THE WHEAT BELLY DIET

Anyone who has followed my dietary advice knows that my first recommendation is to ditch the wheat and all other products that contain gluten. When I talk about "diet" I don't mean losing weight necessarily (although that will follow) but rather your nutritional lifestyle. My revelation about going wheat-free came about with a talk one day at a Starbucks with the author of the book Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, William Davis, MD (see my Recommended Reading list). In my own experience, I lost 30 pounds in six weeks when I first started the diet then another 10 after I incorporated a "cheat day" once a week. A cheat day is the one day a week (I chose Friday) when I would eat what I wanted and as much as I wanted. Despite the fact that I never got hungry following Dr. Davis' advice, my metabolism did eventually slow down and I revved it back up by pigging out one meal a week.
But the "diet" part is actually two-fold: avoid gluten AND avoid sugars and simple starches. While "Wheat Belly" measures the effects of carbohydrates on a person's insulin response, I found it easier to stick with the standard Glycemic Index, avoiding "fast carbs" and consuming only "slow carbs." Those phrases were popularized by Timothy Ferriss in his book The 4-Hour Body . Warning: not for the faint-hearted. He also gave me the idea of the cheat day. The thing I like best about Ferris is that he tries his ideas on himself first. This just supports Dr. Mangold's Rules for Good Living No. 2: Never Trust a Fat Dietitian.
Search for "Glycemic Index" and you will find no lack of sites that not only explain what the term means, but also give you lists of foods that are low and high GI. Sugars and simple starches are highest, while more complex veggies are low. Simply put, I did fine with cabbage, asparagus, kale, spinach, nuts, and legumes. Dr. Davis narrows the choices down even more but I still lost weight eating non-recommended foods. He also has a Wheat Belly Cookbook. As I said, I never went hungry nor should you.
Here's to your start of healthy eating!

Following My Passions: Healing & Teaching

Getting Personal With Medicine

As you know, one of the aims of the second half of my career is making medicine available and understandable to everyone. That is the reason I wrote How To Think Like a Doctor and Como Pensar Como un Doctor, and the reason I am here in Nicaragua teaching medicine to providers at all levels of experience. It is also one of the reasons why I write this blog.

One problem with modern (Western) medicine is that we physicians tend to treat individuals as groups of people. Medications are tested on large populations; they are approved for mass consumption; and side-effects are noted for "common" reactions. Not all medical traditions treat people like this. Chinese and Indian  medicine (Ayurvedic) for example, take an individualized approach to health care. In other words, what works best for YOU?

We used to tease that Rheumatology was the discipline of treating the untreatable. Which means people were dosed with medications that caused HUGE problems, like corticosteroids and non-steroidal anti-inflammatory drugs (NSAID's). Don't get me wrong: I love Western medicine and I'm impressed with modern medical technologies. What I don't like is the shotgun, or in the case of the U.S., cannonball approach to therapy. And secondarily, I don't like being told by mainstream physicians and the government that that is the only way to treat people.

That is now going to change. It first started in the 1990's or the "Decade of the Brain" when neurologists and psychiatrists decided to focus on what happens inside our heads in addition to what we manifest as speech and behavior. This line of research continues at such places as the Amen Clinics, where therapy is prescribed only after a definitive diagnosis is made, only after a full history is taken (including input from family and friends), and a full physical exam is performed. Additionally, brain-imaging studies are now used to narrow down the possible diagnoses, and the patient can then be treated with the medication, dose, and timing specific for THAT individual  patient.

Which brings me to the crux of today's blog. A friend of mine works at a company that uses genetic tests to determine proper medication use for a whole host of "regrettable maladies," from breast cancer to depression. Yes, depression. Remember Dr. Mangold's Rule of Psychiatry: in the long run, psychiatric problems are neurological issues. Check out the site if you can. They are located at http://www.pgxlab.com/about/. Print up their brochure and bring it to your doctor if you think you can benefit from their testing. Make sure your doctor is listening.