The Lipid Hypothesis

As far as I know, I never reached 300 pounds, but there were a couple of months when I avoided stepping on the scale because I didn't want to know.  There are two main reasons why I was able to loose over 100 pounds in the last three years.  The first reason is that I stopped taking a certain prescription medication, but that's a story for another day.  This post is about the second reason, which is diet.  By that I mean what kinds of foods I eat, not some sort of counting program.  I follow a specific variant of the Paleo diet.  The premise of this diet is that, as a species, we have not yet had time to adapt to the types of food available to us in agricultural societies.  This means that some individuals are unable to properly digest many foods that are ubiquitous in our society, including all sugars, grains, starchy vegetables and processed foods.  We unlucky ones can only eat what our hunter-gatherer ancestors ate in the Paleolithic period of pre-history, primarily meat and vegetables.

I most definitely did not loose 50 pounds by "eating less, moving more".  This "common sense" advice assumes the human body is like a car that takes only one type of fuel, which is clearly not the case.  There was virtually no exercise involved in my weight loss, except for walking a few times a week, only beginning in recent months.  I eat as much as I want--of the foods that are allowed--and this can be a substantial amount.  This diet is simultaneously more challenging and easier than counting-type diets where you simply eat less of everything.  Fully 80% of the average grocery store or restaurant menu is off limits to me, which means I generally have to plan ahead and provide my own food in many places.  The surprising upside of this is that shopping and restaurant ordering are much easier and quicker, because there are so few options.  I find it much easier to have hard-and-fast rules on food type and not have to worry about quantity.  And except for sugar cravings that go away after a few days, I feel more full and satisfied now than I ever did when I was chowing cookies and ice cream all day.

In addition to the unlimited quantities, the specific diet I'm on achieves high tummy satisfaction by making sure you get enough fat.  While the diet is wholly compatible with the Paleo concept, it goes a bit further, positing a specific malady called gut dysbiosis.  I never thought I had troublesome digestive symptoms, but again, this is a case where we tend to oversimplify our bodies.  Just because you don't have constipation, diarrhea, or painful gas doesn't mean all is well within your gut.  Digestion is a system of hundreds of interlocking chemical reactions, producing many different products your body needs.  Your intestines contain more bacterial cells than there are human cells in the rest of your body, and many of these microbes are performing absolutely essential digestive functions.  Unless, that is, certain harmful microbial species have taken over and are suppressing the beneficial bacteria.  Gut dysbiosis tends to run in families, but by environmental transmission, not heredity.  Various types of life events, including taking broad-spectrum antibiotics, can cause populations of harmful vs. benign and beneficial species of gut flora to shift in an unhealthy direction.  A diet high in sugar feeds the baddies, and the gut lining becomes damaged from their toxic output.  This "leaky gut" allows partially digested products from our Neolithic diet, such as wheat gluten, to pass into the blood stream where a host of subsequent reactions occur, including neurotoxic and auto-immune responses.  The GAPS diet aims to cure many modern medical conditions by restoring the dominance of beneficial bacteria in the gut so it can becomes a source of nutrition rather than toxins.

I used to eat TUMS like candy, but when I stopped eating sugar, I never got acid reflux again.  I used to get sleepy in the afternoons, but when I stopped eating grains, this stopped happening.  Sometimes things that we think are unavoidable, or are part of the way our body works, can be changed dramatically by changing the type of fuel we put into our bodies.  When I was at my heaviest, I had sleep apnea and type II diabetes. Mainstream medicine gave me a pharmacological mechanism for getting my blood sugar down, but that was maintenance with side effects, not a cure.  Nutritionally, they told me to count grams of carbs, which is extremely difficult and resulted in feeling deprived all the time, since I still had all the cravings.  After only a few months on a Paleo diet, my type II diabetes had completely disappeared, and I went off the medication.  The sleep apnea also went away, presumably from weight loss.

Dr. Natasha Campbell-McBride created the GAPS diet to cure her son's autism, which she did successfully.  You read that right; many conditions that are considered incurable diseases by mainstream medicine can be completely reversed by eating real food instead of the chemicals that come from today's large agri-businesses.  Due to the spectacular nature of these claims, the GAPS diet has been met with a lot of skepticism, but I predict anecdotal successes such as my own will gradually increase participation until medical research is forced to take a closer look at it.  Some conditions are reversed more are easily than others, and the average person may not be able to follow the required diet in today's world.  In order for this type of healing to become available to more people, we need to address the biases of our Western medicine and demand local, natural whole foods from our grocers.

One big reason GAPS is meeting resistance is the emphasis on getting enough fat, which is healing to the gut and provides vital nutrients.  Indeed, any doctor knows the essential role fats like cholesterol play the the body, so why would a high-fat diet be such a seemingly controversial suggestion?  Three words: The Lipid Hypothesis.  You may not have heard the phrase before, but you know the lipid hypothesis well.  This is why we have so many low-fat and fat-free products on our supermarket shelves, and why everyone "knows" that fat in the diet is what causes heart disease.  So then, why is heart disease still our major killer, after decades of declining fat and cholesterol consumption?  Why do certain cultures who eat high fat diets have low prevalence of heart disease?  Simple: the lipid hypothesis is unproved, and I believe, dead wrong.  From Wikipedia:

German pathologist Rudolf Virchow in 1856 suggested that blood lipid accumulation in arterial walls causes atherosclerosis. An accumulation of evidence has led to the acceptance of the lipid hypothesis as scientific fact by the medical community; however, a small but vocal minority contend that it has not yet been properly validated, and that vascular inflammatory mechanisms prevail independent of blood cholesterol levels. 

When my blood cholesterol levels rose after starting the diet, my doctor was suitably alarmed.  But when I protested that inflammation causes heart disease, she had no counter-argument, being a good, progressive doctor.  Now I may have a heart attack tomorrow, so the jury will remain out until I have decades of history, if indeed my cholesterol levels remain high.  If I can start running again regularly, my HDL/LDL ratio ought to change, even if the total level doesn't.  There are certainly a lot of pieces to the puzzle, and everyone is different. 

The main thing the lipid hypothesis has going for it is the consensus agreement of the medical community, along with, of course, the media, the food industry, and the makers of statin drugs.  Other ideas that once had to battle scientific consensus include the notions that the earth is a sphere and that small, invisible entities called "germs" are the cause of most diseases.  Confusing wide acceptance of an idea with proof of its validity is a common logical fallacy, according to the list my tenth grader showed me a couple weeks ago.

There are other low-carb diets which help people lose weight, most notably the high-fat Atkins diet and low-fat South Beach diet.  These diets work by starving the body of sugars from which to make glucose, forcing it to switch to an alternative process known as ketosis for powering cells.  I lost a lot of weight when I was on Atkins many years ago, when I constantly ate little but steak, eggs, and bacon.  However, like many people, I found the diet very unsatisfying, and could not stick to it.

Depending on implementation, GAPS may be a ketogenic diet, but this is not its primary purpose.  GAPS is based on the Specific Carbohydrate Diet, which, as its name implies, is based on restricting the specific types of carbs consumed, not the amount.  The purpose of the SCD is to address gut dysbiosis.  Unfortunately, there are no tests for gut dysbiosis, so following an SCD-based diet is as much trial and error as anything else in medicine.

Again and again in my medical history I've discovered that doctors know almost nothing about what my body is doing or how the treatments they prescribe will affect it.  Modern Western medicine is based on statistical models and trial-and-error.  If treatments are found to be effective in a large enough percentage of the population, these treatments are then prescribed to individuals on the presumption that the individual probably falls into the group which is helped by the treatment.  If this turns out to be not the case, then other treatments are tried.  When multiple treatments exists, or when a treatment doesn't work for everyone, there is almost never a test which will tell you in advance if the treatment will work for you or not.  I started taking statin drugs because I had high cholesterol and the statistical models showed that many people with high cholesterol develop heart disease which can be prevented by the drugs.  There were no tests done to see if I was actually developing the early stages of atherosclerosis, nor any tests done to see if I would be one of the ones who benefited from taking a statin.  In retrospect, taking the drug probably didn't do much except help encourage the development of type II diabetes. 

Medical science is amazing, having worked out many fantasitcally complex systems, as illustrated by the following chart that illustrates how statins affect the levels of cholesterol in the blood. 

 However, once you start to see that the actual practice of modern medicine is often nothing more than taking shots in the dark, it begins to look more like pseudo-science.  Yes, many lives are saved, but mostly by luck, when you fall into the norm that the treatment model was designed to address.  Demand to know why your doctor is prescribing a treatment for you, and how you will together measure whether or not its being effective.

It would be absolutely impossible for me to be on this diet if it wasn't for my wife Carol constantly cooking for me: homemade soups, roasts, ghee, and yogurt, just to name a few.  Thanks, love.