego the drinks I now realize I once needed to unjangle it.

Now comes the hard part

Pretty words you got there, you might say. will it work?

I dunno.

If I can navigate the shark-infested waters of carbs setting me off for an evening of overeating, if I can watch my portions, if I can make it second nature to balance on this knife edge, perhaps it can work. It sounds sane and life-affirming as a lifestyle – but can it lead to weight loss?

I suppose we’ll see.

The April Fool Day 7: Low Carb…or Else

Monday, April 7, 2014 – 229.4

A comment by a long-time reader misinterpreting my existential despair post from the other day made the following comment:

If you had an anaphylactic reaction to carbs and they were going to kill you….you’d find a way to stick to your diet.

Well, anaphylactic shock – which can be caused by a severe allergic reaction to a bee sting or nuts in sensitive individuals – doesn’t exist for eating cookies…or does it for me?

I won’t bore you with my transgressions, but it did involve carbs eaten late at night and the attendant thirst that I typically get when I eat too many carbs. In terms of overall eating for the day it wasn’t all that much of a transgression – given I didn’t eat a good part of the day a total tally would have probably landed me within the normal 200 grams of carbs and caloric intake that was high-normal.

The result of this venial sin was epic, however.

At about 12:30am I awoke choking. I’ve never been diagnosed with GERD, but I would imagine that a combo of eating carbs late at night caused my stomach contents to leak into my lungs. I have experienced this on occasion since my 20s when I was about as fat as I am now – my first experience being with an overindulgence in Eskimo pies late at night.

I never get this when eating low carb.

The feeling is what I would imagine drowning in hydrochloric acid might feel like. The burning in my throat was unbearable. No less than a baker’s dozen of Tums were needed to control the burning somewhat. Even after the fire got put out there was still gurgling in my lungs when I breathed.  I was choking and coughing for at least 20 minutes until I had cleared my lungs and the gurgling stopped. Each cough that cleared my lungs burned my throat again. Both my wife and my older daughter – who I woke from my coughing and came in to see what was going on asked: “Are you OK?”

I gave them a thumbs up, which really meant: mind your own business.

Maybe an hour later I was able to get back to sleep, but this time lying with my head up to prevent another incident.

I awoke exhausted.

It’s not anaphylactic shock, but it’s a damn good reminder as to *why* I can’t eat like a normal person. I’m not a big fan of negative reinforcement as motivation, but this is not something I’d like to experience again. Negative experiences do sometimes result in positive outcomes – a good health scare sometimes works wonders to change long-term behaviors.

I’m more the ‘carrot’ than the ‘stick’ kind of guy with myself and others, but the beating I took from this stick is worthy of remembering – and might just tip the scale towards me being more careful about my diet.

If my transgressions have such dire consequences, it might be prudent for me to remember this.

 

Confirmation Bias News for Low Carbers

Confirmation bias is the psychological term for believing information that supports your beliefs while ignoring or challenging information that contradicts your beliefs. We all do it: it’s the way our minds are wired. It’s also fun and simple to do:

  1. Find an article that supports your beliefs.
  2. Cherry-pick the point of the article that most strongly support your position
  3. Leave out any nuances in the article. If there’s a section about disagreement with the conclusions drawn, ignore that.
  4. Don’t research who did the research, what they measured, nor who paid for the research. If they believe what you believe they must be people of intelligence and integrity funded by organizations dedicated to only pure science and free of any conflicts or agendas. No need to check.
  5. Any comments contradicting the conclusions are made only by people with agendas, the misinformed, or by those who lack integrity

Following these fun and simple rules allow you to wrap yourself in a warm cocoon of self-validating information. It’s a wonderful state to be in: you are confident and self-assured. No self-doubt permeates your cranium. You might have a world-view that is neat, simple and wrong – but two out of three ain’t bad. The warm glow of certainty is certainly less burdensome than trying to weigh all the evidence without bias – that takes thinking and risks your preconceived notions becoming frayed and tattered – who needs that?

Let’s see an example, shall we? You’re going to love this.

Study: Vegetarians Less Healthy, Lower Quality Of Life Than Meat-Eaters

ATLANTA (CBS ATLANTA) – Vegetarians may have a lower BMI and drink alcohol sparingly, but vegetarian diets are tied to generally poorer health, poorer quality of life and a higher need for health care than their meat-eating counterparts.

A new study from the Medical University of Graz in Austria finds that vegetarians are more physically active, drink less alcohol and smoke less tobacco than those who consume meat in their diets. Vegetarians also have a higher socioeconomic status and a lower body mass index. But the vegetarian diet — characterized by a low consumption of saturated fats and cholesterol that includes increased intake of fruits, vegetables and whole-grain products — carries elevated risks of cancer, allergies and mental health disorders.

Vegetarians were twice as likely to have allergies, a 50 percent increase in heart attacks and a 50 percent increase in incidences of cancer.

Now – ignore reading the following – it’s called ‘balance’ and it’s a journalistic convention – they have to say this to make the research and the article appear balanced.

the researchers do caution that continuing studies will be needed to substantiate some of the rather broad dietary distinctions, associations presented in this current research.

So fat, booze-guzzling meat-eaters are healthier – yay!

I feel so much better – don’t you?