Still preparing for my nutrition lecture, I took advantage of being at Touro University California, where I work with a group of really remarkable physicians. Because they are in academia their interests range, from the care of the patients, to students learning to research and delightfully many of them are not burned out but still filled with heart and enthusiasm. (Don’t ask me how they sustain this, it’s not as if family practice doctors who teach in California are paid well, work less hours, or have more say over what they do…. but that’s another conversation.) As I was saying I took advantage of being amongst these doctors and spoke with four of them about my upcoming lecture. One gave me advice on Excell and Powerpoint… turns out what I want to do can’t quite be done that way, but we may have come up with a work around. A second encouraged me and asked really interesting questions, raised interesting points and admonished me not to worry, my enthusiasm and genuine interest in the subject and helping my patients would make the talk fabulous, but then she said “what are you going to do when they ask an antagonistic question?” Hmm…
The third doctor talked to me about level of reliability of the journals – for example, NEJM has multiple statisticians and reviewers on staff. She was fully aware, and as disturbed as I am that many proponents and opponents of a single idea use the same research article to prove their opposing arguments. In other words, the science, like the bible, is interpreted to suit their needs, rather than used consistently. The fourth doctor really peaked my interest. He said, that he was not in favor of paleo or low carb diets, siting the typical arguments ” not sustainable, no long term research, not affordable, and that research really proved that mediterranean was the way to go.” But then he proceeded to tell me that he was running a study in which he helped transition patients to low carbohydrate diet, moving them from a very low 5gm per day (Atkins/ketogenic levels) to a moderate to high level 45 gm per day as maintenance (also seen in some ketogenic or Atkins diets, but more typical of a Paleo type diet.)
So I asked again, if you are not in favor, for yourself or your patients of a paleo diet, why are you doing this? We were interrupted by the more important people on campus – the students – and so the conversation ended…… It reminds me of something my father told me. He said at a conference on psychiatry the speaker asked, “How many of you prescribe trazadone instead of ambien for sleep?” – and most doctors raised their hands. Then he asked, “How many of you take or would take ambien instead of trazadone for yourself if you needed it for sleep?” and yes, you guessed where this was going, most doctors raised their hands. So I wonder, how many doctors eat a mediterranean style diet? Or a government prescribed “My Plate” diet? Or a AHA or Ornish style diet? And how many have tried a low carbohydrate diet, or a Paleo style diet.
Later that evening I went for my bi-weekly acupuncture appointment and chattered on about the talk and nutrition (yes it is consuming me – is your diet eating you or are you eating your diet?) My acupuncturist is a firm believer in a plant based low calorie vegetarian diet. I talked to him about what I was proposing – not all meat all the time, that isn’t really what paleo or low carb diets are – but rather lots and lots of veggies, small but regular amounts of fresh whole fruit and yes animal protein, starting with fish and chicken and if it’s affordable grass fed meat. He paused and said, ok, that’s potentially healthy for some people. A win.
That’s all I’m saying. I hope in the end what I share is heard for what it is. I’m not arguing people should eat just meat, or just fat, or just meat and fat. I’m not saying everyone should eat one way and that way is paleo or Atkins, or grain free or gluten free or anything else for that matter. The only thing everyone should do is avoid refined carbs and sugary beverages.
What I’m saying is Paleo is a good tool and we need to have access to it and understand it isn’t going to hurt our sick, overweight diabetic patients, it’s going to help them. It isn’t going to cause cardiovascular disease. It isn’t any better or any worse than any other diet – done right it’s good, done wrong it’s bad. That’s the facts about all nutritional programs, if you don’t do it right, moderately and sanely and mindfully, it’s not going to work. If you do it moderately and sanely and mindfully it doesn’t matter what it is you’re doing.
That’s the news today and remember: Don’t let your nutrition consume you.