Food, diet and supplements: The story behind the story – The San Diego Union-Tribune
For my in-depth article about dietary supplements and nutrition, I was asked to write about how it came to be. Here’s how:
Q: What made you decide to write about this topic, which has already been extensively covered?
A: I saw the need for a balanced look at what we know and don’t know about diet and nutrition. The public gets a lot of nutritional guidance from various medical and governmental authorities, but much of it is poorly supported by science. The mainstream media often doesn’t comment on this, perhaps because of fear of contradicting the putative experts.
I am inspired by the work of investigative reporters Gary Taubes and Nina Teicholz, as well as Dr. Michael Eades, who have shown just how misinformation and poorly supported advice abound in official dietary recommendations. The decades of warnings against dietary cholesterol provide a classic case of this unwarranted dogmatism.
There’s a personal connection. Along with many others, I have struggled with my weight even while eating recommended foods that left me hungry and unsatisfied.
But the nutritional debate extends beyond diet to the vast array of supplements, some of which are established to be necessary for health, and some that exist in a gray zone. The latter have scientific evidence supporting their potential benefit, but fall short of definitive proof in people. So what is a rational, science-minded person to do?
Q: Since you’ve brought up science, how appropriate is it to give an anecdotal evidence for benefit, as you do in your article with glucosamine and chondroitin for joint health?
A: People have varying responses to nutrients and supplements. A randomized, double-blinded, placebo-controlled trial, the scientific gold standard, can’t say with precision if a drug or supplement will work for you. But you can, with guidance from your doctor or dietitian, experiment on yourself.
For example, sodium may or may not cause hypertension in a given individual’s diet. That person can experiment with a reduced level of sodium intake, to seek if it reduces blood pressure. You can determine the results in a couple of weeks. Of course, it would be best to tell your doctor what you’re doing, and to carefully record blood pressure in a standard manner.
This isn’t anecdotal; it’s individualized medicine, which we’re hearing a lot about these days. Setting one standard for sodium intake for an entire population is outdated science and institutional inertia. Complying with this standard could also be making people sick.
As Scripps Health cardiologist-geneticist Eric Topol said a few years ago in an article on the Great Salt Debate, “average is over.”
Q: How do you know if you’re adequately nourished?
A: Start with assessing how you feel, your energy level, your weight, and any infirmities you may have. Keep track of what you normally eat. Write it all down and take it to your doctor or dietitian to discuss.
If you appear to be deficient, try incorporating foods you like that supply those nutrients. And if you can’t do so regularly, then a multivitamin/mineral supplement is good insurance.
Some deficiencies are more subtle. For example, there’s a considerable body of evidence that vitamin D supplementation can reduce the risk of a number of diseases, but you won’t feel that protection. By contrast, an actual deficiency of a needed nutrient will usually produce symptoms.
Q: Have you performed any dietary or nutritional experiments on yourself?
A: A month ago, I started a low-carb, high-fat diet, similar to an Atkins diet. This violates most of what’s considered nutritionary gospel. But I was dissatisfied with my excess weight and dependence on sugary energy-boosters like Red Bull. I’d get a nice boost, but it wore away fast. Drinking more made me jittery and uncomfortable. And then my energy levels would crash in the afternoon.
I’m now striving to reach a ketogenic diet, which forces the body to burn fat. It does so by cutting off nearly all carbohydrates, consuming protein in moderate amounts, and providing the overwhelming amount of calories from fat. Eating fat promotes satiety, which makes diet discipline easier.
What I’m not consuming on a ketogenic diet is also important. No more sugary sodas, no more fast food, no more highly processed food. Also, very little alcohol.
The ketogenic diet was developed nearly 100 years ago to reduce seizures in children with refractory epilepsy. There’s some evidence it helps adults with epilepsy control seizures. Since I have epilepsy, that is an added bonus. While medication controls my seizures well, the seizure threshold drops with age. So I’m thinking preventively.
I’m not quite meeting the ketogenic requirements yet, but am getting close to complying.
Q: How are you feeling?
About two weeks ago, I noticed having more energy, without the nasty sugary peaks and crashes. I can go longer between meals without hunger. My agonizing acid reflux, which I’ve had for decades, has disappeared.
If those benefits persist, I’ll be happy even if I don’t lose weight.
To help get the high fat I need, I eat a lot of cheese and bacon, as well as avocados, a food with known cardioprotective properties. Since I had a heart attack in 2010 and had a close call last year, that resonates with me. Instead of taking my coffee with an artificial creamer or sweetener, I use heavy whipping cream.
And I’ve kept as part of my diet one of my favorite childhood foods, liver and onions. It’s chock full of nutrients, and I’m among those strange people who actually like the taste. But now I decline the carb-rich sides such as mashed potatoes and choose salads over soups.