While doctors could have easily advised patients to supplement over-the-counter fish oil before the “drug” form came on the market, they instead opted to prescribe Lovaza, reflecting the effectiveness of marketing hocus-pocus and adding several thousand dollars of cost per person under the guise of FDA approval. Of course, the $1 billion in Lovaza sales ends up in the pockets of the drug company, while we all bear the burden of increased costs whether or not the drug was prescribed to us. And all of this from something that you could have taken on your own, easily and inexpensively.
One example: An analysis of 111,000 people who received implantable cardioverter defibrillators, or ICDs, in 1,200 hospitals across the United States revealed that an astounding 22.5 percent of patients receiving them did not have a legitimate indication of need. 10 In some hospitals, as many as 40 percent of implanted ICDs were put in without need. Receiving an ICD is no small matter, as they are large devices implanted under the skin of the chest: bulky, disfiguring, requiring monthly checks and surgical replacement of the battery every few years - yet we have nearly one in four people receiving them without reason.
During my former life as an interventional cardiologist performing coronary balloon angioplasty and inserting stents, each metal stent implanted cost between $500 and $3,000 from the manufacturers. Implanting two, three, or five in a single patient was not uncommon. The average stent weighs 0.2 gram and is made of stainless steel; the pricing for stents means that you are paying $2,270,000 per pound of steel—hundreds of times more than a pound of gold, but for common steel not that different from the spring in your ballpoint pen. Sure, there are research and development costs to recover, but nothing to justify such wildly exorbitant prices.
Arthroscopic knee surgery for osteoarthritis—in which a surgeon passes a narrow scope and various tools to scrape away rough edges and loose debris and shaves down knee cartilage in the hope of providing pain relief—has been shown to have no benefit beyond placebo. 17 (This is not to be confused with arthroscopic procedures to repair torn ligaments or meniscus tears, which have been shown to be effective.) There can be early pain relief after arthroscopic knee surgery for arthritis, but it is short-lived, yielding no long-term benefit over exercise and physical therapy, no better than a sham operation. Yet this procedure has been performed on millions of people over 20 years, with several hundred thousand still performed in the United tates every year.
The Health Care Cost Institute launched guroo.com , which lists prices charged by hospitals, allowing people to shop for better prices. The Healthcare Bluebook ( healthcarebluebook.com ) has launched a similar effort. Emboldened by findings such as those from the Dartmouth Institute for Health Policy and Clinical Practice, policy efforts to control healthcare expenditures while improving outcomes are likely to emerge.
Here’s a basic fact: Eat carbohydrates and blood sugar rises. Every first-year medical student knows this, every nurse or diabetes educator knows this, every person with diabetes who performs finger-stick blood sugars before and after meals knows this. Eat any food with more than just a few grams of carbohydrates and blood sugar will rise; the more carbohydrates you eat, the higher blood sugar will rise. Everyone also knows that foods like butter do not raise blood sugar, nor will a fatty cut of meat, olives, green bell peppers, broccoli, or chicken liver. And since the 1980s, when the sharp upward climb in type 2 diabetes (and obesity) began, the only component of diet that has increased is carbohydrates, not fat or proteins. 4
Whether intentional or inadvertent, misinterpretation or blundering, advice to engage in a diet low in fat and rich in grains with a free pass for sugar was a major contributor to the epidemic of type 2 diabetes and weight gain/obesity. Purported efforts to subdue a disease made the disease worse, and not just by a little, by a lot: We now have the worst epidemic of type 2 diabetes and obesity in human history. Even in the face of science telling us that the ADA dietary approach is wrong, the organization stubbornly stands by old advice. Meanwhile, the healthcare system profits enormously, and the pharmaceutical industry celebrates double-digit annual rates of growth and record revenues due to the man-made financial bonanza of diabetes and associated conditions.
It also means that the nice dietitian you’ve been told to see by your doctor has, in effect, had an education bought and paid for by the food industry. You can no more expect to obtain unbiased, unscientific advice from a conventionally trained dietitian than you can from a salesperson from a soda company—because, in many ways, they are essentially one and the same.
Heart disease, more than any other health condition, is dominated by money and business. Even over the course of my career, I watched heart disease evolve from a low-tech world with few effective tools to a high-tech flurry of new technology—which is great. But it also “monetized” heart disease, making it exceptionally lucrative. More than most other areas of health, heart health is therefore dominated by money. And organizations built around heart disease, such as the AHA, are no different, now a half-billion dollar per year behemoth.
The AHA got into the business of certifying food in 1988, a program that became the Heart-Check program in 1995. Some of the products certified over the years include Berry Berry Kix, Count Chocula, Cocoa Frosted Flakes, Fruity Marshmallow Krispies, Honey Nut Cheerios, and low-fat Pop-Tarts, all declared “heart healthy” with tens of millions of dollars in certification fees paid for by companies including Cargill, Post, Kellogg’s, and Coca-Cola. They won’t certify onions, green bell peppers, or organic kale, of course, since that’s not where the money is. So go for the money rather than health, and what you get for heart-healthy food is low-fat Pop-Tarts.
A recent survey found that two-thirds of academic medical centers own equity interest in companies that sponsor research within the same institution.
(Unlike most other statin drug trials, this one was not supported by the manufacturer. It was funded by nonindustry grants, removing at least one potential source of bias.) There were 10,000 participants enrolled in the study. Half were given atorvastatin, the other half a placebo, and then they were observed for 3 years. Of the people taking the placebo, 3 percent experienced a heart attack over 3 years, while 1.9 percent of those on atorvastatin had a heart attack, a reduction of 1.1 percent. Alternatively, 97 percent on the placebo survived, while 98.9 percent survived on the drug—different, but not very impressive.
By law, the lab results are your property and the doctor and staff are operating out of ignorance. You should apprise them of this fact. If you still encounter resistance, a call to the state medical board can turn the tides, as the board can provide a brief statement that you can present to the doctor and the staff. Recent changes in regulations also allow you to obtain lab results directly from the laboratory facility itself, whether or not your doctor approves. Thanks to regulations finalized in February 2014 by the US Department of Health and Human Services that replaced a hodgepodge of uneven state-by-state rules, laboratories in all 50 states are now required to comply with your request to provide results to you without your doctor’s permission or knowledge.
The Undoctored approach flips the way we think about disease and health on its head. Rather than starting with a health condition such as endometriosis or acid reflux, and then trying to explore treatments via discussion forums or crowdsourced wisdom, we flip-flop the process by restoring overall health first. Because virtually everyone’s health has been disrupted by factors such as diet, weight gain, industrial chemicals, nutritional deficiencies, and inflammation, we all follow the same starting program to reverse these effects.
So-called diseases of civilization—diabetes, overweight and obesity, much psychiatric illness, autoimmune diseases, heart disease, colon cancer, constipation, even common skin conditions like acne and skin rashes—are virtually unknown in primitive societies following traditional diets.
In other words, wheat—along with rye and barley, which share the same gliadin protein structure—are potent appetite stimulants with other mind-altering effects.
Wheat and its two most closely related grains, rye and barley, are therefore not just a vehicle for gluten but are packed with dozens of compounds toxic to humans, with adverse effects inadvertently amplified by agribusiness through efforts that have everything to do with agricultural goals and nothing to do with your health.
Cornstarch is among the most popular ingredients in gluten-free foods, also explaining why gluten-free breads, muffins, and other products are associated with extravagant weight gain and high blood sugars.
The amylopectin content of grains explains why corn, wheat, and sorghum are fed to livestock to fatten them up prior to slaughter, yielding “grain-finished” cuts of meat. Ducks are fattened with corn and wheat, often force-fed through a tube passed into their stomachs, to cause the fatty livers for the much-prized foie gras.
Corn is also a prominent trigger for allergies. As many as 90 percent of people who deal with cornstarch in the pharmaceutical industry (as filler in pills and capsules), food production, or agriculture develop allergic responses to corn over time. 43
Fats, unlike carbohydrates, are essential, as necessary as water or oxygen.
Glycation of skin proteins gives you brown-colored “age spots” and wrinkles. Glycation of cartilage proteins makes cartilage brittle, eroding and leading to inflammation and the pain of arthritis. Glycation of kidney tissue leads to declining kidney function. Glycation of LDL particles in the bloodstream makes them more likely to contribute to atherosclerosis (heart disease). Glycation of brain proteins contributes to dementia. Those with diabetes experience high blood sugars throughout most of the day, in life than those without diabetes.
Fructose follows a different set of rules. Ingested as, say, the high-fructose corn syrup in a soft drink or ketchup, it provokes the glycation reaction even without raising blood sugar, a stealth reaction that is difficult to detect. Even without the immediate rise in blood sugar, fructation—glycation by fructose—is eight- to tenfold worse than glycation by glucose. 32 And as with glucose-induced glycation, it is also irreversible.
By an odd metabolic twist, liver processing of fructose causes an increase of triglycerides, which, in turn, trigger distortions in all other lipoproteins (fat-carrying proteins) in the bloodstream converting, for instance, large and benign LDL particles into small and heart disease–causing LDL particles. This means that fructose increases the particles in the bloodstream that lead to heart disease (despite fructose being a major ingredient in many “heart healthy” products, such as low-fat yogurt). Fructose also increases visceral fat, blood pressure, levels of uric acid (that lead to gout and heart disease), and inflammation, and it contributes to fatty liver. 35 , 36 In short, fructose is a lot worse than it initially appeared.
In one British study, even when calories were limited to a near-starvation level of 1,000 calories per day, if those calories were 90 percent carbohydrate, weight would increase , while 1,000 calories as 90 percent fat or 90 percent protein would result in substantial weight loss . (A diet of pure carbohydrates, by the way, is also associated with extreme hunger, while a diet of nearly all fat is not.)
Foods that trigger insulin the most are therefore the most potent for weight gain, while their absence allows weight loss; the equation is quite simple.
Throw into the mix the exceptional capacity for grain amylopectin A to send blood sugar higher, ounce for ounce, than table sugar, with blood sugar highs inevitably followed by blood sugar lows with shakiness, mental cloudiness, and hunger, a 2-hour cycle that sets the poor grain-consumer in an endless 2-hour hunt for food. The combination provides a perfect formula for weight gain , effects that have caused me to accuse wheat and grains of being “perfect obesogens”—foods that are perfect for causing weight gain and obesity.
Part of the Undoctored way of thinking is to never accept “health” advice on blind faith. This is especially true of nutritional advice.
Tap into the online conversations at Quantified Self ( quantifiedself.com ) to get an idea of some of the new and extraordinary observations emerging. Individuals from varied backgrounds—engineers, teachers, biochemists, college students, and the curious—apply self-observation and quantification to solve health problems in unexpected ways.
Curious thing: If you go to a lab and ask for the direct-to-consumer price, not the price charged to health insurance, it is typically much lower, often 70 to 80 percent less, since direct-to-consumer lab testing lacks the added layer of costs introduced by health insurance.
You will find that by eliminating wheat and grains, by not limiting fat or calories, by avoiding processed foods, and by gravitating to real, whole foods, many of the elaborate rules advocated in dozens of diets become unnecessary. We will not get bogged down with elaborate swaps, point systems, or dietary phases or other complicated rules.
Stop eating wheat and grains and what happens? All hell breaks loose for about a week—an opiate withdrawal syndrome causing 5 to 7 days of misery, an issue we shall discuss in detail later. But like a drug addict who will do almost anything for another “hit,” having a secret stash of cheesy crackers hidden in the hall closet can, as sure as real cheese does not come whizzing from a can, booby-trap any effort to purge grains from your life.
There will be no mad scrambles for food due to overwhelming hunger, no sneaking ice cream in the middle of the night, no hidden snacks around the house. No one will be anxiously counting minutes until lunch or dinner.
Likewise, the Sausage “Rice” Skillet recipe illustrates how we use riced cauliflower as a substitute for all forms of rice without sacrificing taste or texture.
If probiotics and fermented foods are the seeds for bowel flora, what are the “water” and “fertilizer” that nourish them? These are called prebiotic fibers , fibers that you ingest but cannot digest, leaving them for microorganisms in the intestines to consume. Some call prebiotic fibers resistant starch since they are impervious to human digestion and digested by microorganisms. Getting prebiotic fibers is crucial to your health and the success of your diet.
By removing wheat, grains, and processed junk foods, as well as Bt toxin and glyphosate residues that come via genetically modified corn and soy, you have eliminated factors that are known to disrupt bowel flora.
If you use tap water to ferment vegetables, the chlorine and fluoride will block fermentation. Likewise, watering houseplants with tap water can make them wither.
Avoid unnecessary antibiotics. There will be times when antibiotics are unavoidable. But steer clear of them for questionable indications, such as for a viral illness “just in case” it converts to a bacterial infection.
Avoid aspartame, saccharine, and sucralose. These artificial sweeteners have been shown to modify bowel flora and increase potential for prediabetes, helping explain why sugar-free soda drinkers are no more slender, even heavier, than sugared soda drinkers. 23 Choose natural and benign sweeteners instead, such as monk fruit, erythritol, and stevia.
You can assess vitamin D status by measuring the blood level of 25-hydroxy vitamin D, a simple and inexpensive test that you can even do on your own with a finger-stick.
Only choose oil-based gelcaps or liquid drops of vitamin D 3 , never tablets . Most tablets are erratically absorbed or not absorbed at all, while gelcaps and drops are reliably absorbed.
But a 25-hydroxy vitamin D blood level is the one truly essential measure to obtain beyond routine values like blood glucose.
But clinical trials have repeatedly demonstrated virtually no benefit with calcium supplementation—no slowing of bone thinning, no reduction of osteoporotic fractures. Likewise, people who consume plentiful dairy products containing calcium do not have better bone health. One thing that people who supplement calcium do have is more death from heart disease.
Iodine protects against or can reverse fibrocystic breast disease. Fibrocystic breast disease, believed to be a precursor to some forms of breast cancer, occurs to greater degrees in women with iodine deficiency and can be reversed in many women with iodine restoration.
There are plenty of good reasons to supplement omega-3 fatty acids. Omega-3s are essential, not optional, fatty acids, with a very clear performance, depression, impaired childhood development, dry skin, dermatitis, and neuropathies). Many clinical studies demonstrate that higher intakes and blood levels of EPA and DHA yield reductions in sudden cardiac death, heart attack, heart rhythm disorders, autoimmune inflammatory conditions such as rheumatoid arthritis and lupus, and a variety of cancers, as well as improved brain development in children.
It means that for years minerals were prevented from being absorbed whenever any phytate-consuming grain was in the vicinity, blocking the absorption of even mineral supplements. Advice to include grains in every meal and snack predictably caused deficiencies of positively charged minerals, especially magnesium, calcium, iron, and zinc.
In these cases, zinc supplements—such as zinc gluconate, zinc sulfate, and zinc acetate—can enhance dietary intake. As with magnesium and iron, look for the quantity of elemental zinc in the preparation, not total weight. Because zinc supplements are indeed meant to supplement dietary intake, a modest additional intake of 10 to 15 milligrams per day is reasonable.
The Undoctored nutritional supplement program restores nutrients that address intrinsic human needs. Here are the most important ones.
• Vitamin D provides far-reaching and magnificent benefits when restored. We aim for a 25-hydroxy vitamin D blood level of 60 to 70 ng/mL, typically achieved with 4,000 to 8,000 units per day of vitamin D 3 in gelcap form. Delay measuring blood levels for at least 2 to 3 months after initiating or changing dosage to allow the full effect to develop.
• Calcium is not part of the Undoctored process as it does not yield bone health and poses increased risk for cardiovascular disease.
• Iodine is an essential trace mineral that is increasingly deficient in modern populations. We aim to obtain 500 to 1,000 micrograms of iodine per day from kelp tablets or iodine drops.
• Fish oil and seafood are the only reliable sources for the omega-3 fatty acids EPA and DHA, as the ideal daily intake of 3,000 to 3,600 milligrams EPA and DHA is only achievable by this route (and not with linolenic acid–containing foods, such as chia or flax, or krill oil).
• Magnesium is the most commonly depleted mineral from prior grain consumption—with restoration yielding substantial benefits. We aim for a daily magnesium intake of 400 to 500 milligrams of elemental magnesium.
• Zinc, iron, vitamin B 12 , and folate can be deficient in some people, so awareness of how to identify and correct these deficiencies can be situations.