Sanjay Gupta? For Surgeon General?

CNN and others are reporting:

Obama asks CNN's Sanjay Gupta to be next surgeon general

The popular television personality, a practicing neurosurgeon, reportedly would be provided a broader portfolio to make wellness, fitness and healthcare reform a top priority.

Reporting from Washington and New York -- President-elect Barack Obama has asked Dr. Sanjay Gupta to be the next U.S. surgeon general, looking to a popular television personality to help provide a public face for his healthcare agenda.

Best known as a health and medicine correspondent for CNN and CBS, Gupta, 39, is a practicing neurosurgeon in Atlanta and a member of the faculty at the Emory University School of Medicine.

The surgeon general oversees some 6,000 officers in the commissioned corps of the Public Health Service. Officers work as physicians, nurses, dentists and other health professionals in various federal agencies -- including the Centers for Disease Control and Prevention, the Coast Guard and the Bureau of Prisons.

Past surgeons general have wielded the most influence, however, by using the bully pulpit to focus attention on major health issues. And Gupta would come to the post with an unparalleled public profile and background as a communicator.

Sanjay Gupta? Oh, please Mr Obama, no! Great smile.....popular on-air personality.....but not Surgeon General!

A little about me. I am a RN (class of '76) and have been an avid reader of medical topics for several years. Over the past few years, because of my own increasing age as well as some of the articles and research I've looked at, I have become a proponent of many non-conventional treatments and practices. The areas I am especially interested in are diet and nutrition, cardiovascular disease, and diabetes and other diseases of carbohydrate metabolism. I am a low carb advocate even tho I still struggle with weight and other health issues. I am also an advocate of an interactive doctor patient relationship. I believe all should investigate any disease, condition, prescription etc on their own and doctors should encourage this rather than look at it as questioning their authority. I believe strongly that we are pushing medications to excess, often without even attempting other means of treatment. I believe that many of the non-conventional treatments are viewed as a threat to doctors, nutritionists, and others and are attacked rather than looked into with an open mind.

So.....regarding Dr Gupta......I guess it all depends on what you want for a Surgeon General. If you are looking for a person that will be little more than a spokesperson for the AMA, AHA, ADA et all....if you are looking for someone to try to block real health care reform.....if you are looking for a puppet that doesn't do his (or her) own research, but instead depends on talking points provided by pharmaceutical companies....OK, he's the perfect choice.

But, if you want a Surgeon General is someone that will oversee not only the Public Health Service, but also promote truly healthy lifestyle changes...not what is being promoted today, but changes that really will make a difference....well, I'd say keep looking.

There are so many things that are pushed onto the public that have little or no scientific background. Much of the research that is done is poorly done and many times the results are misinterpreted. I would like to see a Surgeon General that looks at all the the policies and practices and study each issue and check out the research himself. Not just read the summaries, but look at the data and make his own interpretations. Of course I'd want this person to do this with an open mind, not just looking to verify his/her beliefs.

Currently much of the "current wisdom" in the medical industry is based on faulty or non-existent research. You cannot conclude anything from observational (or co-hort) studies, you can only form a hypothesis. You cannot promote a practice based on tradition....or beliefs that have since been proven wrong. You cannot continue to push policy and practices on people where the data just isn't there.

The American Heart Association (AHA) has sold out to Big Pharma and various food manufacturers. Allowing the AHA seal of approval on foods that do nothing to promote heath. Allowing Big Pharma to repeatedly conduct "education" seminars that are little more than sales pitches. Ignoring evidence that many of their practices are at least useless and in some cases dangerous. The American Medical Association too.....either they are complicit with manufacturers and drug companies or they just do their own research.....but they are continuously promoting practices and policies that are not based in science.

And the American Diabetic Association? Well they promote a diet based on the very thing that diabetics have trouble handling! Despite studies done to show more effective treatment, treatment that minimizes complications as well as the need for medications, they continue to promote the same treatments that they have for decades. They repeatedly cite "research". Poorly done, misinterpreted research maybe...but not well designed, well executed studies that show results they don't want to see.

The whole medical establishment repeatedly promotes a diet that is based on processed food!! Think of it.....the largest part of the food pyramid is grains. With few exceptions, grains must be processed in order for them to be edible for humans. So....we base our diet on a processed food? And! At the same time, we should limit protein and fat to very small portions. Even tho we likely evolved on large quantities of fats and proteins with minimal (and mostly seasonal) fruits and vegetables and virtually no grains, the diet that is promoted today pushes limiting naturally occurring fats and protein and encourages processed foods.

Please Mr Obama, look into some others for this position. Look
for someone that is more free-thinking. Someone who does his/her own
research and looks at the data and design of studies before forming an
opinion. Someone that is willing, if necessary, to take on the "big
guys" (ADA, AHA, AMA, Big Pharma, etc) and question or correct policies
and procedures that are ineffective or even dangerous.

For further reading, I highly recommend:
Good Calories Bad Calories by Gary Taubes (or any article written by Mr Taubes)
Blood Sugar 101 by Jenny Ruhl
Dr. Bernstein's Diabetes Solution by Dr Richard K bernstein
Weston A Price Foundation: Know Your Fats
The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It by Dr. Malcolm Kendrick

Women and the AHA

Women and heart disease.

I decided to evaluate the AHA's recommendations for the prevention and treatment of heart disease in women.

The AHA, in my opinion, is pretty much a joke. The continuously ignore good scientific findings and allow drug and device companies to steer the way to setting treatment standards.

The AHA recommends exercise. Of course they do, no one will argue that exercise isn't good for you!
"No time to exercise? That's OK. Don’t think exercise — think action. Standing is better than sitting; walking is better than standing. Increase your physical activity to at least 30 minutes a day on most days of the week, even if you do it 10 minutes at a time."

Great to start, but most would argue that at least 30 min a day of some kind of physical movement would be the absolute least amount of exercise required.

And of course the AHA recommends not smoking. Everyone does. There is NO upside to smoking!

How To Love Your Heart

Only you can love your heart. There are some risk factors for heart disease you can control:

• High blood pressure. This condition can increase your risk of heart attack and stroke.
• Smoking. If you smoke, your risk of developing coronary heart disease is two to four times that of nonsmokers. Smoking is also a major preventable cause of stroke.
• High cholesterol. The higher your total blood cholesterol, the greater your risk of coronary heart disease and stroke..
• Physical inactivity. Lack of physical activity increases your risk of coronary heart disease and stroke..
• Obesity or overweight. If you have excess body fat — especially at the waist — you’re more likely to develop heart disease or have a stroke.
• Diabetes. Having diabetes increases your risk of heart disease and stroke, especially if your blood sugar is not controlled.

There are other risk factors to be aware of — talk to your doctor about how your age, race and heredity may affect your risk for heart disease.

Now, just what is a "healthy diet" according to the AHA? Well, check out their No Fad Diet. After drilling down a bit, I was able to find the guidelines:

• Whole grains and legumes: 6 servings.
• Vegetables and Fruits: 5 servings.
• Fat free or low fat dairy: 3 servings.
• Lean meat fish poultry and vegetarian protein: 2 servings.

What is 1 serving?

• Whole grains and legumes: 1 servings is generally 1 ounce. A cup of cereal, a slice of bread, 1/2c hot cereal, 1/2c whole grain pasta, 1/2c cookedstarchy vegetable (this surprised me!).
• Vegetables and Fruits: 1 serving is generally 1 medium piece of fruits, 1 cup raw and 1/2c cooked veggies or 3/4c fruit or vegetable juice.
• Fat free or low fat dairy: 1 serving is 1 cup milk, 1/2c cottage cheese (fat free or low fat only for milk & cheese) or 1 ounce hard cheese.
• Lean meat fish poultry and vegetarian protein 3 ounces lean meat, fish, poultry or 1/2c cooked beans or lentils.

OK....so let's try a menu:
Breakfast:
1 6oz container fat free, sugar free yogurt
1 cup sliced strawberries with 1 tsp sugar.
2 slice whole wheat bread with 2 tsp "light tub margarine"

Mid-morning snack:
4 reduced fat or light vanilla wafer-type cookies
10 grapes

Lunch:
Cheese toast made with 1 oz shredded cheddar cheese and 1 whole wheat English muffin.
1/2cup baby carrots
1/2cup fat free or light ice cream

Afternoon snack:
1/2 medium banana

Dinner:
1 serving pork tenderloin with cranberry salsa (recipe included)
1 baked sweet potato with 2 tsp "light tub margarine"
1/2cup green beans cooked in 1 tsp olive or canola oil.

As you probably already guessed, this isn't my choice of a diet, but the AHA's choice. This is the sample recipe they give for a 1200 cal/day diet.

My totals, when I entered everything in Fitday, come out a little higher.










Here are the totals:

Not too bad,
Fat: 42g (27%) with 12g saturated, 10g poly and 15g mono.
Carbohydrates: 202g (55%) with 24g fiber
Protein: 64g (18%)

Well within their guidelines for fat and carbohydrate, under 30% for fat and 45-60% carbs. I'm not sure of the protein level, but it seems low to me.

OK....so we know we're within the guidelines for fat/protein/carb intake....how about the guidelines for grains, fruits and vegetables, dairy and protein?

Let's see:
Grains: 2 slices whole wheat bread, whole English muffin (we'll count as 2) and 1 serving sweet potato that's 5 servings. (6 is the recommended amount)
Fruits and vegetables: strawberries, banana, green beans, grapes and carrots = 5 servings (5 is the recommended amount)
Dairy 3 servings: yogurt, cheese and ice cream. 3 servings (3 is the recommended amount)
Lean meat/fish/poultry: 2 3oz servings. hmmm...3 oz pork is one serving. Yogurt and cheese both contain protein, so maybe that counts for the other serving? (2 is the recommended amount)

OK....below their recommendations on grains, but others are OK.

Now, I must go off on another track at this time. Trans fats. There is absolutely no excuse (in my opinion) for anyone, let alone the AHA, to recommend any food that may contain trans-fats without a warning or notation or something!

Most commercial breads contain at least trace amounts of trans-fats. Cookies, commercial ice cream and tub margarine often contain trans-fats! But not one word about checking labels.

OK....back to the sample menu.

How about RDA, How does it add up?






Shocking, isn't it? RDA is met or exceeded, for only Carbs, fiber, protein, Vitamins A & C, and Manganese. Phosphorus and riboflavin are close with 97 & 99% RDA, so I'll give them those two also. But, it is deficient in every other parameter! Look at Vitamin D! Zinc! B12!

OK....so the RDA is based on more than 1200 calories, which I agree are too low for the average woman.

Let's take a look at their recommendation for a 2000 calorie diet:
Breakfast:
1 omelet made with egg substitute, mushrooms, spinach and milk and canola or olive oil cooked in 2 tsp "light tub margarine".
1/2 whole wheat English muffin with 1 tsp "light tub margarine" and 1 tablespoon light sugar preserves.
6 oz low sodium tomato or fruit juice.

Mid-morning snack:
1 6oz container fat free, sugar free yogurt
1/2cup raspberries

Lunch:
Sandwich with 2 slices whole wheat bread, 3 oz fat free, reduced sodium deli roast beef, lettuce, tomato and mustard
1oz baked potato chips
1/2cup blueberries with 1 tsp sugar
8oz fat free milk

Afternoon snack:
1 medium banana

Dinner:
1 serving bistro chicken with asparagus (recipe included)
1 cup cooked summer squash with 2 tsp "light tub margarine"
1/2 cup couscous (98% fat free, reduced sodium)
1 whole wheat dinner roll with 1 tsp "light tub margarine"
1/2 c fat free or light ice cream with 1/2 cup sliced peaches and 1/4 cup sliced almonds.

Sounds like a pretty reasonable menu. Again with the tub margarine and packaged foods, and I don't get adding sugar to berries! They're sweet enough!

OK so here are the numbers:










Again, my numbers are a tad higher, but again, the guidelines for fat, protein and carb is pretty much on track. Carbs are actually a little low (based on 45-60% of calories from carbs).

Here's the nutrition stats:








And the %RDA:






And, once again, we see some serious deficiencies, especially in Vitamin D, Vitamin A and Folate!! Better than the 1200 calorie example, but still deficient in important nutrients.

So. This is the AHA's idea of a healthy diet?

Even though Folate is very important for women, and Vitamin D is now being implicated in several diseases and disorders (including cancers and heart disease), this diet is below the RDA. And look atcalcium! We hear how important calcium is, but this diet is barely adequate.

So. You follow this "No-Fad Diet" and what happens? Because your carb intake is high, you'll likely have high triglycerides and small denseLDL. Your HDL will likely be low due to the artificial foods and lack of saturated fats. Because you're eating processed foods that likely contain at least HFCS or trans-fats, (not to mention a slew of other chemicals!) you'll have higher levels of inflammation. And because you're deficient in some key vitamins and minerals, you'll have less protection against not only heart disease, but also cancers anddegenerative diseases!!! You're also probably well on your way to developing insulin resistance and possibly even diabetes. If you're already diabetic, you're probably finding it hard to keep your sugars in good control.

And then what?

For the high cholesterol readings, especially the low HDL, they'll tell you to cut saturated fats even more, watch cholesterol intake, and maybe even be given drugs to lower your cholesterol. Drugs, I might add, that show NO benefit to women.

For the inflammation, you'll also be given anti-inflammatories and possibly be pushed into taking statins as they have a strong anti-inflammatory effect.

And for the diabetes and insulin resistance, you'll be given prescriptions and told to eat less and exercise more.

What about taking vitamins? minerals? anti-oxidants?
"The American Heart Association doesn't recommend using antioxidant vitamin supplements until more complete data are available. "
“Our study does not suggest that taking folic acid, B₆ or B₁₂ primarily to prevent cardiovascular disease (CVD) would be worthwhile. Women who are taking them solely for that purpose may want to discontinue,”
"The possibility that magnesium deficiency has a role in the development of coronary heart disease is only an interesting and provocative hypothesis."

In summary, The American Heart Association, which is "a national voluntary health agency whose mission is to reduce disability and death from cardiovascular diseases and stroke". is recommending the intake of a diet that is deficient in several key nutrients.

Statins. Even though there is NO evidence that statins do anything for women, or even that lowering cholesterol naturally benefits women, the AHA continues to recommend statins for women. There are articles on the AHA website that extol the virtues of statins:
Statin drugs lower heart disease risk in postmenopausal women
"Treatment with a cholesterol-lowering statin can significantly reduce the risk of heart disease and possibly death in postmenopausal women taking hormone replacement therapy (HRT), investigators report in the rapid access issue of Circulation: Journal of the American Heart Association."

American Heart Association's Guidelines At-A-Glance for Preventing Heart Disease and Stroke in Women

• ACE inhibitors and beta-blockers are recommended for all high-risk women.
• High-risk women should be prescribed statin therapy even if their LDL cholesterol levels are below 100 mg/dL.
• Niacin and fibrate therapies are given a strong recommendation for high-risk women with specific cholesterol abnormalities.

In the 12 guidelines, 6 of them, fully half, recommend some kind of medication. Only two are diet related, and says "In addition to a heart-healthy diet, supplementation with omega-3 fatty acids and folic acid may be considered in some high-risk women." and "Smoking cessation, regular physical activity, a heart-healthy diet and weight maintenance are given a strong priority in all women." It specifically excludes the use of antioxidants too! "Hormone therapy and antioxidant vitamin supplements are not recommended for CVD prevention for women at any level of risk." Now I can see the HRT, but antioxidants!?!?

Nothing about limiting processed foods. Nothing about avoiding HFCS (high fructose corn syrup) and trans-fats that are present in many processed foods.

For more information about statins and their effects, I strongly recommend Dr Graveline's website.
For information about lowering blood sugar levels, I would check out Dr Mary Vernon, Dr Michael Eades and Dr Mary Dan Eades. Also nutritionists Jonny Bowden.
For information on the truth about dietary and blood cholesterol, and the "risk" of heart or other diseases, see Dr Michael Eades, Joseph Mercola and Uffe Ravnskov.
The Weston A Price Foundation is a great source of information on the benefits of natural foods vs the dangers of industrial foods.

Diabetes

Diabetes: Why would anyone think it makes sense to eat the very thing that caused your disease???? I know the general consensus in the medical/pharmaceutical industry is that there is no cure for diabetes, I personally believe that excess sugar intake causes diabetes (NOT Type 1 that starts in childhood, but Type 2, which is preceded by insulin resistance).

OK.....so even figuring that sugar/carbohydrates don't cause diabetes (which they do), we all can agree that diabetes is a condition in which the body cannot handle the amount of sugar that is found in the blood. For most diabetics this sugar comes from the food they eat. Right?

The body can't properly metabolize glucose. So we feed the body mainly glucose? OK, yea, that makes sense!?!?!?! Not to me!!

Gluten Intolerance, what do you do to treat this? Avoid gluten.
Seafood or peanut allergy? Don't eat seafood or peanuts!
Intolerance to food additives like soy, MSG and sulfites? Don't eat them!!
Can't metabolize phenylalanine (PKU)? Don't eat high protein foods!!!

But man, if you can't metabolize carbohydrates what do they want you to do? Yep, eat more carbs! Insanity! But that is exactly what they want people to do! Eat more carbs!

I'm not sure if my school was behind or ahead of the times, but I was taught in nursing school that diabetes, then called "adult onset" was caused by high carb intake and that people on diabetic diets should not only count their carbs, but they should restrict them. I remember a "serving" of cake for a diabetic being a mere 1" cube of angel food cake! Forget any other kind, you just don't eat it!

My first 8 yrs of nursing were working in the acute care hospital. (I can remember when you were admitted for GI tests!!!) I worked on both medical and surgical floors, pediatrics, and have over 3 years working in intensive care (ICU/CCU/ER/Recovery/OR).

During that time, the majority of patients I saw that had complications of diabetes were patients that didn't follow their diet and/or take their meds!!!! People didn't have limbs removed the way they do today! And people didn't die of kidney disease as often as they do today....and I remember the days before transplants became routine!

I don't know the numbers, but I have read several articles that indicate that more people get complications of diabetes today at a much higher rate than they did 30, 40 and more years ago! The prevalence wasn't as high back then, no one argues that. But the incidence of complications was much lower than they are today. And the complications seem to be much more severe.

Regina posted a blog about a study that indicated that clocking carbohydrate absorption didn't change the progression of diabetes. What I question is why the heck would you want to feed someone carbs, and then give them a drug that prevents them from being used????? Why not just lower the carb intake????

Unfortunately, the levels that the medical establishment says is appropriate for diabetics are way too high. Again, I say.....stop feeding diabetics sugar and you'll prevent the complications of the disease.

This is funny too....sad funny, not funny funny. The cause of diabetes as far as the medical/pharmaceutical industry is concerned is fat. Not being fat, overweight, and obese....but dietary fat!!!

Now, think of this. Our ancestors ate high fat diets. Yep, lots and lots of fat. Our ancestors evolved on eating fat.....so why did diabetes not show up then? Why has the incidence of diabetes gone up, even though the intake of fat for many has decreased? Maybe it's because fat plays little or no role in developing diabetes????? Now, if you're talking about body fat, especially visceral fat, then yes....fat does likely at least contribute to diabetes. But that fat is a symptom of insulin resistance and diabetes. A symptom that becomes part of a vicious, dangerous circle.

Drugs. Oh this is my favorite!!!! First line of treatment is not diet, not lifestyle change, but drugs. Initially you might get a drug that increases your insulin sensitivity....later it's drugs to push your pancreas into producing ever more insulin....and then finally, when your pancreas is completely (or almost completely) destroyed, you take insulin injections!!!!

If people were put on a low carb diet and a simple exercise program, they would likely be able to prevent medication....or at least slow the progress from one drug to another.

But do they do this? Far too often the answer is no. They tell people to eat carbohydrates, even though those very carbs are what is causing all their problems!

From the CDC:
The Diabetes Prevention Program (DPP), a landmark study sponsored by the National Institutes of Health, found that people at increased risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight through increased physical activity and a reduced fat and lower calorie diet.

Now, I can't argue with loosing weight or the lower calorie diet. Since it's a good bet that the person is overweight any cutback on intake is only going to be good. And any weight loss will also be good. But where does fat come in?

Is insulin influenced by fat intake? No, not really.
Is blood sugar level influenced by fat? Not by much!

Sooooooo....why are diabetics told to limit fat intake???? Because they are at higher risk of heart disease of course! Does dietary fat have anything to do with heart disease? No (except for trans-fats). So why are people told to cut back on dietary fat? Because everyone KNOWS fat is bad!!! (More about this later)

Does the fact that we require certain fats matter? Nope. Does the fact that we also require certain proteins matter? Again, nope. Does the fact that we have no requirement for carbohydrates matter? Once again.....NO!!!!

This is the way I see it. A diet of 45-55% carbs (some articles I've read have advocated as high as 65% from carbs recently!) provides too many carbs and too few calories from fat and protein. We evolved eating a high protein and high fat diet. Our ancestors not only survived, but thrived on mainly fat and protein. Yes, I'm sure they also ate fruits and veggies that they found wild, but these were mostly seasonal, not a part of their regular diet. In preparation for winter our ancestors preserved extra meet and fat for use at a later date. They probably didn't do much with trying to preserve fruits and vegetables because they didn't have the technology. (I have no doubt they did dry some fruit and maybe veggies, but in small quantities, not large amounts like meat and fat)

Since we haven't been around for very long, I believe that we have not yet evolved to be able to handle a diet that is only 45-55% fat and protein!!!! We need fats and proteins....we don't need carbs. Since we evolved eating mostly fats and proteins doesn't it make sense to understand that we still would do better on a diet rich in fats and proteins?

If, on top of this you have a disease that prevents you from metabolizing those carbs, does it make sense to continue to promote a high carb low fat and low protein diet? The ADA thinks it makes sense....so does the AHA. Even though diabetes and cardiac diseases are at epidemic proportions, and even though there is evidence showing lowering carbs is beneficial for both conditions, and even though people are getting larger and larger and lower carb has been shown to again be beneficial in loosing weight. Yes, even though all these things are true, the ADA, AHA, and other groups continue to recommend low fat, high carb diets for people that have been diagnosed as being overweight (or obese), have diabetes, or heart disease.

Please, if you have diabetes read Dr. Bernstein's Diabetes Solution, if you have heart disease read Heart Frauds, and if you have high cholesterol read The Cholesterol Myths. Check out some of the blog links, especially both of the Eades and Regina Wilshire. And talk to your doc. I'm hearing more and more about docs who are turning to low or lower carb diets for their patients, especially diabetics, but many only recommend it if a patient asks.