Live Blogging from the Paleo Summit XI: Dr. Cate Shanahan
Link: "Dr. Cate" Shanahan
Title: The Paleo Diet vs. Top-Selling Drugs: Who Wins?
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Basically, just eat a low carb paleo diet folks and you won't get osteoporosis, schizophrenia and need cholesterol lowering drugs. While Dr. Cate spends quite a bit of time discussing how diet can cure/prevent diseases, she goes into scant little detail as to what exactly she means by such a diet. Shanahan's science is very poor. If I were a parent I think I'd go nuts just worrying over my kid turning into a schizophrenic any day now after listening to Shanahan. Just go paleo folks and skip all your meds. Look, I'm on board with America being a WAY overmedicated society where doctors don't tend to pay enough attention to the role of diet and nutrition in our health. But after listening to Cate for almost an hour, I'm seriously considering a trip to the walk-in this morning for some pills ... any pills!
The Medical Problem:
As for so many, and I'm not knocking this, but Dr. Cate got interested in nutrition when she experienced some unspecified medical problem. Through Dr. Weil she discovered essential fatty acids which eventually led ther to Weston Price's works on fats. Then she had a diabetic coworker who said "none of her cells work right" which led Dr. Cate to go back to her biochemistry text and rediscover that evil: glycation.
Shanahan discusses how glycation is basically sugar sticking to your tissues. We're eating too much sugar -- as you all know the USDA with their recommendations really is behind this, right? This is a meme of low carbers that we started eating less fat and more carbs. Cate's solution? More fat + less carbs = paleo/traditional diet! Dr. Cate gives an even worse take on sticky sugar and glycation in her recently aired podcast with Jimmy. I'll have at that one when I get a chance.
Are you serious?
Cate claims that there's a feeling amongst both doctors and patients that "anyone who is serious about health will ask their doctor for a pill". Serious doctors dole out pills and everyone is ignorant that diet causes the problem. Well have no fear, Dr. Cate is here. She's an "alternative" doctor who will counsel you how to change your diet to get healthier. If you take drugs, you get sicker. I tend to agree with that, actually, as those who take medications for chronic illnesses/conditions, like BP, tend to get sicker and more dependent on them than better. But the sanctimonious snobbery about how doctors are all so stupid about nutrition -- as if they don't eat, live and breathe like the rest of us lowly humanoids -- is getting a bit much from the likes of Dr. Cate. (I don't like the Dr. First Name thing). So why don't docs focus on diet first? Well, according to Dr. Cate, they do but the advice is exactly the wrong advice so they lose faith in it because it never works.
More ravages of war
We're all familiar by now that good obesity research was a great casualty of WWII. Now we learn that after WWII, farming all became industrial (well, tis true) and antibiotics were discovered. Medical schools stopped teaching students about how to raise pigs and chickens, and how cows should be grassfed and started teaching "cool gee whiz surgeries". That's a direct quote there. Cate laments having learned about "cool gee whiz surgeries". Sigh. She also learned the old failed (?) conventional wisdom about cutting calories, fat, exercising and cutting salt. All that stuff that doesn't help with weight loss. So after trying that, if you're a really serious patient, you come back to get the pill! Really??
Time, time, time ... (cue song) ... and Osteoporosis
Sean asks about his clients who all say they don't have the time or interest to do the diet thing, so take the pill, right? Cate launches into the side effects that only she knows about because she's looked into this! There's a long discussion of the side effects of drugs like Boniva -- I'm no fan of these drugs -- but then we get to the Mercola Moment! ALERT!!!! Do you want to lose your jawbone??? Sally Field might just lose hers any moment now. That's right folks. Chemo patients often suffer bone loss so they get infusions of these drugs and 1-2% suffer from osteonecrosis. And IF you get that in your jawbone, treatment often requires removing the bone. So then she gets back to the pills, which are nothing like the infusion. Again, I'm no fan of these drugs, but to conflate a side effect of infusing likely high doses of these drugs with the one pill a month style treatment is just idiotic. So these drugs work by blocking resorption of old bone and minerals. They stop working after 4-5 years. This information is worth looking into if you're considering going on these drugs.
The cure is vitamin D. Eat your pastured eggs which have D in the yolk. Everyone in New Hampshire not taking 2000 IU/day is deficient in her practice so she recommends everyone take that amount because she's not seen any problems arise from that recommendation. Taking Ca doesn't help because these pills are hard and only 10% is absorbed and the 90% goes to the colon where it causes constipation. The body can't handle supplements like this b/c it can't use isolated nutrients. So get it in your food (just don't tell Mark Sisson) with protein, Mg, A, D, K. I agree. Calcium supplements react with cholesterol particles leading to calcific atherosclerosis.
Food as a Language
Here's the woo woo alert. I'm not sure what this means other than that our body only knows to make proteins and tissues and such with nutrients based on how they were put together in our food or something. Otherwise I have no clue!
"There's information in the foods that contains building blocks for your body and the whole complex of materials that tell your body what to do with the building blocks. And that's why supplements just can't quite cut it, no matter how many you take. There's a lot of stuff in there that we just don't even know what it is, so we can't put it into supplements.
Paleo is a High Protein Diet!
Paleo diets are really high in protein! Eat nuts and seeds for "mineral pills". Brazil nuts have selenium, pumkin seeds Mg, and others are high in Ca (she snuck that in with a nervous laugh which was curious). Here's a gem:
Paraphrase: a paleo diet doesn't have a lot of potatoes or other starchy foods so you can have an extra helping of those green leafy veggies that are really rich in Ca.
Oh! That's the problem. We all just don't have room in our diets for that extra helping of veggies because we're stuffing our pie holes with potatoes. But supplement vitamin D, it's the exception to Shanahan's no-supplement rule because our bodies are used to it all by itself because we make it. And did you know that strength and balance training can help us build strong bones? Is that paleo? Doesn't the Boniva commercial show Sally doing yoga at least?
What about dairy? "Swiss paleo" Evidence that paleo were raising goats ... where there's goat there's dairy ... dairy from pastured milk and some hormones like lactoferrin -- stimulates bone growth. Those are my notes but I notice she says nothing about raw dairy or fermenting. I'll have to look into the lactoferrin stuff.
Back to the pill stuff, she says docs would rather have patients do diet but we Americans have been trained to expect a pill ... trained that they need pills ... most common pills are cholesterol lowering pills -- pretty much once a day -- nervous to get off that pill ... cut the fat -- dietary cholesterol minimal effect on blood cholesterol. Nobody should worry about total cholesterol it doesn't mean anything it doesn't distinguish HDL. OK, I'm on board there. But she does worry about LDL: over 140 may have higher risk. See Chapter 8 in her book for the problems with LDL when it gets oxidized. Here's where she launches into the diatribe about LDL, carbs and weight gain that I addressed HERE.
Cliff Notes version is that she blames high LDL on carbohydrates and she claims that when one switches to a paleo diet, it almost no fail lowers LDL. This is so out of sync with what happens as to be laughable. Some will see LDL go down with significant weight loss, but soaring LDL levels are commonplace on low carb diets, especially in maintenance or, cough ... Jimmy Moore ... cough, when one packs fat back on eating low carb. She says this is not true for everyone, the genetically predisposed are excepted, but for most people
LDL is a less reliable marker of heart attack but it is predictive of .... weight gain! And here she dons her official hat of the Nora Gedgaudas school of human physiology and tells us that carbs are converted to cholesterol! I agree with her on the misconceptions of where cholesterol in our bodies comes from, but please doc don't replace that with more bullshit. Check out my link for more on this utter nonsense.
We're all Schizo-bound!
Dr. Cate says food is the only answer and she now goes into discussing the brain and building a brain. This discussion is seriously in Mercolaland for alarmism. Children with behavior problems ADD/anxiety are putting up red flags for serious mental illness down the road. She says that in 2008 antipsychotics eclipsed cholesterol and heartburn pills as the most commonly prescribed drugs. I want to see the citation on that!! If that is even remotely true it's amazing our society has survived. Please ... stop the hysteria. But it's no longer controversial that early detection can prevent schizo but most of the early intervention is drugs that lead to weight gain and increase diabetes risk. I totally agree we should avoid drugging our children, but this notion that all we have to do is feed our children fish oil and all will be well is not the answer. A paleo diet (a diet that remains undefined by Shanahan) will ward off schizophrenia. Yay!
Here are the signs that your kid may be on the road to schizoland: not wanting to play, sad, fear, general whininess, increased sensitivity to rejection, overreaction, sleeping habits, appetite, stomach aches, headaches, loss of interest in favorite activities, bothered by bright lights or noisy environments, seeing things in shadows like people or hearing sounds like knocking at the door. Oh ... and not just kids. She describes a patient who was a new father who started pursuing odd new hobbies and became fearful of going home to his new responsibilities. So ... let me get this straight. This 30-ish year old man was fine until he had a kid and now he's on the road to a serious mental breakdown. Next thing you know we'll learn that carbs cause mid-life crises too. Sheesh. Oh ... and if you're a woman who gets sad and moody around your special time of the month, it's because you're eating too many carbs. Paleo cures that too.
Because, folks, the brain is made of fat and if you don't have it to build new brain structure and repair old worn out stuff you're fried. Egg yolk has fats that aren't really calories -- I agree -- because phospholipids, cholesterol etc. are used for "maintenance". Sugar causes anxiety sugar swings. Did you know that we don't eat enough protein? And if we don't we eff our neurotransmitters because neurotransmitters are built from protein. Just eat paleo. Eggs and grassfed protein. And go for it with WAPF style diet, just watch your carbs. Uhn huh.
Take home messages:
- If you're willing to change your diet there is no reason you have to take most of the drugs out there. I agree.
- Let's make food the mainstream treatment and turn drugs into some kind of alternative. I agree.
- The earlier you start the more powerful it will be. I agree
Long time lurker, first time poster :)
I know the food/language thing is woo but I actually find that aspect more speculatively interesting than anything else she has to say.
"The IMS reports that Americans spent $307 billion on prescription drugs in 2010. The 10 drugs on which we spent the most were:
Lipitor, a cholesterol-lowering statin drug -- $7.2 billion
Nexium, an antacid drug -- $6.3 billion
Plavix, a blood thinner -- $6.1 billion
Advair Diskus, an asthma inhaler -- $4.7 billion
Abilify, an antipsychotic drug -- $4.6 billion
Seroquel, an antipsychotic drug -- $4.4 billion
Singulair, an oral asthma drug -- $4.1 billion
Crestor, a cholesterol-lowering statin drug -- $3.8 billion
Actos, a diabetes drug -- $3.5 billion
Epogen, an injectable anemia drug -- $3.3 billion"
No anti-psychotic drug was on the list of "the ten most-prescribed" drugs.
"Abilify, an antipsychotic drug -- $4.6 billion
Seroquel, an antipsychotic drug -- $4.4 billion
No anti-psychotic drug was on the list of "the ten most-prescribed" drugs."
I beg your pardon?
WebMD's most prescribed:
Hydrocodone (combined with acetaminophen) -- 131.2 million prescriptions
Generic Zocor (simvastatin), a cholesterol-lowering statin drug -- 94.1 million prescriptions
Lisinopril (brand names include Prinivil and Zestril), a blood pressure drug -- 87.4 million prescriptions
Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone -- 70.5 million prescriptions
Generic Norvasc (amlodipine besylate), an angina/blood pressure drug -- 57.2 million prescriptions
Generic Prilosec (omeprazole), an antacid drug -- 53.4 million prescriptions (does not include over-the-counter sales)
Azithromycin (brand names include Z-Pak and Zithromax), an antibiotic -- 52.6 million prescriptions
Amoxicillin (various brand names), an antibiotic -- 52.3 million prescriptions
Generic Glucophage (metformin), a diabetes drug -- 48.3 million prescriptions
Hydrochlorothiazide (various brand names), a water pill used to lower blood pressure -- 47.8 million prescriptions.
I see what you mean, now.
There's most prescribed in terms of number of prescriptions and most prescribed in terms of cost of prescriptions.
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