Thank you

You won't get much argument from me there, depending on the degree of overweight that we are talking about. Obesity from a SAD will more than likely worsen all of those, but you have to ask yourself if it's the weight or the foods that got them to that weight causing the problem. I've seen statistics showing that those in the 25-29 BMI range lived longer on average than those who were lower. What bothers me a bit is what seems to be the assertion that those who are thin or CRONers won't get these diseases at all and that has certainly not been my experience and I'd have a hard time believing that it's yours, either. The 3 that I mentioned earlier weren't thin because of some miracle of metabolism or disease and probably lived a calorie restricted life either out of habit or preference but in the end developed many of the same diseases non CRONers do.

Check out this new artilcle AND Video on a person doing CR

ST. LOUIS, Dec. 30, 2005
http://www.cbsnews.com/stories/2005...in1172297.shtml

Watch the video and see what you think, you can choose media player or Real player to play it in (video on the right)

Matt

I have had far too much medical training at this point to ever speak in absolute terms. I speak more of trends. Certain medications, for example, have been clearly shown to increase lifespan in someone with heart disease risks (HTN et al). That does NOT mean that everyone who takes the medication regimen will live longer or have fewer heart attacks, but that there is a statistically significant chance of living longer with the drugs than without them. And, as I've said before, everyone knows a person who did everything wrong from a health standpoint, and lived a long and healthy life. Sometimes you can beat the statistics. And, as I said before, I do think that being SLIGHTLY overweight (BMI no higher than 27) is probably acceptable, as long as the patient is eating healthfully and is physically active. This goes out the window, however, if there are complications such as HTN and DM, because it is very clear that weight loss positively affects both of these. In fact, for type 2 patients, weight loss is very often more helpful in reducing blood sugar than medications, because the pts are so insulin resistant to begin with. I'm sure there are a few thin Type 2s out there with high blood sugar, but there aren't many, in my experience. In fact, there are so few that when we encountered one, we often found they were actually Type 1 pts that had been misdiagnosed!

Somehow, even at 290 pounds, I had dodged the DM bullet, but I had full-blown metabolic syndrome, and it was really just a matter of time before my taxed body became resistant to insulin. Thankfully, at my current weight, and with my current eating habits, it is unlikely that I will develop DM. I'm not sure what the future will hold with respect to HTN and dyslipidemia -- there is a strong genetic factor in my family, and I have a thin sister with elevated cholesterol. But I do know that I used to have HTN, and since dropping weight, I don't anymore. And since HTN reduces lifespan, not having it has probably increased my lifespan. And I'm happy about that!

I'm sorry Wooo, I misposed. In the interests of clarity, I should have asked What is the genetic advantage to human genes (not individuals and not the species) if we live a third longer than we do now?

Whenever some theory runs afoul of genetics and natural selection--and almost forces a stance of human exception to these--we may safely deny its viability. After years of trying, it's the hole that CRONfolk cannot crawl out of.

If we look at all other living things on this planet, and use them as the logical beginnings of a theory of energy acquisition (feeding ourselves), we realize very quickly that calorie restriction/optimal nutrition is an oxymoron. Just like feeding ourselves less sugar, vegetable oils and other abominations of our expected diet makes us healthier, so does feeding lab animals less monkey chow make them healthier.

For every other living thing that has ever existed in the history of our planet, less energy is the kiss of death, and I'm not talking about starvation. I'm talking about genes. The red-in-tooth-and-claw realization that keeps most people from accepting evolution is that they can't come to grips with the notion that genes can kill their host dead and still be enacting a successful reproductive strategy. And if it IS successful, then they continue on, while you die. Try not to take it personally; you are here so that they can reproduce, not vice versa.

Let's say there's a Believe-In-CRON Gene. Some folks got it, some folks don't. Those that have it, have fewer ofspring, the gene eventually disappears, and no one believes in CRON anymore.

Here's a quote from the news that Whoa posted above.

"The whole idea of calorie restriction is recognizing that calories are basically bad for you," [Joseph] Cordell says.

One of us is crazy. See if you can figure out which.

That may be, but again I ask is it the weight loss that brought about the improvement or the change in eating habits? I'll use myself as an example. I'm a type 2 diabetic and clinically I still qualify as obese. If I were to go to a new doctor now who had no knowledge of my diabetes and have a blood test, I would have a hard time convincing him or her that I am a diabetic without my previous records because my bloodwork shows that my blood sugars are those of a non-diabetic even though I am still clinically obese. The same situation goes for my hypertension; still clinically obese, but now my BP is normal. I'd maintain that it wasn't the obesity causing my problems, but the foods I was eating. In other words, the obesity was a symptom, not a cause. If the reverse were true that it was the obesity causing the disease, then one would have to lose weight to the point of no longer being obese to even see improvement let alone complete reversal of the disease process.



Hmmm...units of energy measurement are bad for us? Go figure. Given that the studies are based on feeding animals not less of the diet that they would eat in the wild but less of a man-made 'chow' for whatever animal that contains foods it would never have eaten in the wild, I'd say that the theory is based on a faulty premise. Sort of like feeding meat to herbivores to prove that eating meat is bad for everyone.
It would be more accurate to say, "If I feed an animal less of foods that it wasn't designed to eat in the first place, it lives longer. Therefore, if humans eat less of foods that they were never designed to eat in the first place, they will live longer." It's not about the calories, but about where those calories are coming from.

Nicely worded LisaN...I'm not sure I could have expressed it so well.

Lisa, I am glad that you were able to get your BG levels and BP into the normal range despite still being overweight. My experience is that this is not always true, even when the patient follows an optimal diet. In my own case, my BP didn't drop to an optimal level until I had lost quite a bit of weight. (and I was eating very carefully) At the DM clinic, I had pts who were compliant with diet, exercise, and medication and still had non-optimal A1C and FBG levels. And I had others who did the same thing and brought their levels right down, and these pts were able to go off their meds. So it's highly individual. I have friends who were morbidly obese, who had GBP surgery and who went from having severe DM symptoms to having no signs of DM at all (once their weight came down...again, it is highly individual as to how much the weight has to come down before BG levels drop).

The bottom line is that in virtually every case I've observed, weight loss and exercise has helped lower BG levels and BP levels. The only variable is how much the levels go down. I agree that if one is eating a lot of simple carbs, the drops in BG won't be as dramatic, but again, I know people who have lost all their extra weight and can now eat any food they like with no significant increase in FBG, because they are no longer obese. In general, I don't think that refined carbs are good for anyone, but I don't necessarily think that Atkins is the only way to go (it wasn't as effective for me as just eating clean foods).

And, in my own case, I feel so much better at this weight than I did when I was obese or overweight. It's just easier to ambulate now! Less of me to haul around, I guess. Unlike Whoa, I won't go below a BMI of ~20, because I could not maintain that weight. But I will keep my BMI below 25, because I feel so much better when I'm not overweight.

That's my story and I'm sticking to it!!

If they were following the standard ADA diet, the results don't surprise me at all; mine were quite similar on that plan which is way too high in any kind of carbs, complex or otherwise, to reasonably expect any kind of good control for the majority of type 2 diabetics. If someone is compliant with diet, exercise and medication and still not seeing good numbers, obviously there's something wrong with that plan and it's not that they don't have enough meds on board.

Nope, not ADA (at least not the ones I counselled). Frequent small meals, always a high quality protein on board, total cals kept to reasonable level, etc. Not rocket science, just basic common sense, really, to keep sugar spikes down. In fact, very similar to the way I lost my weight. And exercise as tolerated by the pt (some were in wheelchairs, having lost limbs in war or to peripheral neuropathy secondary to the DM -- it was the Baltimore VA hospital).

Most of the people I work with are pretty "cutting edge", b/c I'm in a teaching environment. We have access to all the current clinical data, including dietary recommendations. The traditional ADA recs are not current and are not always used in this type of clinic. Therefore, when a pt came in saying that they followed Atkins or another LC program, we didn't necessarily try to talk them out of it (unless it wasn't working or the pt's BG had worsened). It was the ones who followed a high refined carb diet (whether lowfat or not) that got counselled, and the importance of always having a protein to temper spikes as well as frequent snacks (eating 6 times a day or so) was stressed. As a matter of fact, the DM nurse educator had herself lost over 100 pounds and kept it off following this type of diet, so she was an excellent role model for the pts.

Dietary recs were always given with the pt's specific needs in mind. So if the pt had CHF and was prone to edema, they would be told to weigh daily and told to avoid a lot of sodium. If the pt had CKD, total protein was kept to a certain level. If the pt had frequent bouts of hypoglycemia, they were told exactly what to take for this in an emergency (usually pts overcompensated with too much sugar) and how to tweak the meds/diet to avoid these sugar swings in the future. It was such a rewarding work experience, and I saw firsthand the dramatic results when pts followed our advice. Although I probably won't be doing ambulatory care in the near future, I liked it a lot, and would happily do it again if given the opportunity. Of course, since my specialty is pharmacy, we also tweaked meds up or down based on the labwork and the pt interview. Each pt was seen at least an hour, so it was a very complete workup.

OK, I'm off to continue cleaning house...I think my kids are messing as we're cleaning, so there's an overall conservation of messiness, unfortunately!

As a side,I would bet those who are thin and type 2 have some sort of genetic abnormality causing the perturbations in insulin signalling (meaning it is something other than your garden variety D & E induced IR & obesity bundle).

Is it possible both diet and calorie amounts (weight status) affect health? In other words you may enjoy health that qualifies as normal simply by controlling the types & quantity of food you eat, but who's to say you wouldn't be even further in the "good range" if you ate less calories and lost weight? There is a lot of data which shows body fat does things that increase IR after all. Plus there is a ton of evidence which shows lower calorie diets and eating less reduces your risk of diseases (like whoa provided)...

As I said I've noticed that those forum members who have the healthiest lab work tend to also be low weight (both naturally and unnaturally i.e. dieted) & eating low calorie diets. OTOH members who LC traditionally and eat higher cals tend to weigh more and not see the same degree of improvement in health. It seems to me every time I see one of those lab works with normal/low LDL, super high HDL and zero triglycerides the person who owns it is thin, and low cal and low carbing as well. In fact, I can't remember ever seeing someone who was obese post the same kind of fantastic blood sugar/cholesterol lab results.
Sure many obese people have had dramatic improvements, even gotten rid of many medications (or all of them), made it to "not dangerous/normal" health levels. I've seen a ton of posts like that. But I can't recall seeing those kind of "jaw droppingly good" numbers that you see when people get to the normal/low end normal and are mindful to eat low cal consistently.



I too wondered if maybe the studies were useless because lab animal feed is so unhealthy the way junk food is unhealthy for humans. Who knows. Maybe it's all what you eat, but I have a suspicion that there might be something to staying low weight & not eating much. Likely being low normal weight and eating as low calories as you can without running into side effects of the restriction is probably where the money is ...

I tend to agree with what you've said, Woo. And again, I can draw from my clinical experience, as well as the experiences of friends, etc. I have yet to see truly outstanding labwork (that's outstanding, not just acceptable) from people who are obese. I've certainly seen numbers go down, either from appropriate medications, or from lifestyle changes. But I haven't seen the kind of aggressively low numbers that are now recommended. The latest Joint Committee (JNCV11) recommends BP levels be below 120/80, and HTN is diagnosed at lower levels (anything over 140/90), with a new category of pre-HTN, which is 120-139/80-89. So your BP needs to be <120/80 to be considered normal. As far as DM goes, we were usually happy to see A1C levels below 7%. But here again, lower is better, and most clinicians would be shooting for <6% in an ideal world. In addition, recommendations for treating dyslipidemia have tightened quite a bit, especially if the pt has DM or other complications. LDLs should generally be below 100, and for those at risk, the recommendation is to have them below 70! As I was told, you can't really get LDLs to low...the data supports very low levels. HDLs on the other hand, should be >50, and optimally, >60. My HDLs were in the 60s when I was fat, but my LDLs were also high, so my total cholesterol level was not terrific.

But really, this is all kind of secondary in some respects...I mean, you can walk around with dyslipidemia and HTN and feel just fine. Same is true w/high blood glucose levels. But chances are, if you're fat, you are going to get winded more easily, have a harder time fitting in airplane seats -- or the seats at my school, which are small! -- and if you have little kids, like me, you may find that it's tough to run around with them. I really feel my day-to-day quality of life is tremendously better now that I'm thin. I just get around so much easier. And Woo, I've also been a bit bemused when people on this site have tried to tell me what I'm doing wrong when in fact my stats are better than theirs! The passion is admirable, I suppose, even if a bit misguided. I do believe that eating fewer carbs is a good idea, especially if it means eating MORE veggies, berries, high quality proteins, and so on. I don't feel the same way when I see people eating boatloads of nitrate-laden bacon and sausage, and heavy cream. Technically, both ways are acceptable on DANDR, but I'd go for the clean eating over the cream and bacon. I realize there may be extenuating circumstances which make losing harder -- like if one has PCOS or takes corticosteroids -- but I think there are those who just still eat too much and exercise too little. It is possible -- easy even -- to eat too much on an LC diet. I never lost much on Atkins, and I followed it to the letter. But I ate too much, and after the first 10 pounds or so, I stalled. My current WOE is much better in every possible way, and my weight loss and labwork support that.

Ehhhh...enough rambling. I think I've made my opinions more than clear at this point! My children are driving me nuts...when does school start again??!!

How about 5.2 without meds?

Very good number. At what number did you start? Is all your other labwork as good?