Letter to Paula Deen
Wednesday, April 04, 2012
I feel bad for the recent lack of support you received about your diagnosis of Type 2 Diabetes.
As humans we have an innate liking to sweets. Our bodies naturally seek high sources of energy like concentrated sweets or fat as a way to obtain sufficient energy to survive. Up until the industrial revolution, the majority of humans underwent famine, were exposed to the elements and lived in poor conditions. That has been pretty much the case during the history of humans on earth. Therefore, it makes sense to me that 1) our minds and bodies love high-density calories 2) our human ancestors who had the best "anti-starvation systems" survived and that we, their descendants, inherited the best “anti-starvation system”. The goal of the human body is to allow us to survive in periods of deprivation long enough to reproduce. We owe our bodies a debt of gratitude for adapting to such extreme conditions.
When times where good, humans would spend most of their waking hours walking and looking for food. When times where bad, this type of routine would be interrupted with running, stress, food deprivation and an eventual food binge when food was found and our enemies averted. During the bad times our bodies would lower the metabolic rate to help preserve any energy stored. When the binge would occur, the food would also be stored.
Our ancestors’ bad times are our current “everyday” days. We eat in a hurry, most often less than 3 meals a day; we are under constant stress and any exercise we include in our day is done at “super” intense levels a few times a week. Our bodies would do better on 3 meals and 3 snacks a day with mild recurrent episodes of exercise.
In my practice, I see lots of patients that have difficulty changing their cooking and exercising habits to control their weight. A lot of the denial is based on feeling ashamed. People don't want to admit to themselves that they need help and they need to change because admitting this in some way makes them feel it's their fault. It's not your fault. Obesity is the result of a lack of understanding of our own human body needs. Every single person in the world today is alive because of excellent anti-starvation systems. It is only logical that with our current lifestyle we should eventually see a 100% obesity rate.
A history of constant dieting leads to a constant struggle with our inborn instincts to eat. Deprivation leads to binging. Low calorie diets lead to a low metabolic rate and loss of muscle, which further decreases a person's metabolic rate. When popular diet plans and centers put people on less than 1800 calories a day for men and women on 1200, the energy needs for our metabolic rate is not met. Initially, people will see a very sudden decrease in body weight with a subsequent decrease in metabolism. The hunger usually leads a person to abandon their diet and the weight bounces up higher than before. These centers are great moneymakers because nobody ever gets "cured". Instead, people get a lower metabolic rate that reinforces the anti-starvation system. These centers “create” customers for life.
But, there is hope. Measuring the person metabolic rate to obtain the right amount of calories a day helps determine the right amount of calories a person should consume. I also recommend eating 6 times a day with a balance of carbohydrates and protein to maintain even glucose levels throughout the day. A program of regular walking and weight training to recover some of the muscle lost helps remediate past wrongs.
I calculate a person's daily intake to be the person's weight multiplied by 10, adjusting the calories a few hundred up or down based on the person's activity level. Exercise needs to be increased very gradually to avoid injuries. Walking should be done every other day at whatever initial level a person is comfortable at, for example, 5 minutes. When the person can do 5 minutes 3 times a week, the person will add a few minutes while maintaining the number of days. Gradually more and more minutes are added until the person can walk 30 minutes without interruption 3 times a week. Once the person reaches this level, then the person should include a supervised weight-training program with a certified instructor. The reason why I advise to get a certified instructor is to learn to maintain good posture and prevent injuries.
Changing habits takes time, a year or more. Diabetes can't be cured but it can be controlled so that a person is no longer on medications. With good daily glucose control one can minimize complications to the point that diabetes doesn't affect the body significantly. It is also important to rule out any medical problems that might be affecting a person's weight, such as an imbalance or inadequate secretion of regulating hormones. I don't specialize in treating hormone imbalances but I know of good doctors that can do the necessary tests and follow up to manage the conditions. I don't get any financial remuneration from any referrals or medicines or products. My main goal is to give excellent nutritional therapy in a compassionate manner and to invite patients to ask the right questions to their doctors.
Best of luck