Due to popular demand the producers of this terrific series are making it available again on line this weekend. If you have not taken advantage of this information you can do it here:
Bob Hansen MD
Due to popular demand the producers of this terrific series are making it available again on line this weekend. If you have not taken advantage of this information you can do it here:
Bob Hansen MD
Today I watched a great TED talk by Dr. Rangan Chaterjee discussing his own journey in the discovery and implementation of a functional medicine approach to caring for his patients. The concept of using basic science and clinical science to diagnose and treat the root causes of illness, rather than treating symptoms, has been around for more than two decades. This approach has recently started to attract more attention, especially within the community of younger physicians who have become more dissatisfied with the frustrations of traditional allopathic medicine.
Here is the talk. Dr. Chatterjee covers lots of ground in a passionate and informative talk.
Enjoy this talk. If you would like to learn about how a functional medicine approach can CURE ALZHEIMER’S DISEASE then watch this video of Dr. Bredesen who gave this lecture at a meeting of the American College of Nutrition.
Doctor Bredesen, an acclaimed neuroscientist, researcher, and more recently a brilliant clinician, has been criticized by the academic research community for implementing a clinical research protocol that addresses more than one variable at a time! Unfortunately, medical science has been handcuffed by the drug-model of clinical research wherein only one variable (drug vs. placebo for example) is studied. But if an illness has many potential contributing root causes, changing only one variable is doomed to failure, as Dr. Bredesen explains in this lecture.
Sleep well, eat clean, get outdoors every morning to help keep your circadian rhythm and biological clock in order.
Bob Hansen MD
This week the European Court of Justice ruled that the European Commission has not adequately identified and banned harmful endocrine disrupting chemicals that play a role in hormone related cancers like prostate, thyroid and breast as well as obesity and type two diabetes.
The FDA, European Union and Canadian authorities have claimed that BPA exposure likely does not pose health risks but the endocrinology societies, research scientists, and now the European Court of Justice thinks otherwise.
Most folks have heard about BPA (bis-phenol A). But there are over one hundred endocrine disrupting chemicals (EDCs) in our environment. These chemicals interfere with our hormone function by mimicking hormones or blocking normal hormone signals. Using BPA free plastic bottles and cans does not guarantee you are safe from the toxic effects of these chemicals because BPA is often replaced by one of many other disrupting alternative chemicals. There are 13 types of bisphenols alone, along with over one hundred total identified EDCs. Many beverage and food items come in plastic containers or cans lined with EDCs, exposing us to the unnecessary risk of endocrine disruptors. Acidic beverages and acidic foods (such as coffee, soda, lemon juice, etc) are particularly more likely to leach out these chemicals into the foods and beverages contained therein. Extremes of temperature (hot or cold) will also increase the amount of chemicals leached into the food and then into your body. So sipping a hot coffee or tea through a plastic lid is not an innocuous event, yet millions of Americans do it every day. Serving “bottled water” in plastic containers that have been sitting on shelves, shipped in hot trucks, or sitting in the sun at a party may not be very helpful to your guests.
Emerging evidence has established a role for these endocrine disruptors not only for cancer but for obesity, diabetes, ADD and autism.
A recent study has suggested that because of endocrine disruptors in our environment, we must today consume less calories and exercise more to avoid obesity. (Obes Res Clin Pract. 2015; DOI:10.1016/j.orcp.2015.08.007).
“for a given amount of caloric intake, macronutrient intake or leisure time physical activity, the predicted BMI was up to 2.3 kg/m2 higher in 2006 that in 1988 in the mutually adjusted model (P < 0.05).”
From a Medscape report on this topic:
“A European ( study ) reported earlier this year suggested that health effects from endocrine-disrupting chemicals cost the European Community €157 billion annually, and this report linked prenatal exposure to BPA to childhood obesity, with associated lifetime costs of €1.54 billion.”
Links to some articles and resources are listed below.
Be careful out there!
Jason Fung is a brilliant Canadian physician who has treated obesity and diabetes with a fasting protocol. Intermittent fasting produces physiologic changes similar to a low carbohydrate ketogenic diet (LCKD). Both approaches have been successfully used to treat diabetes, insulin resistance, obesity and metabolic syndrome. Learn why most medications that are used to treat diabetes do not address the underlying root cause by watching this video.
After watching that video consider the following discussion by Dr. Tim Noakes who cured his own “pre-diabetes” with a LCKD. Dr. Noakes was criticized by his less open-minded colleagues for employing a beneficial lifestyle change that allows most diabetics to reduce or eliminate their medications. Dr. Noakes had followed the “prudent diet” recommended by the USDA and AHA for decades. Despite following that “prudent diet” and exercising regularly by running long distances he had developed “pre-diabetes” (insulin resistance which often leads to type II diabetes). Then he stumbled upon an iconoclastic approach,
So he read more about it and decided to try it. The results were stunning to this physician who became an ardent proponent of carbohydrate restriction.
Now if you have not heard enough, listen to Eric C. Westman, MD, MHS who treats patients and teaches medical students and residents at the Duke University Lifestyle Medicine Clinic.
A paleo diet in combination with carbohydrate restriction is arguably the most beneficial nutritional approach to diabetes, pre-diabetes and obesity. The data that supports this statement grows on a daily basis.
You can read about why a LCKD should be the default diet for diabetes here.
Eat clean, live clean.
Yesterday I posted a comment on Medscape after reading an article Longtime Dietary Fat Advice Unsupported by Data: Analysis . Medscape is a website with articles and news written for physicians and other health professionals. Anyone can access this information by creating a user name and password, there is no fee.
Here is my comment. It is long and technical. I will provide an explanation in lay terms after quoting myself.
Sugar, especially HFCS (high fructose corn syrup), used in so many foods is more inflammatory than saturated fat. Grass fed meat from ruminants has a fatty acid mix that is exactly the same as wild game, which we evolved to eat, along with tubers, green leafy vegetables, and fruit in season. Excess refined fructose intake AND use of modern refined “vegetable oils” along with non-healthy grains combine to cause excess caloric intake, NAFLD (non-alcoholic fatty liver disease), obesity, metabolic syndrome and CAD (coronary artery disease). N6 PUFA (omega six polyunsaturated fatty acids) are easily oxidized. N3 PUFA (omega 3 fatty acids) despite greater number of double bonds are protected from oxidation in cell and Lipoprotein membranes by plasmalogens as opposed to linoleic acid which is not easily incorporated into plasmalogens. The PUFA in vegetable oils (linoleic acid) is the FA (fatty acid) that is oxidized on LDL particles and remnant particles, stimulating monocytes to transform to macrophages and then foam cells. The USDA, ADA and AHA have had it upside down for decades and they still fail to admit folly. We evolved for > 1 million years without grains and they have contributed to disease. Per calorie fresh vegetables have five times the amount of fiber compared to whole grains. We do not need grains and would be better without them. They contain anti-nutrients and wheat, hybridized in the 1980s to a storm resistant dwarf plant, now has 50 times more gluten/gliadin than the old wheat. This has generated more gluten intolerance and celiac. Our greatest nutritional threats to public health include refined sugar, carbohydrates predominantly from grains and refined vegetable oils. Vegetable oils are not healthy, we did not evolve to eat them. N3 FAs are anti-inflammatory but have been competing in our diets with a sea of inflammatory N6 PUFA from unnatural refined and easily oxidized “vegetable oils”. Even though PUFA can reduce LDL-C they wreak havoc by creating ox-LDL particles which initiate the cascade of atherosclerosis. Substituting SFA (saturated fatty acids) with PUFA results in increased levels of Lp(a) and oxLDL in humans, not a good thing. Close the feed lots, stop government subsidy of corn, wheat, dairy and soy, eat meat from grass fed ruminants, wild seafood, fresh organic vegetables and fruits in season. Nibble on tree nuts. Stop creating carcinogens with high dry heat cooking methods and we will watch obesity, insulin resistance, metabolic syndrome and atherosclerosis melt away.
That was my comment. Here is some explanation.
I have previously discussed the pro-inflammatory nature of refined “vegetable oils”. “Vegetable oils” are actually not from vegetables, they are from grains, seeds and legumes. The two major sources of excess omega six polyunsaturated fats in the American diet are corn oil and soy oil marketed by various brand names such as Wesson. They are major components of margarine and other butter substitutes and are present in most salad dressings. Most salad dressings sold in our supermarkets contain high levels of easily oxidized unhealthy refined “vegetable oils” and HFCS. The use of these salad dressings converts a healthy salad into a vector for disease.
The major source of caloric sweeteners in our food and beverages is high fructose corn syrup. Both corn (oil and sugar) and soy predominate our processed food supply because they are cheap. They are cheap because our tax dollars subsidize their production. This subsidy started during the Nixon administration. Once a food subsidy is put in place it is very difficult to eliminate, Big Agriculture provides a deep pocket for lobby money and our elected officials from the mid-west bread-basket respond to $$.
Another major source of disease causing elements in the standard American diet is highly refined flour from wheat. Doctors Davis and Perlmutter discuss the problems associated with wheat-flour foods in their books Wheat Belly and Grain Brain respectively. The production of wheat has also been subsidized since the Nixon administration.
Wheat is not what it used to be. A new dwarf hybrid wheat has predominated the US market since the 1980s. Bread and pasta are not what they used to be when great grand-mother made her own bread and pasta in the kitchen from coarsely ground whole flour. But even if we all went back to making our own whole-grain bread and pasta from locally ground pre-1980s wheat, bread, pasta and pastry would still present a health risk because of issues related to intestinal permeability, auto-immune disease (now epidemic in the USA), and the presence of nasty lectins and phytates (discussed in my manifesto and previous posts).
The Medscape comment quoted above describes adverse consequences caused by replacing saturated fat in the diet with “vegetable oils”. This is a complex subject and I will try to be brief for now but promise to expand on this in a future post.
Many factors contribute to atherosclerosis, heart attack and stroke. Sedentary lifestyle, stress, inadequate restorative sleep, smoking and poor dietary choices top the list. These factors also contribute to obesity, diabetes, metabolic syndrome, insulin resistance and many cancers.
The combination of sugared foods and beverages (predominantly sweetened with HFCS), refined flour foods, and excess consumption of the PUFA in “vegetable oils” TOGETHER contribute to the formation of plaque in the walls of our arteries (atherosclerosis).
How does this happen?
LDL (low density lipoprotein) is a particle that transports cholesterol and triglycerides through our blood to our organs. This particle is comprised of a core and a surrounding membrane. Here is a picture.
The core contains cholesterol in a storage form (esters) and triglycerides. The outer membrane includes a large protein called apoprotein B-100, “free” cholesterol molecules and phospholipids. The phospholipids contain fatty acids, including PUFA.
LDL has been demonized as “the bad cholesterol” and that demonization has mislead the public.
LDL is the major lipoprotein in our blood but there are others that have different names.
Cholesterol is cholesterol, whether it is carried in LDL or HDL. When carried in the core of a lipoprotein it is carried as a cholesterol ester. 80% of the cholesterol in an LDL particle is carried as an ester in the core. 20% is carried as “free” cholesterol on the outer surface or membrane.
HDL (high density lipoprotein) is smaller and denser. HDL has been called “the good cholesterol”, another misnomer.
HDL particles, when they are functioning correctly can protect us from atherosclerosis but in patients with diabetes, obesity, and insulin resistance, HDL particles do not function well and in fact probably contribute to disease. (More about that in a future post)
But back to LDL.
Although the risk of cardiovascular disease is correlated with the amount of cholesterol carried by LDL in our blood (referred to as LDL-C), the total amount of cholesterol shuttled by LDL particles is much less relevant than one would be led to believe given the great use of statin drugs to lower LDL-C.
The short version is as follows.
Compared to LDL-C, a much better predictor of cardiovascular disease is the amount of “modified” LDL particles circulating in the blood. Oxidized LDL particles are one form of “modified LDL”. LDL can also be modified by excess blood sugar levels (especially from HFCS). This modification is referred to as glycosylated or glycated LDL. In this latter form of modification, the major protein on the outer membrane of the LDL particle (apo B 100 in the picture above) becomes attached to a sugar and the result is an LDL particle that is not easily cleared by normal processes. The modified LDL is not “recognized” by the LDL receptors that act as entry points into our cells for proper processing. The result is that the glycated LDL particles circulate longer and are more likely to use up their anti-oxidants (Vitamin E and Co-enzyme Q 10).
As a result glycated LDL are more likely to become oxidized. That is not good because oxidized LDL sets up a cascade of unhealthy events.
The portion of the LDL particle that becomes oxidized is the fat (fatty acid) from “vegetable oil”, specifically the fatty acid called linoleic acid. This fatty acid has two double bonds making it more likely to be oxidized than for example oleic acid, the major fatty acid in extra virgin olive oil which has only one double bond.
The double bonds between the carbons in the fatty acids are unstable and easily oxidized. The single bonds in saturated fat do not get oxidized.
All other things being equal (and you will see that they are not), the more double bonds in a fatty acid the greater chance for oxidation.
Here is a picture showing the linoleic acid, also called linoleate, on the outer membrane of the LDL particle.
And here is a picture that shows the phospholipids that contain the linoleic acid.
Let’s say it again. The fatty acid found in “vegetable” oil, linoleic acid, is easily oxidized because it has two double bonds.
Saturated fats are not oxidized because they contain no double bonds.
The part of the LDL particle that becomes oxidized is the fatty acid that comes from “vegetable oils”.
A particular kind of immune cell (white blood cells called monocytes) have special receptors for oxidized LDL particles. When ox-LDL are “seen” by these monocytes, the monocytes become transformed into macrophages. Macrophages are designed to destroy bacteria that invade our bodies. The oxidized LDL particles resemble the structures of invading bacteria. The macrophages, with very specialized receptors for oxidized LDL, “swallow” the LDL particles and release toxic chemicals to destroy “the invader”. The macrophages then become “foam cells” in the walls of our arteries, initiating the creation of plaque. Here is a picture.
This picture depicts the oxidation occurring in the wall of the artery after LDL particles have penetrated the wall. However LDL particles can and do become oxidized while still circulating in the blood and these oxidized particles can stimulate monocytes to transform into macrophages and gobble up the oxidized or modified LDL while these particles are still circulating in the blood.
How and whether unmodified LDL particles cross the wall of arteries into the “sub-endothelial” area remains an unsolved complex issue. The picture above implies that LDL particles simply move across the endothelial cells that line the wall of the artery but that is a presumption.
Clearly, macrophages that have “swallowed” modified LDL particles have mechanisms to work their way between the junctions formed by adjacent endothelial cells.
This is an important distinction because many cardiologists believe that what drives atherosclerosis is a mass effect. The greater the number of LDL particles, the more likely they are to cross the endothelial barrier, get oxidized and retained and start the process of plaque formation. However the process is much more complex and not clearly understood.
We do not yet know or understand completely the factors that influence the permeability of the endothelium to Lipoprotein particles. We do know that modified (oxidized and glycated LDL) disrupt the protective surface of endothelial cells which is called the glyocalyx. Other factors that disrupt the glyocalyx include high blood sugars, dramatic fluctuations in blood pressure (too high or too low), oxidative stress, infections, and circulating endotoxin (which is governed by intestinal permeability).
It is clear from several studies that modified (oxidized) LDL as a single variable predicts cardiovascular disease and heart attacks with much greater accuracy than LDL-C (total cholesterol content of LDL particles). It is also clear that monocyte receptors are specific for modified LDL and that the process that initiates the cascade of events that leads to plaque formation involves the interaction between modified lipoprotein particles and the immune system (monocytes).
Now here is another twist.
Omega 3 fatty acids in fish oil are considered “heart healthy”. They help prevent heart attacks and strokes. They also decrease inflammation throughout the body thereby producing many health benefits.
BUT OMEGA 3 FAT HAS MORE DOUBLE BONDS THAN OMEGA 6 FAT (LINOLEIC ACID) YET THEY HELP PROTECT THE HEART. HOW CAN THAT BE?
How do they avoid contributing to atherosclerosis? Are they not even more readily oxidized than linoleic acid?
The simple answer is no.
The major reason is that the omega three fatty acids are protected by “plasmalogens” which are important components of our LDL particle outer membranes. Plasmalogens are found in the membranes of lipoprotein particles and in the membranes of human cells. Because of their chemical structures, omega three fats are easily incorporated into plasmalogens which protect the double bonds of omega three fats from oxidation. Linoleic acid, the predominant component of “vegetable oils” is not easily incorporated into the protective arms of plasmalogens.
This selective protection is well described on pages 141-142 of “The Fats of Life”, written by Dr. Glen Lawrence and published in paperback in 2013. (link below)
I asked Dr. Lawrence about this issue in an email and here was his response.
“The omega-3 fatty acids are preferentially incorporated into plasmalogens, which act as antioxidants due to the double bond adjacent to the ether linkage of these phospholipids. This structure would tend to scavenge free radicals or reactive oxygen species near the surface of the membrane, rather than allowing them to penetrate deeper in the membrane where the double bonds of PUFA are located. This makes any polyunsaturated fatty acids attached to the plasmalogens more resistant to oxidation than they would be in a regular phospholipid. See pp 141-142 of The Fats of Life. The shorter chain and less unsaturated linoleic acid does not tend to be incorporated into plasmalogens.”
These are the major points, but there is allot more to discuss. Substituting “vegetable oils” for saturated fat in our diets not only increases the amount of oxidized LDL but also increases a dangerous lipoprotein called Lp(a). On third of Americans have an amount of Lp(a) that is considered “high risk” for heart attack and stroke. More about that in a future post.
Then there is the process of an actual heart attack or stroke which involves disruption of plaque and the creation of a blood clot that ultimately disrupts the flow of blood and the death of heart or brain tissue. The susceptibility of plaque to disruption is a huge topic that involves high blood pressure, diabetes, insulin resistance, oxidative stress, inadequate sleep, and stress to name a few. So much more to discuss.
But getting back to the title of this post, why don’t you ask your elected representatives why our tax dollars continue to subsidize nutritional root causes of death, disability and disease?
Here are some links to papers and books that support the discussion above.
Finally a quote from the Dali Lama (thanks to my cousin Diane for bringing this to my attention).
“Man. Because he sacrifices his health in order to make money. Then he sacrifices money to recuperate his health. And then he is so anxious about the future that he does not enjoy the present, the result being that he does not live in the present or the future, he lives as if he is never going to die, and dies having never really lived.”
Eat clean, live clean, sleep well, exercise wisely, rest often, enjoy the company of loved ones, spend time outdoors and live in the present.
Mindfulness based stress reduction (MBSR) has been demonstrated to have beneficial effects relative to several physiologic measurements in humans. These include improved immune status, decreased inflammation as measured by blood tests, improved DNA repair (increased telomere length), and alterations in metabolic activity in areas of the brain that are viewed as beneficial relative to stress, anxiety and pain as measured by functional MRI scan of the brain (fMRI). Similarly other forms of meditation have been studied relative to cardiovascular risk in humans. The results indicate that stress reduction from meditation can decrease the “composite risk of death, heart attack and stroke” by 48% in patients who have experienced a previous heart attack. (1)
“A selected mind-body intervention, the TM program, significantly reduced risk for mortality, myocardial infarction, and stroke in coronary heart disease patients. These changes were associated with lower blood pressure and psychosocial stress factors. Therefore, this practice may be clinically useful in the secondary prevention of cardiovascular disease.”
This degree of protection exceeds the benefits of statin drugs in patients who have had a heart attack and exceeds the risk reduction accomplished by cardiac rehabilitation exercise programs.
A review of studies on the effects of meditation on cardiovascular disease reported: (2)
Psychosocial stress is a nontraditional risk factor for cardiovascular morbidity and mortality that may respond to behavioral or psychosocial interventions. …. Randomized controlled trials, meta-analyses, and other controlled studies indicate this meditation technique reduces risk factors and can slow or reverse the progression of pathophysiological changes underlying cardiovascular disease. Studies with this technique have revealed reductions in blood pressure, carotid artery intima-media thickness, myocardial ischemia, left ventricular hypertrophy, mortality, and other relevant outcomes. The magnitudes of these effects compare favorably with those of conventional interventions for secondary prevention
Dr. Dean Ornish utilized both meditation and yoga training in his lifestyle intervention program along with moderate exercise, smoke cessation and elimination of junk food (low fat vegan diet). The results demonstrated reduced coronary artery plaque within 2 years. Although many have attributed this to the vegan low fat diet, I have suggested in the past that the beneficial results were accomplished by stress reduction, exercise, smoke cessation, and elimination of junk food (especially refined sugar, flour, trans-fats and refined vegetable oils)
Our culture is not attuned to the regular practice of meditation or yoga. When I recommend stress reduction with these techniques to my patients few pursue it despite providing them with detailed descriptions of the physical benefits demonstrated by medical studies. One does not need to become a Buddhist in order to benefit from the practice of meditation. In the early 1970s the first stress reduction clinic utilizing MBSR(Mindfulness Based Stress Reduction) and Yoga was established at the University of Massachusetts Medical Center by Jon Kabat Zinn PhD. Since then many studies have documented the benefits of stress reduction relative to cardiovascular disease, diabetes, hypertension, chronic pain management, depression and anxiety.
Patients who have experienced their first major depressive episode can reduce the risk of a subsequent major depressive episode by 50% simply practicing MBSR regularly.
Unlike drugs, angioplasty, coronary stents, surgery, and injections, meditation and yoga have no potential negative side effects or complications. They simply require time, practice and a modest amount of training. Inexpensive self-help books, CDs and on-line resources are available to get started. Measurable physiologic benefits are experienced within a few weeks. Blood pressure drops, stress hormones decrease, blood sugars come down, insulin sensitivity improves, immune cells work better, sleep improves, suffering from chronic pain decreases, and functional status improves. That’s a considerable amount of benefit achieved by simply sitting quietly and observing your breath as it moves in and out of your body.
Meditation and yoga are two ways to reduce stress. For a healthy life to achieve stress reduction we must examine many areas. What aspects of daily life can increase and decrease stress and our physiologic response to stress?
Important factors to consider include social isolation, physical and social contact with friends/family/pets, meaningful work, laughter and humor, time spent outdoors, exercise, proper sleep habits and exposure to natural rather than artificial light. These all play significant roles in governing our stress levels, physiologic response to stress and the attendant changes in health.
Social isolation is harmful while regular contact with family and friends is beneficial. Caring for a pet seems to reduce blood pressure and enhance longevity. Engaging in meaningful work for pay or as a volunteer is essential for health, longevity and happiness. Spending time outdoors regularly and cycling your daily activity with the sun (circadian rhythm normalization) are essential to health and stress reduction. Laughter and social interaction provide healing while rumination over problems causes illness. All of these aspects to healthy living deserve attention but if you are ill, overweight, suffer chronic pain, disability or substance abuse then meditation and yoga can have profoundly beneficial effects. When combined with a Paleolithic diet and adequate restorative sleep, stress reduction techniques provide a powerful healing pathway.
Below is a long list of links to articles related to stress reduction, meditation, and yoga in the areas of chronic pain, cardiovascular disease, cancer, pre-natal care, anxiety disorders, depression, insomnia, smoke cessation, burnout, immune function, inflammation, migraine, blood pressure control, traumatic brain injury and even psoriasis.
Read to your heart’s content.
Bob Hansen MD
Here is the long list of other references. I have tried to group them in categories. There is allot of overlap between categories so my classification is somewhat arbitrary.
Neruoimaging and EEG
Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients.
A pilot study evaluating the effect of mindfulness-based stress reduction on psychological status, physical status, salivary cortisol, and interleukin-6 among advanced-stage cancer patients and their caregivers.
Insomnia and Sleep Physiology.
Psych, Depression, Anxiety, Burnout, Students
Misc. and General
Post Traumatic Brain Injury
Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA).
Telemorase, DNA, Genes
A great review article challenging the current low fat dogma has been published. This should be required reading for all physicians. It brings clarity, data, and perspective to the discussion.
Here is the abstract:
Here are the opening paragraphs.
“The benefits of carbohydrate restriction in diabetes are immediate and well-documented. Concerns about the efficacy and safety are long-term and conjectural rather than data-driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss) and leads to the reduction or elimination of medication and has never shown side effects comparable to those seen in many drugs.
Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term random-controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.
“At the end of our clinic day, we go home thinking, ‘The clinical improvements are so large and obvious, why don’t other doctors understand?’ Carbohydrate restriction is easily grasped by patients: because carbohydrates in the diet raise the blood glucose, and as diabetes is defined by high blood glucose, it makes sense to lower the carbohydrate in the diet. By reducing the carbohydrate in the diet, we have been able to taper patients off as much as 150 units of insulin per day in eight days, with marked improvement in glycemic control – even normalization of glycemic parameters.”
— Eric Westman, MD, MHS .
Here is the link to the whole article.
Peace and good health.
Bob Hansen MD