Here’s part of an interesting email from a friend who has recently decided it’s (past) time to reshape his approach to food, starting moving again, and drop the 80 or so excess pounds he’s been carting around for the past decade.
As a way of background, he’s a physician (orthopaedic surgeon), busy family guy, still helps when he can with his parent’s ranch two hours away, is an avid hunter, and loves to cook and eat.
…I appreciate your time on the phone last week, and I’ve read through some of the sites you suggested, though clearly there are conflicting positions as to the roll carbohydrates play in the typical American’s diet, particularly those of us who are above our ideal body weight and in our 40’s or older.
I get that the traditional medical/nutritional establishment, as a larger collective, still touts various carbohydrates as the foundation of the food pyramid (even though they’ve more or less moved on from that construct), but even a cursory search of food plans to lower carbs yields what appears to be highly anecdotal recommendations that are all over the map.
Your simple explanation of a lower carb, moderate protein, higher fat approach makes sense on one hand, though what the hell is one to make of the no-carb carnivore stuff being waved around today? Or the high carb recommendations still flooding the sports medicine literature, particularly at the elite level and in the endurance disciplines. Or the high carb, high protein regimens that come out of the power lifting / body building worlds? Not to mention those choosing the vegetarian or vegan roads, of course neither of which are so carb-phobic.
For a guy still in practice today, this all presents something of a conundrum – actually two to deal with. One, recommending that patients lose weight as I sit on the stool next to them with my panniculus hanging over my belt rings a bit hollow. And two, dispensing specific nutritional advice to patients puts me on the hook in a way, and I damn sure want to engage personally with an approach that’s physiologically/scientifically sound.
You know where I’m coming from, and with your health success personally and study over the past few years, would you mind steering me to some solid, evidence-based data to incorporate here?
My wife and I have tried and failed with a number of different approaches, like The Zone, South Beach, Weight Watchers, and even some crazy thing she bought for over a grand that had us drinking meal replacement shakes twice a day that tasted like dirty socks soaked in dishwater with a sprinkle of Nestle’s Quick stirred in. We need something that is geared for the long haul that still lets us enjoy good food. We’ve both had enough of running out of energy two hours after eating and reaching for what must be the wrong snacks to reach the next meal…
Let’s Start With Some Simple Points about Food (and Life) to Agree On
Those of you who have chosen to amble down a food plan path different than that of the Standard American Diet (SAD) have heard some variation of the comments / questions levied by my friend above.
You also know that what initially might appear to be confusing for some – for example the differing carb intake recommendations my friend pointed out above – often comes into much sharper focus as one digs a bit deeper and separates the science from the noise AND takes an honest appraisal of one’s own health, unique physiology, and approach to food.
That said, I quickly responded to my friend and commended him for several things.
One, simply choosing to get started, drawing that line in the metaphorical sand, and deciding to make a change is a critical step.
Two, there’s no question that excess body fat isn’t your friend. As a busy orthopaedic surgeon making his living (for the most part) replacing hips and knees that have worn out, he understands this better than most. The obesity epidemic impacts the morbidity of his arthroplasty patients, their implant longevity, and eventual return to function (link), among other things.
The list could go on and on, but just for example’s sake, excess belly fat increases your risk of an early death, abdominal obesity increases cancer, cardiovascular, and all cause mortality, and can severely impact quality of life (including sexual function).
Three, the current SAD approach to nutrition clearly isn’t a workable longterm plan for health and wellness. Looking for proof? Explosion in adult obesity over the last 40 years? Check. Explosion in childhood obesity over the last 40 years? Check. Skyrocketing rates of T2DM, hypertension, auto-immune diseases over the last 40 years? Check. (Frankly, go to an area shopping center and people watch for 20 minutes…).
And four, I agreed with him that there is a tremendous amount of noise out there about carbohydrates and their role in human nutrition. That duly noted, there are good scientists, physicians, and health advocates telling the truth about carbohydrates around, and some diligent personal research and careful thought is called for here, as is the imperative of paying attention to what your own body is telling you (as evidenced by the simple fact that my friend’s current approach to food clearly wasn’t working by what he’d described).
More tomorrow on clarifying my buddy’s carb conundrum.
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