Grain’s Addiction

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I’m well into my second month of The Vegan Before Six experiment.

At the end of the month, I will report on whether or not there’s been any further weight loss, but for now I feel my subjective experience of this experience is worth a little bit of reflection.

As a quick review, this approach to eating involves eating no animal products , processed foods, or refined grains before 6 PM everyday. After six, you’re on your own and can eat what you wish.

Personally, the vegan aspect of the diet was no problem at all. It was the refined grains that were harder to quit at first.

The obvious reason for this was that 90% of the foods I was presented with each day contained some form of refined carbohydrate.

But it is becoming increasingly apparent to me that there’s more at play here.

I’m becoming convinced that refined carbohydrates are addictive.

A quick web search on “refined grains,” and “addiction” Will yield an avalanche of scientific, and pseudoscientific arguments for this hypothesis.

Experts will happily give you evolutionary, biblical, an empirical justifications for including less refined carbohydrates in your diet.

But this blog post (like most of my blog posts,) comes from a very small and personal place.

I have little interest in what Cro-Magnon man snacked on his sparsely furnished cave dwellings.

paleolithic

Pssst….between you and me, eating gluten causes digestive issues

 

Despite being a doctor, I’m not terribly interested in the glycemic index of any specific food.

What I am interested in reporting here then, is merely my own anecdotal experience. Make no mistake, this post has no scientific validity.

You might ask, if I’m making the claim the refined grains are addictive, what experience do I have with addiction?

My answer simple. For three years at the end of college I smoked cigarettes. I quit shortly after leaving college.

And the way that I experienced that addiction was as a guttural craving for nicotine. It was a continual thirst behind my sternum that was a primal and strong craving that affected me from the time I woke in the morning until the late nights before I went to bed.

At the time I described it as a hunger. And one of my great joys was to have a long filling meal. And at the point when I was no longer hungry and wanted not another bite, I could then light up a cigarette, and satisfy a separate appetite.

What then does this have to do with refined carbohydrates?

Well, since embarking on this experiment, hunger feels different now. It is not so much a craving as a feeling of emptiness in my physical stomach. And at the point I feel hunger I merely need to eat something like an apple or some celery or some Farro, and the hunger is extinguished.

I no longer feel a craving, similar to that which I used to feel before smoking my next cigarette.

And why do I implicate the carbohydrates? Why not the meat or eggs or Dairy that I am also not eating before 6 o’clock?

A couple of strange experiences.

Whole grains are permitted on VB6, but I usually just have apples with peanut butter for breakfast.

On one occasion I had homemade brown rice Mochi (glutinous rice cake) with seaweed for breakfast. Although this is technically permissible in VB 6, I was startled at 10 o’clock in the morning, during clinic, to feel a ravenous hunger stirring in my belly. I felt weak and shaky and desperate for food. So intense was this craving, that I actually ran out to the parking lot in in between patients in order to grab a handful of almonds from my car.

ford3

Yeah, I grabbed some almonds.  I’m embarrassed, but it’s true…

Similarly, on weekends, I will sometimes get a loaf of sourdough volkenbrot (a dense 100% whole wheat/rye seeded country loaf) and eat a few slices with peanut or almond-butter for breakfast. And when I do this I do notice that I have a deeper hunger a couple hours after eating (usually I can make it the 5 hours between breakfast and lunch, easy.)

It could be that when we grind Whole grains like brown rice and wheat berries into small particles we’re pre-digesting them so that they are absorbed faster and cause more dramatic swings in our blood sugar.

Tough to say. But experientially when I eat these things, my subsequent hunger feels an awful lot like my previous cravings for my old friend nicotine. A primal, nonverbal compulsion, powerful and intense.

The medical definition for addictive substance is one that causes:

1. Habitual use.
2. Tolerance (The need for progressively higher doses of the substance to satisfy the user.)
3. Withdrawal symptoms.

Personally, I would give refined grains a check, check, and check for all of the above.

And as enjoyable as it is it is to feed an addiction, it is also liberating to be freed of one.

Of course this discovery means that I can’t help but wonder what else am I unknowingly addicted to.

Does sunlight cause lust? Does rain drive one to consume wine?

And I don’t want to falsely represent that VB6 offers a complete reprieve from addiction.

The other day at 3 o’clock in the hospital I had a craving for an apple so intense that it occurred to me that I might be developing a literal apple addiction.

The more things change, the more they stay the same.

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22 Responses to “Grain’s Addiction”

  1. Robert February 24, 2014 at 4:51 am #

    I’ve recommended previously, but again, please check out Dr. John McDougall’s website or his latest book, “The Starch Solution.” There is a lot of science that would guide your thoughts in this area.

    Incidentally, in an earlier book (The McDougall Plan) he included several references to studies that have looked at the effect of food processing (i.e., ground vs. whole grains) on (a) satiety, and (b) glucose/insulin response. Turns out that you do in fact eat more before feeling full if eating processed foods (vs. whole). You also assimilate it faster for a faster glucose/larger insulin response. Not surprisingly, then, whole grains are better for weight control.

    There is a also a world of difference between complex carbohydrates and simple sugars. Keep this in mind as you evaluate the effects of processed grains, apples, etc. Dietary fiber is a key to satiety (and regulated absorption/insulin response). Research has shown significant differences in glucose/insulin response of raw apple vs. applesauce vs. apple juice eaten in isocaloric quantities, due in part to breakdown of dietary fiber during processing (TMP, p. 14).

    Don’t forget that you aren’t in a lab, though. I find it interesting to read stories on glycemic index and how rapidly you get a boost in blood sugar from a potato, for example. But how often do you eat just a potato? How fast does that potato raise your blood sugar if you are eating the potato laden with beans or vegetables or other items on your plate? Dietary fiber is critical.

    One of McDougall’s emphasis is the role of dietary fat. Fat alters insulin response. Low fat diets are best for addressing diabetes. Given the symptoms you describe, should you perhaps examine the role of fat and dietary fiber in your diet, and emphasize complex carbs over simple sugars (such a fructose)?

  2. Miles Dividend M.D. February 24, 2014 at 12:42 pm #

    Robert,

    The chief downside to writing this blog is that I no longer have as much time for reading. I must triage more, and so my reading has become less broad.

    This starch solution sounds interesting, well reasoned, and effective. But it is something that I will keep my back pocket for a time when I’m looking for a more extreme dietary adjustment.

    Good food is such an important source of pleasure for me, that the thought of cutting out any one component, even refined carbohydrates, or fats, is a non starter at this time. I’d feel too deprived. I wouldn’t be able to sustain such an approach indefinitely.

    With diets there are many ways to skin a cat. VB6 feels like the right approach at the right time for me. (As Macdougals is for you. )

    • Robert February 24, 2014 at 7:48 pm #

      As you wish, but the symptoms you described sounded as if you had some blood sugar issues. I’d be careful if I were you. (But then, you are the doctor…)

  3. Miles Dividend M.D. February 24, 2014 at 8:37 pm #

    No evidence for that yet, Robert.

    But keep the suggestions coming.

    Alexi.

  4. Robert February 24, 2014 at 9:11 pm #

    ” I felt weak and shaky and desperate for food.” Also, your bread experience and apple experience. Sure it isn’t a “sugar crash” (aka “glucose crash”)?
    From http://en.wikipedia.org/wiki/Sugar_crash: “Symptoms associated with sugar crashes are similar to those experienced during periods of hypoglycemia, though not as severe. This is because the difference between usual and post-meal blood glucose levels is not as large as in diabetic cases of hypoglycemia. A crash is usually felt within four hours or less of heavy carbohydrate consumption. Symptoms of reactive or postprandial hypoglycemia include:
    Confusion and difficulty concentrating on daily tasks
    Anxiety
    Light-headedness
    Fatigue
    Headache
    Irritability

    The majority of these symptoms, OFTEN CORRELATED WITH FEELINGS OF HUNGER, mimic the effect of inadequate sugar intake as the biology of a crash is similar in itself to the body’s response to low blood sugar levels following periods of glucose deficiency.”

    A diet rich in fiber and complex carbohydrates vs. simple sugars and fats (which cause insulin resistance) is the solution. Contrary to your assumptions, a healthy diet can be delightful from a taste perspective. You needn’t feel deprived at all. Frankly, I’d rather skimp on oil than have a quadruple bypass. THAT is the non-starter for me!

  5. Miles Dividend M.D. February 24, 2014 at 9:17 pm #

    Robert,

    I assumed that your use of the term “blood sugar issues,” was referring to insulin resistance. I have been tested for that I do not have it.

    Whether or not I have “sugar crashes,” is an unanswered question.

    I would wager that another unanswered question, is whether or not The starch solution prevents coronary artery disease.

    Alexi

    • Robert February 25, 2014 at 5:54 am #

      That should be a no-brainer for a cardiologist! 😉

      Seriously, until you read the book and/or the research it cites, it is reasonable for you to be skeptical. There are lots of claims in the diet/health arena. They can’t all be true! But McDougall doesn’t stand alone, and he backs up his recommendations with references. There are several other doctors in the same camp, and they cite a lot of relevant nutritional research, including epidemiological studies that prove what you are asking about. Caldwell Esselstyn is a Cleveland Clinic cardiologist and advocates the same dietary changes, and has demonstrated actual reversion of coronary blood vessel blockage after a period of dietary change. I’ve seen the before/after images he has presented, and they are impressive (to a layperson, anyway!).

  6. Miles Dividend M.D. February 25, 2014 at 7:47 am #

    Robert,

    I know my limitations, and I cannot intelligently debate with you a book I have not read.

    In a world of unlimited time, I would surely read the book just to continue this interesting discussion.

    But I will part with this.

    In my view, neither expert opinion, Epidemiological observation or anecdote, constitute proof of the efficacy of an intervention. They are all starting points for more rigorous assessment.

    Alexi

    • Robert February 25, 2014 at 1:26 pm #

      True, but it is an ironic parting shot to a thread discussing the anecdotal account of a group of…one! 😉


      If Esselstyn is correct about the prevention of heart disease, it is surprising that this would be a low priority to you, both personally and professionally. I was addressing specifically your questioning that McDougall’s diet would prevent coronary artery disease. Since you are so busy, here is a mere 15 minute video where Esselstyn (whom I mistakenly called a cardiologist; he is a surgeon) makes his argument at TEDx Cambridge. http://www.youtube.com/watch?v=EqKNfyUPzoU. A TEDx talk can only provide a brief introduction, of course, but I’d be interested in your comments.

  7. Miles Dividend MD February 25, 2014 at 3:31 pm #

    There’s a difference between representing an anecdote as as an anecdote, and representing anecdote as scientific proof, no?

    • Robert February 25, 2014 at 4:33 pm #

      Agreed, but you said, “In my view, neither expert opinion, Epidemiological observation or anecdote, constitute proof of the efficacy of an intervention.” I think that “proof” in an absolute sense is impossible to achieve in science. Since Popper, falsifiability has been the standard, and we propose tests that would disprove a hypothesis; if those tests fail, then we still have not “proved” the hypothesis but we have increased our confidence in it being a reasonably accurate representation of reality. In medical science as well as nutritional research, a lot of hypothesis testing is in the form of controlled experiments on target populations, with the gold standard being a double blind experiment. Many nutritional studies have followed the same standard. When doctors like McDougall or Esselstyn reference these publications, they are experts citing primary sources. Provided they are accurately summarizing the literature in that field, their interpretation is as close to “proof” as you are likely to get. Epidemiology is more like hypothesis screening in my view; you get correlations, then you have to dig deeper to find causal links and test them. But cut it some slack; you and I both know that sometimes complexity is such that a perfectly controlled experiment is impossible. Even in a drug double blind study, they may try to match for key variables like age, gender, fitness, etc., but they can’t possibly control for all variables, and yet these are accepted as “proof” of efficacy. I submit that epidemiological studies of dietary factors have similar deficiencies but probably are as close to “proof” as you are likely to get short of turning people into lab rats–which can be done short term but not long term.


      Did you take 15 minutes to watch the Esselstyn link I sent? Comments?

  8. Miles Dividend M.D. February 25, 2014 at 6:42 pm #

    I watched the Esselstyne link.

    My impressions.

    1. Impressive talk.
    2. Lots of unsubstantiated claims. (Not unexpected for such a Layman talk.)
    3. Anecdotal.
    4. Extreme.
    5. Not what I’m looking for right now.
    6. But when longevity of life becomes much more important to me than quality-of-life, I might become more interested in researching further.

    Alexi

    • Robert February 25, 2014 at 6:58 pm #

      LOL. Sounds like you are planning on a deathbed confession! Hope that works out for you. A talk like TEDx is obviously not going to get into scientific references, etc., but if you want that, it is there. (See the McDougall book I mentioned, for example, for a bibliography). But it sounds like you really believe that it isn’t possible to have a great quality-of-life and eat this way. You are making a judgment without having tried it, and without having informed yourself of the reasons for doing so (on a scientific basis), but that is, of course, your right. For myself, I’ve been having a blast the past month cooking from Lindsay Nixon’s new cookbook, “The Happy Herbivore Light & Lean”. No suffering going on here. My wife loves it too. A chef with that “it” factor can make magic happen with food regardless of whether it is high fat, animal-based or low fat, plant-based. I, for one, am not willing to bank on a switch later in life, because we are talking about chronic diseases, not acute ones. And, I’m 55!

  9. Miles Dividend M.D. February 27, 2014 at 9:02 am #

    Robert,

    Your last deathbed comment, while hyperbolic, has irritated me for a couple of days now. (which is why I have tried and failed to ignore it.)

    The limits of such a statement are not difficult to define.

    A couple of easy facts then demonstrating the logical fallacy of the statement:

    1. The oldest recorded human being was a Frenchwoman who smoked, ate a standard french diet with lots of fat, chocolate and port. Do you think her death bed confession was that she hadn’t eaten a plant based diet?

    2. I routinely put pacemakers into nanogenarians in enviable health who continue to eat the standard American diet.

    More importantly, even if we are to imagine a world in which your plant based diet has unequivocally been proven to be Curative of CAD, I still would not choose such a diet at this point in my life.

    Why? For the same reason that I save between 50 and 60% of my take home income, not 90%. Although saving 90% of my take home income would undoubtedly get me to an enviable goal (financial independence) quicker, it would come at a cost that I’m not willing to pay (severely decreased financial freedom/happiness now.)

    And finally, an ad hominem attack of my own in the form of a question.

    Has it ever occurred to you, that you are even more of an ideologue than me (and admitted ideologue?) The “deathbed” comment suggests a very dualistic way of seeing the world. And Might this extremism be your own blind spot?

    Respectfully,

    Alexi

    As an aside I started the peak prosperity link you posted yesterday. I Love it. Though our economic perspectives are divergent, his writing style and humor are right up my alley (as you predicted). I will savor it the rest of it this weekend. Thanks.

    • Robert February 27, 2014 at 2:10 pm #

      LOL. I sent the link to Collum’s document before I had even finished it myself, but this morning I did. Some pretty sobering stuff at the end (that I suspect you as a progressive and me as a libertarian can agree on more than you agree with his Austrian slant economically). I chased some of the references and wasted even more hours of time. (Not really a waste, though; I’m better informed). Especially disturbed about the ex-CIA guy in federal prison for disclosing waterboarding in an interview. I hadn’t heard of him before. I read his “Letters from Loretto” and got even more upset. :-(


      I wasn’t trying to upset you with my deathbed confession comment at all. Sorry you took it that way. I was just referring to your comment #6, and, OK, making fun of it just a bit! As in, Would you really wait until you were having health problems that made you worry about longevity before considering a change to a more healthy diet? I actually don’t believe you would, contrary to what you say, because you are already experimenting via your VB6 diet. But if you are sincere in saying that even if a low fat plant-based whole foods diet were proven to prevent CAD, you wouldn’t change, then let me ask, Would that also be true even if it were known that CAD is a cumulative/chronic condition, and that you may even do a significant amount of potentially irreversible damage before you are aware of it? (Or, as a cardiologist, maybe you differ from the regular population by routinely scanning yourself and having a defined threshold of arterial blockage at which you’ll change? 😉 ).


      In any case, you seem to be assuming that longevity and quality of life are mutually exclusive and I just don’t see it that way. I believe you can live a lifestyle that offers longevity and still enjoy a good quality of life. And, in fact, I suspect that statistically the qualify of life is better, since once you lose your health, your quality of life plummets as you can no longer do what you enjoy. I’ve tried to nudge you to read McDougall’s book so you could perhaps get a glimpse of that possibility or give it a try and see if it actually does lower your quality of life unacceptably. However, it is possible that eating certain foods is so important to you that you would trade off the risk of future life quality reductions for your perceived current high quality of life.


      Having just watched the carnage at the Olympics (which concerns me, to be honest), I guess a 23 year old snow-boarder who dies might be said to have died doing what she loved and it was all worth it. Or, one who becomes paralyzed can argue that she had a wonderful quality of life for those first few years and it was worth the cost of living the rest of her life as a paraplegic–in fact, perhaps she could even argue that there was not an alternative lifestyle she could have lived that would have been just as enjoyable but without the same degree of risk. On the other hand, most of us are OK driving cars even though thousands are killed or maimed every year. We all make risk/benefit judgments, and it isn’t for me to say that you are making the wrong one. I personally find that I enjoy the way I eat and have a wonderful quality of life with it, but if you think you’d be miserable eating this way, then you may prefer to draw your lines differently. I just hope people who make decisions about diet, drinking, snowboarding, driving, etc., do so with as much information about risk and reward as they need to make an informed judgment, and that they are mature enough to make that decision wisely and be content with it if they are one of the unlucky ones on the low tail of the distribution. And, I also think physicians have an extra burden of responsibility to inform patients of how lifestyle affects their health conditions; far too few physicians do that. Medicine focuses on screening, radiation, drugs and surgery.


      Anyway, I may seem an ideologue, and maybe I am, but it is silly for us to compare ourselves with each other and argue over who is the greater ideologue–we haven’t met, we’ve only discussed a few topics, and we have little conception of how we each think/talk/behave in real life off this blog. I have changed my mind about a great many things over the years (I was once a creationist, for example, but no more), so if I’m an ideologue, I’d like to think of myself as a flexible one! It isn’t as if I’m a McDougall junkie; I am open to the possibility that other ways of eating work, perhaps especially so for some subgroups of people. But I am pretty convinced that the low fat plant-based whole foods diet is at least one way that works well, can be incredibly satisfying and delicious, makes me feel good when I do it, and–more to the point that started this discussion–has been shown to prevent cardiovascular disease. Your questioning that is what restarted this discussion.


      As for your patients or an old French woman, I’m surprised you’d trot those out after criticizing Esselstyn’s presentation for being anecdotal. I know you don’t believe smoking is conducive to good health or longevity. The fact that a Frenchwoman who smoked also lived long means little to me. I’ve known long-lived smokers too. And drinkers. And carnivores. And couch potatoes. But I know a lot more that have not. I’m in agreement with you that the French woman probably didn’t regret her lifestyle. But she is a statistical outlier. I suspect that the bulk of people who have preventable heart disease or cancers do have regrets. Hopefully they aren’t focused on those on their deathbed, but some may be.


      What matters to most of us is, “What will happen to me individually or to my family?” We can’t answer that. Maybe someday soon you doctors will be able to analyze our genome and tell which of us can safely smoke without negative impact on our health or longevity, and which of us cannot. I’m skeptical, but someday you may be able to do that. You may also be able to tell us what other (confounding) lifestyle/environmental factors we need to adjust/control to make sure that those genes are/aren’t expressed. But, until that day comes, my best option to maximize the probability of achieving the desired individual outcome is to go with statistically favored lifestyle(s). If possible, controlled double blind experiments, but as I said before, often that isn’t possible for extended lifestyle factors. So, at least epidemiological studies. If not, and if I have to use anecdotal evidence, then at least I should consider a large group of examples, and not cherry-pick.


      When you first implanted a pacemaker, you probably did so because studies had shown them to be helpful (or, more likely, because you were trained by physicians who told you that). After that, though, I’ll bet you continued doing it because of anecdotal evidence that you developed. In fact, I suspect that you may have been even more convinced by that. When a patient who was functioning poorly is transformed by your implanted pacemaker into an energetic, fully functioning person again, you become a believer. I suspect that this personal experience has assumed even greater weight in your own thinking than the original evidence that started you on that treatment path. In fact, I bet if you had first done pacemaker implants based on positive published studies, but then you found that in your practice most patients got worse after pacemaker implants, you would quit doing them until you either (a) learned the right way to do them, or (b) wrote a paper citing your results and arguing against the original study(ies). Likewise, doctors like McDougall or Esselstyn were motivated by scientific research but also by what they observed in their own clinical practices. Get enough patients to transform their health through dietary change and you become a believer! It doesn’t logically rule out other approaches as also being able to accomplish similar results, but that is a burden of proof for someone else, touting another approach.


      Back to my hideout…quit tempting me to come out!

  10. Miles Dividend MD February 27, 2014 at 7:02 pm #

    There is an important logical distinction that is being missed here.

    While anecdote can not prove a theory, (ie. a patient on a plant based diet who has regression of CAD does not prove that plant based diets cause CAD regression.)

    Anecdote CAN disprove a theory. (ie. the statement that “not eating a plant based diet will necessarily cause premature death” is disproved by a single very old person who does not consume a plant based diet.

    This is the so called black swan effect. (Although this is not such a rare occurence. Plenty of people with non plant based diets live to a ripe old age).

    This is an important distinction.

    • Robert February 27, 2014 at 8:03 pm #

      I don’t believe I’m missing any logical distinction. The theory you state is not the one I’m discussing. I most definitely am NOT saying, “Eating a plant based diet will necessarily cause a premature death.” I am talking about statistical distributions of outcomes, and that the mean is shifted favorably for low-fat, whole foods plant-based diets compared to the standard American diet. I’m also arguing that emphasis on starch provides the satiety and energy needed for long-term compliance with a low fat plant-based diet (that’s the McDougall twist). Furthermore, specific to this conversation, my point is specifically about cardiovascular disease. You’ll find black swans on either end of both distributions. Thus, even if the average longevity for Diet A is longer than for Diet B, you’ll find some people on Diet A who live less than the average of Diet B, and you’ll find some people on Diet B who live longer than the average of Diet A (assuming the distributions overlap, which in this case they certainly do). The statistical nature of the argument makes your point moot: a single (or even several) outliers don’t disprove the theory (actually, I feel more comfortable calling these hypotheses).

  11. Miles Dividend M.D. February 27, 2014 at 8:40 pm #

    The quote in question was “you must be planning a death bed confession.” The inference I took here was that you were stating that if one chose not to follow the starch solution diet, one would necessarily (must!) die prematurely, and have regret at having made the wrong decision.

    If I am mistaken here, please explain your true meaning of your phrase.

    Alexi

    • Robert February 28, 2014 at 6:34 am #

      Surely you don’t think I believe THAT, do you? To say that if you don’t eat McDougall’s diet you MUST die prematurely? I’m talking about statistical distributions and most probable outcomes (vs. standard American diet). I also have said that there may be other ways to eat that achieve similar outcomes, but that this is one that has been shown to work.


      You said, “But when longevity of life becomes much more important to me than quality-of-life, I might become more interested in researching further.” Then I jokingly said, “LOL. Sounds like you are planning on a deathbed confession! Hope that works out for you.” “Deathbed confession” was meant tongue-in-cheek; it was “hyperbolic” as you said (i.e., “hyperbole”). It was not intended to mean when you were dying, necessarily (though that would be one extreme possibility), but when (and if) you started suffering chronic effects from your current diet. Or as you put it, “when longevity of life becomes much more important to me”, which I assumed from your comments isn’t going to happen until you start suffering illness attributable to lifestyle (which is when most people “get religion” about their lifestyle, to borrow another religious idiomatic expression). And probably “deathbed conversion” would have better conveyed my meaning than “deathbed confession”.


      It is certainly possible that you could live a long life with your current lifestyle (which I never set out to criticize because I don’t even know much of what it is; this started as a suggestion for how your VB6 could be improved, minimizing “sugar crash” symptoms, and a discussion of how CAD could be prevented; I’m assuming from your comments that your current diet is not as conducive to cardiovascular health or diabetes prevention as a low fat whole foods plant-based diet would be, but I have little idea how the various risk factors add up or don’t for you)–maybe you’ll even beat the French woman! If you have a heart attack at age 50, though, you may start asking yourself why that happened. Hopefully it wouldn’t be a deathbed confession/conversion, but a post-operative recovery conversion. And hopefully you won’t have CAD anyway (many people on SAD do not; again, this is a statistical argument).


      Anyway, the key point was not intended to be that you will die young if you don’t adopt the diet advocated by McDougall or Esselstyn. It was that statistically, your chances of living longer and with higher quality of life (by which I mean “good health”) are greater if you follow that approach than a standard American diet. Furthermore, my point was that that diet has been shown to prevent cardiovascular disease. If you follow that diet, you could still be the unlucky person who gets heart disease, but you’d be the tail of a vastly shifted distribution. If everyone followed that diet, there would a favorable shift in the health and longevity distributions.


      But, allow me to turn this around and ask you something. You said, “But when longevity of life becomes much more important to me than quality-of-life, I MIGHT become more interested in RESEARCHING FURTHER.” (my emphasis) Are you saying that you aren’t interested in researching this further until you personally are ready to weight longevity higher in your portfolio? Even if you cared nothing for longevity personally, wouldn’t you be at least curious enough to research further for the benefit of your patients? When this dietary change has been shown by other physicians to improve the outcomes for those suffering from cardiovascular diseases, prevent CAD in those that don’t yet have it, and also prevent and even reverse Type 2 diabetes and several other diseases, why would you not want to research it enough to be able to at least offer more than a questioning opinion on the claims that they make such as CAD prevention? Wouldn’t you want to be able to share this enthusiastically with your patients if these guys are right, or denounce it if they are wrong–and do so based on scientific evidence, not uninformed opinion? Do you just reject it out-of-hand and refuse to research it because it doesn’t fit your paradigm or personal lifestyle choice? I realize you can’t chase every rabbit and there are a lot of them competing in the field of diet and lifestyle, but these physicians are not crackpots. Seems to me it would be worth at least a quick read. Or, call one of them up on the phone and challenge them! They are both surprisingly available even to laypeople, so surely as a fellow physician they would give you plenty of time.

  12. Robert February 28, 2014 at 6:39 am #

    P.S.–if it makes you feel any better, I had a “deathbed conversion” myself (in the sense I meant it above) when I was diagnosed with LAF. It motivated me to find a lifestyle that would eliminate the condition. Sadly, my personal physicians had no interest in approaching LAF that way, so I had had to find it on my own. I was happy to find online resources–scientific and anecdotal both contributed!–that led me to complete elimination of symptoms (presumably structural damage still exists since the literature suggests that isn’t reversible, but I’m optimistic that perhaps the body can heal even that, as long as I treat it right). McDougall’s diet is a part of that.

  13. Miles Dividend M.D. February 28, 2014 at 6:54 am #

    I will take your word for it then Robert. I misinterpreted your deathbed confession comment. Which is why I found it irritating. I am sorry.

    • Robert February 28, 2014 at 8:27 am #

      Amazing how people can talk past each other some times. Sorry for the misunderstanding.

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