Thursday, July 24, 2008

Why are American's overweight?

Diagnosing Our Weight Problems

The US government recently announced that Medicare can pay for obesity treatment, officially making excess weight a “disease.” But this gross influenza of the waistline is particularly American. Why is that?

A generation ago, American families were thinner while eating eggs, breads, butter, vegetables … REAL foods. Then they were told to eat low fat processed items, pressed orange cheese slices euphemistically called a “food product”, and that most respectable heart-saver … margarine.

Since then, the collapse of the entire low fat idea has given way to its equally bizarre twin sister, the “low carb revolution.”

Shoppers who once could not believe it was not butter, now indulge in food products just as oxymoronic as fat free Half-n-Half.

What in the world would a “low carb” pasta or “carb free” bread be?

There must be a clinical explanation for the bizarre lemming effect of galloping from low fat packing materials to low carb oxymorons. Maybe there’s a cultural pathology to explain these epileptic swings.

But what would it be? What would we, as a cultural patient, reveal under careful observation?
In nailing down our particular malady, the key is to look at the problem from a dispassionate, clinical perspective.

Patient adopts irrational behavioral mood swings brought on by prolonged demoralizing failure (i.e., low fat dieting never worked).

Diagnosis 1a:
The observation may indicate either a mild or a severe condition. The mild condition is commonly experienced when a patient is “jilted” after a hopeful relationship goes bad. The one spurned typical leaps after the very opposite of their jilter — the “hiker to biker” effect.

Diagnosis 1b:
However, the complete and irrational embrace of this particular low carb “biker” may indicate a more serious problem, not with the heart but with the mind. Such severe changes strongly indicate a brain condition on the order of dietary Bipolar Disease. Should this prove to be the case, only a national inoculation program of very strong drugs could reverse the symptoms.

Diagnosis 2:
Having consulted brilliant physicians, another possibility knocks at the door. Perhaps it’s not so much that our culture’s collective brain cells are fried in too much Olio, but that the patient has simple myopia.

Yes, near-sightedness is indicated by the fact that other cultures don’t share these food aversions. No other country invents things and then advises their people to eat them. All skinny cultures eat real food, eat at meal times, and eat at a table.

The extent that this particular patient cannot see this fact, indicates a strong need for coke-bottle-bottom glasses of Mr. Magoo proportions (pardon the medical jargon).

Of course the problem with myopia as a diagnosis is the difficulty of getting pharmaceutical reimbursements for prescribing glasses. Thus, until an anti-near-sightedness drug is developed, the condition obviously cannot be diagnosed in this way.

Diagnosis 3:
Old fashioned country doctors would squint at our patient and pronounce their educated opinions in the most concise manner known to the medical arcana: “they’re nuts”.
This pithy point of view is not without merit. After all, what would any sane business do if its people got together and agreed on a strategy (like the low fat dogma), did that, and then failed with flying colors? Would they rely on the same group to come up with some other idea? That would be, well, nuts.

Any sane, rational CEO worth the standard 42 billion dollar salary would look outside the company’s own people for answers, find ideas that already work, and then steal them. That the patient has not done this supports Diagnosis #3.

Diagnosis 4:
Although “wacko” can explain such passing cultural norms as disco, professional wrestling, and the 1980’s era of the effeminate rock star, a kinder gentler possibility for this subject remains: the patient merely has a national short-term memory loss — possibly suffered by a conk on the head or sniffing too many greenhouse gasses.

This debilitating disease, now known as Dori’s Disease (after the fishy medical case study in Finding Nemo), causes the sufferer to lose all but the most recent of memories.

The observation that most clearly argues for Dori’s Disease is the fact that the patient can’t seem to remember being very slim. The patient was once proud of its control over weight.
Sadly, however, prodding the patient to recall a time when weight was not a problem only results in denial of governmental proportions. Rather than return to eating the diet of those skinny days (fruits, veggies, meats, eggs, dairy, fats, carbs, and proteins) the patient blindly reinvents the dietary wheel and creates new ways to eat.

Certainly, this behavior argues for the “wacko” hypothesis, although it may be compounded by any of the other possibilities.

Unfortunately, a grim outlook is ahead for the patient due to the most likely possibility — that some alchemy of all these psychological, social, and mental problems have conspired to produce the observed irrationality.

Drugs. Lots of drugs.

Alternatively, psycho-babble (non-drug-industry supported) behavioral therapy could also be tried once the medicine cabinet is exhausted. Getting the patient to understand the problem better could prevent yet another mass lemming migration among the stable of new theories.

Such intense counseling might include:
A look to other traditional cultures of eating. France provides a perfect example of a dietary lifestyle that works. The reason why it works may be a “paradox”, but the bottom line is that it worked while this patient was eating processed cheese food, and it still works while the same subject gulps zero-calorie sweeteners and chews on carb-free breads.

While dietary fads lurch from one bizarre extreme to the other, the cultural habits of thin, healthy cultures have stayed the same. A common sense solution would be to find approaches that remain successful (Asian, French, Indian, etc.), and then do that.

Understanding this will show the patient HOW to eat, WHAT to eat, and stabilize the bi-polar tendency to ricochet between the oddities of newly invented dietary extremes.

Dr. Will Clower, Founder of Mediterranean Wellness LLC

Wednesday, July 23, 2008

Could Diet Soda be making you Fat?

Diet Sodas and the American Dream

Work hard, play by the rules, and you can be anything you want to be. This is American Dream, sewn into our souls as a fundamental truism. Do the right thing, do it with diligence, and you will succeed.

There’s a dietary version of this dream that we hold to just as implicitly. Eat the right thing, keep your “calories in” less than your “calories out”, and you will succeed in holding your weight down. But somehow, the only thing that has upward mobility lately seems to be our national obesity problems.

The American Dietary Dream has been frustrated somewhere, and diet sodas make the point. These zero calorie drinks, if the theory is correct, should not contribute to your overall weight. And yet two major studies have both contradicted this assumption.

In the massive Nurse’s Health Study, researchers at Harvard followed the detailed dietary patterns of tens of thousands of nurses since the 1970s. The scientists looked to see whether those who drank regular soda (at least one per day) gained weight. To no one’s surprise, these sugary drinks were linked to weight gain over time – the nurses were about twice as likely to develop type 2 diabetes as well.
What surprised everyone, however, was that the effect was even stronger for diet sodas!

The very same result was confirmed in the San Antonio Heart Study. After reviewing 26 years of patient data, they found that every can of diet soda a person drank made you 65% more likely to become overweight and 41% more likely to become obese!

So, if diet soda consumption increases the risk of becoming overweight or obese even more than regular soda, this particular dietary dream turns out to be an unhappy one. Perhaps what we need is another way of thinking about our weight that doesn’t lead us to drink drinks that make the problem worse. Perhaps the “calories in, calories out” dream was … just that.

After all, anyone who has struggled with their weight can tell you that calorie/carb/point accounting may work fine in principle, but is really difficult in practice. Perhaps a more reliable idea would be to return to the principles that actually have worked to keep us thin and healthy in the past. The first of these principles is to “Eat Food”.

Of course there are many more components to living a healthy life, but if you start with this rule, at least you won’t have to wait for another study to tell you faux foods and faux drinks (diet sodas) are associated with a raft of health problems. That’s because you won’t be drinking them anyway – and that is a good dream to wake up from.

Dr. Will Clower is the founder and director of the Mediterranean PATH Curriculum.

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