Monday, 13 March 2017

Update on Expertise Pages


Dr Aseem Malhotra

It's taken two weeks but I've finally completed an update of the experts we feature in the Open Future Health website.

A Summary of Who's New

Aseem Malhotra - Cardiologist UK - Advocate for Better Medicine
Dr Malhotra is a stern critic of the medical system. From heart surgery, which is his specialty, to diabetes treatment and obesity, where he's also very vocal. It's clear that we can do much better, often the key is to do less medicine not more. Too many procedures, that have no medical value, are done every day, just so doctors can avoid the argument that they didn't do "everything possible." This is silly. There is a limit to medicine, and we should be open about saying that.

Kieran Clarke Biochemistry, Ketone Specialist
Professor Clarke has an illustrious career. She's published hundreds of scientific papers. She's build a very successful department in the University of Oxford, UK. She's a biochemist who trained under Dr Richard Veech, and they have worked together for 20 years. They have a special interest in the medical uses of ketones and hope to build a business to market their patented products. A drink for athletes and specialist military people, has been successfully used to improve elite performance.

Richard Veech Biochemist - Laboratory Manager NIH
Dr Richard Veech, might be the world's leading researcher on the Krebs Cycle, the production of ATP and the use of ketones in the body. He's past retirement age, but he still runs a big laboratory, starting work at 6.30 each morning. He thinks that the dietary method of achieving ketosis is never likely to be popular, even though it works well. He thinks the key is to make a drink or a pill, that will put people into ketosis in a few minutes, whenever they need to achieve that.

Ian Lake UK GP and Type 1 Diabetic
After more than 20 years dealing with his own diabetes, Dr Lake realised that he was losing control, just like his patients. His additional medical knowledge was not protecting him. He discovered LCHF living by accident, listening to online discussions. He tried an experiment on himself, with success. Then slowly he began to work with his patients and found they had success too.

David Unwin NHS Innovator of the Year UK
Dr Unwin was very concerned about the rising rate of diabetes in his practice. For 25 years he had faithfully followed the guidelines the NHS had established for diabetes treatment. It had never gone well. Thinking about why, he looked again at the Glycaemic index, and realised that the wholemeal bread they were recommending created an enormous amount of sugar in the blood stream. Surely the key was to eliminate foods like that. So he began to run his own trial with some young diabetics in his practice, and had a lot of success.

Verner Wheelock Agricultural Scientist, Food Advocate
This is a more unusual story. Dr Wheelock is an agricultural scientist who realised that something was wrong with the diet of the nation, and began to explore what that might be. He wrote a book about it a few years back. In the last five years he's been writing a blog, quietly documenting his developing knowledge in preparation for another book. There are 250 posts in the blog and nothing has been added recently, so I assume the book is currently being written.

Joanne R McCormack - Children's Health
Dr McCormack has practiced medicine for 23 years, in the UK. She built her reputation around he work with children, winning a national award. That work took her online, where she discovered a diverse range of opinions on medical treatments and health problems.

Of particular concern was the rise in diabetes patients that she could see in her own clients. A real benefit of the Internet was that she could update her own knowledge, and participate in the discussions that concerned her. She began to put her own material online. That now includes a website called Fat is My Friend.

John Stephen Veitch                     Printable Version Printer of this Essay
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Friday, 3 March 2017

It's NOT Your Fault - Schooling and Deschooling

dietitian
Overweight Dietician
Not Her Fault
Blame her Schooling
If I speak to overweight nurses, dietitians or doctors, I find it impossible to talk about the success of their "education," the failure of their dietary practice, and their need for deschooling. These people are super-sensitive on the topic, because they know they carry excess weight and they have tried to do something about it. Their failure is clear indication of the success of schooling, and educational failure.

I'm an old teacher. In the 1970's Ivan Illich was writing about the failure of traditional education in South America, to meet the needs of the children who were in schools. I guess today we would see this as colonization of the mind. The establishment decides what young people should know, and makes sure that happens. Schooling was seen as essential, both for the community and for the future success of each child. But that schooling, wasn't often in the best interests of the child, as Illich pointed out.

Like it or not, schooling in the beginning at least, is indoctrination, of necessity. Learning the rules of the family, the tribe and the wider community, isn't left to chance. You have to understand and reflect to others, certain knowledge and behaviour, to be acceptable as a friend, as a colleague, as a team member, as an employee. Although lip service is given to the process of education, freedom to think independently, to develop creativity and innovation, those abilities are always constrained by "the box," the social and cultural limits our society imposes on us. This is the price of being a member. Without "membership" you can't be accepted in that society.

You can see the failure of the schooling process today, in youth unemployment, alienation, and the failure of young people to engage in the political process. Schooling selects some people and rejects others. That's an old problem, with many new features in an information rich world.

To be accepted you have to demonstrate the success of your schooling. That's what makes it possible for you to find employment and to become a professional. So it's ridiculous to talk about thinking outside the box. To do that is almost certainly, the end of your professional career, and probably the end of many personal and family relationships. This is a cultural trap, that schooling forces upon us. If you are in that trap it's not your fault. The problem is in the whole of the society. We all get fat together. We can also get well together.

Non-Alcoholic Fatty liver disease is killing this man.
He is strongly insulin resistant, and probably diabetic.
I expect that he could recover his health in 12 months
He needs deschooling, and then LCHF nutritional knowledge.

So you succeed at school, and you go to University, and you get a degree. You have earned your professional qualification, which commits you to uphold professional standards. People with a training in any of the health professions, are expected to "know" about eating a quality human diet, and how to control one's weight. What they "know" is the standard diet recommended by the Department of Health in each country. That recommendation in turn, is almost certainly modeled on the Dietary Guidelines for Americans. What most health professionals "know," is only schooling, a simple set of rules to follow.

For the last 60 years there has been a bias against fat in the diet, based on the idea that dietary fat might make heart attacks more likely. This was reinforced after 1980 around the world, when the Dietary Guidelines for Americans were generally copied by the health authorities in most countries. Thirty years later, it turns out that the fundamental ideas behind that dietary recommendation are wrong.

There were no health benefits in the recommended diet.
Neutral for heart disease. Worse for both diabetes and cancer.
Ineffective in reducing body weight.

There have been signals indicating this error since the 1960's, the MRFIT Trial and the Anti-Coronary Club for instance, but we've ignored those results, because the idea that dietary fat was bad for us seemed to make so much sense. Only in the last 15 years, has clinical research in small trials demonstrated in a precise way, how obesity develops and that dietary fat isn't harmful. When the massively large NIH study, the Women's Health Initiative, confirmed that result, in 2006, there should have been rapid change. But there wasn't, instead the schooling of established leaders in nutrition took over, and that "rogue result" of the WHI was set aside.

I have two personal friends, both ex-teachers, well educated, intelligent people, who have this problem. Their schooling tells them that the "know" how to eat a healthy diet, and they've done that for 30 years. So why are they overweight, and why do they have metabolic syndrome? "That's just old age coming on. It happens to everyone." Too true. It happens to 75% of the population. Why is that? I contend that it's not normal and it's certainly not necessary.

The escape from this trap demands two actions. First of all, understanding that one's "knowledge" isn't working as expected, that there is a fault in your knowing and that deschooling is necessary.

It takes time to do that. Unlearning our aversion to dietary fat takes time. In the same way we've been taught that "healthy whole grains" should be a significant part of our diet. So we love our muesli or our porridge, and we eat loaves of grain filled bread each week. Now we know this makes us fat. Understanding that and eliminating bread from your diet requires deschooling.

Once you understand that you don't know how to eat a healthy diet, your real education can begin. I can tell you where to start, with Banting. I can tell you what to do; but that's just more schooling, and in the long run isn't helpful. You need an education. Education is self driven, a process you need to control yourself. Or I can tell you what others have done, but where your education leads you, will depend on the choices you make.

John Stephen Veitch                     Printable Version Printer of this Essay
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Thursday, 2 March 2017

What did you Eat Today?

The last two posts have been heavy going. This one is about real food, it should be interesting in a different way.

I've been eating a low-carbohydrate diet for perhaps 18 months now. I'm getting better at not falling into the little traps like eating too much fruit, or going to a dance and eating sandwiches, because that's what people usually offer as healthy food. One of the things that's quite surprising, is that cakes and really sweet foods don't have any appeal. Unless you eat one. So take the easy route to success, don't.

One of my early discoveries was the power of a single water biscuit. I can eat up to 50gm of carbohydrate a day. A single water biscuit looks innocent, it contains 3gm of carbs. What harm is there? But that biscuit leaves a taste in the mouth. You want a second and a third. Soon you are binge eating again. Don't do it. Try one quarter of an apple instead. Or better still a single sardine. Just the sardine on it's own, with a little of the oil. You'll feel satisfied and there is no craving that follows.

Typical Breakfast
This is a typical breakfast in our home. Egg, a little bacon, lambs hearts today, but usually some offal meat, and a vegetable, today it's tomato. Followed by tea or coffee. It actually takes very little time to prepare, maybe 10 minutes.

For 20 years we ate home-made muesli and fruit, with low fat milk. There would be a single slice of toast, with margarine, and some peanut butter for me. We thought that was healthy. The toast was removed 10 years ago, when we realised that bread in the diet made us fatter.

I always go past the offal meats in the supermarket. I love liver, or chicken livers and kidneys. Hearts are fine. Beef bones or bacon hocks are a special treat. Offal meats are very dense in nutrition, and contain all the vitamins and minerals that are lacking from the diet of most modern people. So there is a double bonus here. Offal meats are cheap, and the food value is superior.

Don't forget to look for fish offal too. Fish heads and carcasses and fish roe are all delicious.

I think there is a place here for a return of the local butcher. Someone who can give you full fat meat, at a sensible price. If you are Banting, the thing you need most is more fat. We pay extra at the butchers for them to cut the fat off the meat. I want the fat left on, and the price to come down. I imagine buying breakfast chops with lots of wonderful fat, and not paying through the nose for them.

Saturated Coffee - No Craving for Food
Nut and Seed Crackers, Home-made

There's never any need for morning tea. Really there is no need for lunch either, except that it's a habit. So for lunch I eat two of our nut crackers with butter, a lump of cheese, and usually two sardines. If I'm lucky, I can replace the sardines with three muscles.

If we're busy, lunch is often about 2pm, and sometimes it doesn't happen at all. A cup of saturated coffee is a treat, if I'm ever feeling hungry.

I purchased the book, The Real Meal Revolution, as soon as the international edition became available in 2015. There is now a new 2016 edition available. As we've become more familiar with the Banting Diet we are using that book more and more for the excellent recipes it contains.

Here is a list of our favorites:
Nutty Crackers from page 74.
Spicy Bacon nuts from page 84, but that's expensive.
Kale with sliced Chorizo sausage and eggs from page 96.
Nut Granola from page 114.
Beef and Cauli-mash Cottage Pie from page 132.
Not-Butter Chicken from page 162.
Creamy Butter Chicken Curry from page 164.

Anyway, that's how the day goes. There is no supper, but if I work late, after midnight, I'll often eat a couple of those nut crackers. I don't like to drink coffee so late.

Chicken Casserole and lots of Silver Beet from our garden
This diet does cost more. The question is can you do it on $10 per person per day? I'm not sure. But for many people that's an important question. That's why I buy muscles in the shell and steam them myself. They cost $4 a kilogram in the shell and you get about 530gm of cooked muscle for that. That's lunch for three days.

I'm not the cook in our house, and I've never previously filleted a fish, but recently I did. I purchased a trevally weighing 2kg for less that $8. I did manage to get two large fillets off the carcass without making too much of a mess of it. One fillet I ate that night. I pan fried it in butter. I was very pleased.

Whole Fish purchase - Cost cutting

Then I realised I had a large fish head and a carcass. Fish soup. So the following day I made a fish soup stock, and later in the day I converted that into fish soup, adding some muscles, the other fish fillet and lots of vegetables to the stock. It tastes wonderful. I made four 1 litre tubs of fish soup, about four servings in a tub. This was a very successful experiment. I will certainly do that again.

John Stephen Veitch                     Printable Version Printer of this Essay
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Wednesday, 1 March 2017

The Fault in Each of Us - Cognitive Resistance

In the way our brains work, we struggle to see our own mistakes. It's difficult to accurately proof read your own writing. Once we develop a concept, we use that understanding as a measure of the importance and/or the reliability of new information. We build our knowledge on the foundation of our earlier understandings.

When something comes to our attention that's contrary to "what we know" it's not understandable, and it's usually identified as unimportant or unreliable. If our previous knowledge prepares us for new concepts, we still need to; acknowledge the facts presented, to hold the new information in conscious view, to allow the conflict between what we "know" and the new "knowledge" to reside within us. We have to allow both the conscious mind and the subconscious mind to struggle with the incongruent information: learning takes effort.

Finding "Truth" - or Seeking to Know

Even if the new information is called scientific research, we are likely to make a much easier choice, and reject the new ideas without consideration.

This is well demonstrated by the life of filmmaker Waldo Salt. Salt was 20 when he graduated from Stanford University. He was idealistic, his first film script was released in 1937. In 1938, he joined the Communist Party, fully convinced that Communism was the way to social and economic justice. He suffered for his beliefs, being blacklisted in 1951. Five years later, the news of what was really happening in the USSR and China shocked him. He finally recognised his misguided thinking. But he couldn't immediately adopt a new viewpoint. There was a long period of disillusionment and soul searching, before he could develop a new set of life principles, a new understanding of "the truth."

I first wrote about this in my journal over 20 years ago. Salt also kept a journal, mostly in the form of proposed film frames like a comic book. On one page there are only these words. "To search for truth one must first have lost it." See this article that I wrote in 2007. It refers to the schooling that we all have, and the difficulty of deschooling ourselves. For Waldo Salt that process began in 1956, when he realized that Communism was not after all a solution to the evils of the world. He was 42, but was lost and unsure of himself. At 53 he was once again writing successfully.

Why we Reject New Ideas

Most people reading this blog will be familiar with the concepts behind the Banting diet. It's simple really. I could tell you in one line, or in ten principles, in a lecture, or on a web site. If you believe that a low-fat, cholesterol reduced diet, or a vegetarian diet is healthy, you cannot allow yourself to "hear" the message in any of the previous links. If you already "know the truth," there can be no search for a better truth.

I have good friends who have weight issues, and type two diabetes, and severe symptoms of metabolic syndrome, but I can't help them. They already "know." When they know they don't know, when they've "lost the truth" they might be reachable. Each of us is our own master.

Dr William Castelli Director of the Framingham Heart Study, looking at many black swan results, said in 1992; "We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories; weighed the least and were the most physically active." Even today, for most people that makes no sense at all. However, Banters, or other LCHF diet people, will understand it easily.

In the same way, Banters will understand the results of the dietary study in the the Women's Health Initiative. We understand that a low-fat diet can't be a healthy diet.

But in 2006, that was a shock result to the nutritional establishment. The official response to the unexpected results to the dietary study in the Women's Health Initiative was to set it aside. Dr Elizabeth Nabal, appeared on television to reinforce the importance of the low-fat diet, and to promote business as usual. A strategy that's continued to work for eleven further years, never mind the continuing damage done to public health. The WHI result was "unfortunate" so they chose to ignore it.

In the 1960's Dr George Mann's work in Kenya was ignored. As part of the Framingham study he had also collected data on 1000 American people over two years. The results of that study were unexpected and contrary to what the NIH wanted to publish. In 1977 because of that work, he knew the Diet Heart Hypothesis was nonsense. When George Mann was openly critical of the Diet Heart Hypothesis and the Cholesterol theory of cardio vascular disease, he had years of good science on his side. He was very bitter that his advice was discounted and that his career had a premature end.

It took ten years for the establishment of accept that stomach ulcers were caused by a bacterium, Helicobacter pylori, and not by stress or food intake. The evidence for that change was scientifically clear. In the same way it's been clear for more than 20 years that low-carbohydrate diets give diabetics superior control over their glucose peaks and reduce their need for insulin. But the recommendation is seemingly impossible for Diabetic Associations and many doctors to accept.

We all have pre-conceived ideas, and convincing evidence in support of those ideas is readily accepted. Evidence to the contrary is easily minimised, ignored or dismissed.

For instance this data from India is compelling, but it was never taken seriously. Note the date, 1960's. The heart disease rate was seven times higher, in the vegetarian, low-fat, south of India. There is a cultural barrier, it's about India, Americans are saying "it's not about us," as if the people of India, and science from India, are not to be trusted. There's a cost to that.

Sometimes people prepare elaborate defence's of their existing position. The Stellenbosch University - Cochrane Collaboration usually called the Naudé Review is a case in point. They compared several low-carbohydrate diets with a standard diet and claimed that for weight loss there was no difference. The study is significant for what it didn't do. The study defined low-carbohydrate as less 40% of total calories, about 220gm of carbohydrate per day. They did not do a comparison with very low-carbohydrate diets, less that 50gm of carbohydrate per day. Their study by design, didn't look at very low-carbohydrate diets like the Banting Diet. (Probably because the Stellenbosch researchers, and many researchers around the world, are lipophobic, and cannot recommend a high fat diet to trial participants.)

On publication, in July, 2014, the lead author of the Naudé Review, Celeste E Naudé, was active in the South African news media, using the study as evidence to discredit Dr Tim Noakes, The Real Meal Revolution and the Banting diet. Given the limitations of the study this attack was unprofessional and dishonest.

We can all be guilty of allowing our prior knowledge to blind us to new thinking. Commitment to well established conventions, professional standards if you like, can cause that sort of blindness. Loyalty to a convention can trap us in the tradition of the past, and cause us to ignore highly relevant data that should compel us to action.

That applies to each of us as individuals. We can be told what a better diet is, but we won't believe it, if we already "know" what a better diet looks like. That also applies to institutions, where the standards are written down and agreed to, and supported by members. When it becomes clear that something is wrong with those standards, making a proposal for change is both personally difficult, and politically dangerous. All our institutions and political parties suffer in that way, the rate of real change is quickening. The slow response of our institutions puts them under constant pressure.

John Stephen Veitch                     Printable Version Printer of this Essay
The Network Ambassador
localOpen Future Health Limited - local You may comment privately to John S Veitch here:    Or write publicly in the comment box below.

John Stephen Veitch
The Network Ambassador
Open Future Limited - You may comment privately to John S Veitch here: