Celebrity Diabetes ~ Tom Hanks now

Before Paula Deen got in hot water over racial issues, she was the subject of controversy a few years back with her belated disclosure that she had Type 2 diabetes, and then became a spokesperson for Novo Nordisk's Victoza.  The "mainstream" balked, including rebukes from fellow celebrity chefs for using so much butter in her cooking while hiding the effect it had on her health.  When the news hit the LC community, it of course went nuts.  I discussed this pretty thoroughly HERE.  A quick summary might be that the low carbers didn't like that people blamed the fat in her foods and finger pointed at the carbs (ignoring sedentary lifestyle entirely).  Further, they didn't like that she was dieting per mainstream guidelines and using Victoza rather going on a LC diet.   Stress certainly has taken a toll on Deen, but she seems to have maintained her weight loss, perhaps even losing a few more pounds.  It would be interesting to get an update on her condition, but somehow I doubt we will.

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A tale of two "Wheat Bellies"

Before Dr. William Davis' name became synonymous with the elusive* Wheat Belly, he was well known for his subscription Track Your Plaque website.   This website currently charges $90 (all prices rounded) for the first year with yearly renewals at $72, for the basic membership ... more for shorter "contracts".  That's just the membership fee, that basically affords you discounts on various TYP products such as your Basic Membership Kit for $70 (reg. $110) or a Supplement Kit for $175 (reg. $215) or the testing kit for a cool $530 (reg. $570).   In the marketplace you can purchase all manner of testing supplies, etc.  

Now Davis is a huge backer of Jimmy Moore's Cholesterol Clarity book.  He contributed to it as an expert, provided an Editorial Review for Amazon.com and, as if that weren't enough, offered up a glowing 5 Star review on same, entitled Cholesterol bashing at its finest.  In it he writes:

Widely-held beliefs, many of them propagated by "official" agencies like the FDA, USDA, American Heart Association, Academy of Dietetics and Nutrition, American Diabetes Association, etc., are crumbling under the scrutiny of informed people uninfluenced by the pharmaceutical industry, agribusiness, or the excessive profiteering ways of modern "healthcare."

Uninfluenced by them, but influenced by profiteers and profiteers in their own right nonetheless.

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More thoughts on the KKKonfederacy of Dunces

The past couple of days, I have been spending my spare time, while I still have a bit more, on some outside/related projects so I apologize for not being as engaged as usual in my comments section.

I must say that the commentary on my last post, William "Wheat Belly" Davis agreed to interview with David Duke personally, is both amusing and appalling to me.  Amusing, because the predictable anonymous advisors have swooped in to offer their unsolicited wisdom on how I should best spend my time and/or what content I should put forth here.  Newsflash!  It's my life, my time and my blog.  The door is up there in the right corner, just click on the X and watch your backside as the door tends to slam a bit ;-)

I am appalled by those comments critical of me for merely posting this information, and/or expressing my opinion that a NYT best selling author should offer up a full explanation for his actions.  I can guarantee you that if anyone in the mainstream had granted an interview to David Duke, their ass would be toast, or at the very least there would be widespread public pressure for them to answer to the circumstances surrounding their actions.  Early on (elsewhere), I even saw defenses of all three for going on his program as perfectly acceptable to spread the Good Word ... after all, neo-Nazis are people too, why should they be deprived of lifesaving nutritional information?  While that latter point may be true, the former simply is not.  When someone like a NYT Best Selling Author and cardiologist such as Dr. Davis it lends credibility to Duke.  It matters not even if they only discussed the book and there was no discussion of Duke's beliefs.  At the very least, they provide content to attract an audience to Duke's promotion of his books and DVDs of his speeches and such.  That is reason enough.  There are appropriate venues for sharing and spreading one's message.  David Duke's radio program isn't one of them.  

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William "Wheat Belly" Davis agreed to interview with David Duke personally

Duke the Deceiver

A major publisher of diet and health books says one of its writers, a Milwaukee cardiologist, was deceived by a controversial ex-Congressman from Louisiana, Dr. David Duke – a man the Anti-Defamation League calls "perhaps America's most well-known racist and anti-Semite" – into appearing on his radio show.

Danielle Lynn, public relations manager for Rodale Books, says Duke contacted the author, Dr. William Davis, in early 2012 and claimed to be a "Dr. Duke" from "Europe." 

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The JimKKKins Trio: What did they know, When did they know it, and Does it Matter?

Since no other names have popped up over the past few days, it appears that only three people in the greater low-carb/paleo community were ensnared by the cunning "Dr." David Duke.  I've now listened to all three interviews on Duke's radio program.  Coupled with the stories/explanations each have provided, there are three different sets of circumstances for those trying to decide for themselves what appearances by these individuals on this notorious racist's show mean to them.    In order of their appearances on the show:

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The REAL JimKKKins Scandal: Dr. William Davis, Dr. Doug McGuff and "Dr." David Duke

In his zest to pull his a$$ out of the firestorm he created, by knowingly going on prominent white-supremacist  and anti-semite  David Duke's radio program, Jimmy Moore has done a great service to the community by "outing" two prominent MD's associations with same.  

Don't you mean disservice?  No.  Service, because nobody seemed to be aware of this, and it is important information.  Unlike the one-man Jimmy Moore show, these are prominent men with "real jobs", besides their books, blogs and whatever else, as medical doctors.  They also have books published by mainstream large publishing houses and "handlers" -- whatever the title:  managers, agents, publicists, assistants, you get the picture.

The following post was brought to my attention in comments here, and just so it doesn't get buried, I'm putting it here and encouraging all of my readers to go read it:  Two prominent physician/authors -- one a NY Times bestseller -- promoted their books on white supremacist David Duke's radio show.

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I was a bit taken aback by the title on a recent blog post by Dr. William Davis at his Heart Scan Blog
Why doesn't your doctor try to CURE diabetes?

Dr. Davis paints the medical profession with a rather broad unflattering brush.   Are there docs out there who are more concerned about profit over your health?  Yes.  Are there doctor-drones who reflexively reach for the prescription pad?  Again, yes.   But I believe that most doctors -- and I know several since before they became docs -- do care about their patients and dole out advice based on what they believe to be the best course of action.

Certainly the statement that "Adult diabetes is the one chronic disease that nobody cares to cure" goes more than a bit over the top!

Davis goes on to say that most docs don't think it can be cured, and that is probably true.  The old school re: type 2 would be based on when the disease was more rare and probably not detected until progressed significantly to the point of beta-cell impairment.  But nowadays, with earlier onset and screening, it really can be reversed and "cured" by ..... drum roll please ..... eating less and moving more!  Reducing fat stores below the max fill line (caloric deficit) and exercise work in conjunction to reduce insulin resistance.  I believe successful early intervention can indeed cure the disease.

Dr. Davis goes on to describe a scenario whereby you present at the doctor's office with a FBG of 156 and an HbA1c of 7.1%.  The doc puts you on metformin and the ADA diet.  Now this scenario is presented as if this is some uncaring robo-doc basically going with the flow recommending a course of action with  no track record towards improving patient health.  He also presumes there is no prior treatment history here.  I would venture to guess that most of those who get the diabetes diagnosis from their docs have previously been diagnosed (formally or cautioned) as pre-diabetic and counseled to lose weight .. perhaps on multiple occasions.  IOW, this isn't the first attempt at intervention in the progression of the disease and the patient has failed to make the appropriate lifestyle changes.

OK, so we could argue until we're blue in the face what diet is preferable for weight loss, but there's such a high correlation between obesity and T2 that some have taken to calling it diabesity, and there is ample evidence that just modest weight loss alone can cure it.  LC advocates would blame the doctor for recommending a "failed" low fat diet, but they would be ignoring the fact that many people fail to lose weight on low carb diets as well (and/or fail to maintain it).

If my doctor counsels me to lose weight and I come back 6 months later weighing the same or more, whose fault is that?  The doctor can't hold our hands and can only take our word for it that we tried to lose weight but couldn't or how hard we really tried (vs. compliance was not so hot).    Given the deleterious impacts of glycylation, the doc is doing the responsible thing to lower HbA1C as rapidly as possible with the metformin.  If a patient has not demonstrated an ability to reverse their insulin resistance through lifestyle change, the doc has no choice but to resort to pharmaceutical intervention.

There is emerging evidence that early intervention with metformin is more effective.  In other words, use metformin to attain glycemic control in the early stages and there will be LESS of a need for other medications down the line (or their need will be postponed).  So could it be that the doctors are trying to cure diabetes after all?  Metformin may reverse the condition more rapidly in the short run, and if patients adhere to a reducing diet (even that of the ADA), their diabetes can be cured.  

But Davis will infer no such positive motive on his colleagues.  He presumes that patients will gain 10-15lbs a year on the ADA diet, thereby inferring that in prescribing the diet the doctors intend for their patients to do so.  Huh?!   There are obese/overweight people with serious health issues due to their weight and even those don't "scare them straight" to adhere to a weight loss plan.  I am not condemning or criticizing those people -- I was one although w/o the serious health issues.  But Davis ignores the reality that losing and MAINTAINING weight is both difficult and rare for any number of reasons not related to the composition of one's diet.  The ADA formula of counting calories is a little too low in fat and protein for my tastes, but I hardly see recommending a reducing diet -- any reducing diet -- as irresponsible.  Certainly since weight loss has been shown to reverse (aka "cure") T2, especially if caught early, this advice is what Martha would call a "good thing".

I continue to be concerned over whether LC diets that either do not produce weight loss and/or are not consistently complied with present a significant improvement over a HCLF diet.  BOTH elevated glucose and NEFA/FFA produce deleterious results, and it is the NEFA that contributes to insulin resistance.  LC can lower 24 hr AUC glucose, but if IR persists you haven't "cured" a thing -- only masking a down-line symptom in the progression of a disease.  Metformin, OTOH, increases insulin sensitivity and reduces gluconeogenesis. Perhaps early NEFA lowering pharmaceutical intervention is an avenue to pursue  (metformin's action on lipolysis is inconclusive, it lowers NEFA in some while having no effect in others).

I would agree that all too often patients request a pill and/or doctors reach for the prescription pad to solve medical conditions.  But in progressive lifestyle diseases like this, by the time it gets to the point of diagnosis, lifestyle changes alone may be either too slow or ineffective.  The boat has sailed.  But pharmaceutical intervention need not be for all eternity.  It may well be that just as chemo "cures" cancer by killing off the cells, early intervention to lower circulating glucose and NEFA may well "cure" diabetes provided the IR inducing lifestyle (diet and inactivity) is altered and modest weight loss achieved.

What does it mean to be "cured" of diabetes?  That would be normal basal insulin levels, normal fasting glucose and NEFA's and a normal insulin response to carbohydrate.   If a low carber can't eat a bowl of rice without blood sugar going out of control, I contend their diabetes is not cured but rather controlled.